What is Lightning Crotch?

As prenatal chiropractors, the term "lightning crotch" is one of those random, rare, and strange complaints we hear during pregnancy, among the more common complaints of lower back and hip pain.

Patients don't often bring it up but once asked I often hear “oh yeah, I’ve had that!” I’ve treated pregnant women with musculoskeletal complaints for several years, and I never even realized Lightning Crotch was a thing until I experienced it myself during pregnancy.

What's Lightning Crotch? Why does it happen in pregnancy?

Lightning crotch is a sharp, sudden pain felt in the pelvic or vaginal region. Typically present in the third trimester, but can happen as early as the first few weeks of pregnancy when the uterus is just starting to expand and the structures of your pelvis start to shift. The shifting and stretching of your pelvis helps make room for the baby to grow, and ultimately for the baby to birth through the pelvis. As the baby moves deeper into the pelvis during the third trimester of pregnancy, lightning crotch can become more common or more intense as the baby puts pressure on the nerve endings of your pelvis. Lightning crotch is a quick “stop you in your tracks” type of pain. It’s compared to lightning due to the fact that it often feels like a quick “zing” in the crotch. It typically occurs at rest and during movements. Lightning crotch tends to present lower than round ligament pain. While round ligament pain is also sharp and sudden, it tends to be felt higher in the abdomen in the lower uterus and belly. Lightning crotch is felt lower, down by the pubic bone or vagina.

Why does Lightning Crotch occur?

Think of your pelvic floor like a bowl. Your pelvic bones make up the top of the bowl, while the muscles of your pelvic floor make up the bottom. Within those muscles are your vaginal and rectal canals. Your uterus sits in the bowel, so as the baby grows and uterus grows, there's a lot of extra weight and therefore stretching on that pelvic floor. During childbirth, the vaginal canal stretches to be able to accommodate the baby's head and body. So during pregnancy, it’s prepping for that. Which can unfortunately lead to some pain and discomfort during pregnancy.

As Webster certified chiropractors, we assess the sacrotuberous ligaments, hip flexors, and pubic bone, to help your pelvis relax and to promote comfort as pregnancy progresses.

What are some common symptoms experienced by pregnant patients?

Each person experiences lightning crotch differently. There are some pregnant women who never experience lightning crotch, some who very occasionally do, and some who experience it a lot. Depending on the pregnancy, you may feel lightning crotch frequently or never at all.

Symptoms typically include the following:

• A strong sensation in the vagina, rectum, uterus, or pelvic region that feels like a bolt of electricity, a shooting pain, or like pins and needles

• A painful moment that "takes your breath away"

• A abrupt, unforeseen onset of pain followed by brief periods of relief

• leg ache with a shooting, tingling sensation

Is Lightning Crotch an indiction of labor?

Lightning crotch is not a sign that labor is about to begin, even though it usually happens in the last two or three months of pregnancy. It's most likely related to the baby's head lowering as they prepare for labor and birth. You might be wondering if lightning might break your water under all that strain. Don't worry, rupturing membranes are not a symptom of lightning crotch. While it's normal to assume that any form of discomfort experienced toward the end of pregnancy signals the start of labor, lightning crotch is different from contractions in that it doesn't come and go.

Are there other health conditions associated with Lightning Crotch?

SPD or Symphysis Pubis Dysfunction is a common musculoskeletal disorder of pregnancy, where there is sharp and shooting pain in the pubic/pelvic region. SPD tends to follow more of a pattern, such as worse at the end of the day or worse during provocative movements. Lightning crotch is seemingly random. Chiropractic care can be very helpful for those experiencing SPD in pregnancy to improve function and comfort.

With similar mechanisms to lightning crotch, there is also a phenomenon tenderly referred to as “lightning butthole”. Lightning butthole will present in a similar fashion, sharp and quick, but instead of presenting in the vagina, it presents in the region of the tailbone and rectum. The rectal canal as part of the pelvic floor, is under much of the same pressure as the vaginal canal. In the third trimester and in the beginning stages of labor, as the baby engages into the pelvis, the sacrum is rocked posterior, which puts strain on the tailbone and surrounding muscles. For Webster technique, we release the sacrotuberous ligament which attaches to the sacrum and to your ischial tuberosities or “sit bones”, which can help relieve pressure and tightness in this area.

How can you relieve or alleviate symptoms?

A few things can help squeezed or aroused nerves and joints in women who experience lightning crotch episodes frequently:

• In case of pain, change your position. Be mindful to pause and adjust your stance after any lightning crotch shocks when trying these remedies.

• Look at your posture. When you are pregnant, your balance and posture alter. In order to prevent your lower back from hunching forward, Riordan suggests that you contract your abdominal muscles while standing.

• Make use of a belly support band. These useful bands are highly recommended because they add a little more posture support and mild compression.

• Try getting some bodywork. Yoga positions and pelvic floor strengthening exercises may assist in repositioning the baby and relieve pressure on your pelvis and joints. Prenatal massage or a chiropractic adjustment, according to Riordan, may also be effective. Just make sure to receive the go-ahead from your OB or midwife and ask them to identify doctors who are specially qualified to treat expectant patients.

• Take a dip or a soak. Try swimming or unwinding in the tub, advises Riordan, as these activities can help your body relax and release pressure at your joints and ligaments.

What should I know about "lightning crotch" during postpartum?

Lightning crotch will disappear after the baby is born. As soon as your pelvis is free of the pressure from your baby's head, the pain will go away. According to Church, if you experience pelvic discomfort after giving birth, it's probably due to an issue with your pubic joint or other pain. In case something doesn't feel right, always check with your doctor.

In Summary

The muscles of the pelvic floor are incredibly complex and pregnancy, labor, and delivery stretches further strain these muscles. Your body is smart, and knows what to do when it comes to growing and birthing a baby – but sometimes we need a little help to ease discomfort and to promote the best possible mobility!

Make sure to see a Webster certified chiropractor, or a physical therapist that specializes in pelvic floor therapy to address any concerns. The staff at ANH Wellness are passionate about helping you have a happy, healthy, and pain-free pregnancy and would be happy to answer any of your questions.

By: Dr. Megan Stavalone

Perinatal Certified Chiropractor at ANH Wellness

Disclaimer: "The information including but not limited to text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment."

Sources: Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364059/