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Pelvic Girdle Pain related to Pregnancy
Pregnancy is a unique and special time for a woman as she watches her body change and becomes aware of the child that grows inside her. For most women, pregnancy and childbirth is a positive experience, and the bodily changes occur without pain or dysfunction in the body.
It is normal for the womans’ hormones to change during pregnancy in anticipation of a natural birth……
Picture created by Alexander Tsiaras, 2003
It is not uncommon for pregnant women to notice a feeling of increased movement in the joints of the pelvis, the pubic symphysis and / or the sacroiliac joints at the times when the relaxin levels are high. This is because this hormone, in conjunction with progesterone, increases the water holding capacity of the ligaments surrounding these joints which in turn means less stiffness of joint motion. Movements at these joints is normally very small, but the relative increase in mobility can become irritating and produce pain and inflammation.
There are a couple of ways to lessen the effect of increased pelvic mobility during pregnancy:
- A sacroiliac or pelvic belt
- Specific training of pelvic floor, transverse abdominis (deep tummy muscles) and multifidus (deep back) muscles. Research has shown that there are muscles deep within the abdomen and pelvis that help to support the pubic symphysis and sacroiliac joints. Improving the activity of these muscles may create enough support of the pelvic joints to decrease pain during movement. The specific retraining required to get these muscles working properly requires a certain understanding of the body’s anatomy and should be performed by a trained physiotherapist
After child birth the deep pelvic muscles are hard to turn on, and their activation is often less effective than normal, due to the birthing process or caesarian section. This means that without specific retraining of these muscles after child birth, a womans low back and pelvic area may not have sufficient stability to cope with the loads put onto it when walking, lifting her child, sitting or exercising. She may develop a number of symptoms:
- Low back or pelvic pain, or leg pain
- Pain at the pubic symphysis or groin with walking or lifting
- Urinary incontinence (either stress or urgency incontinence)
- difficulty getting the abdominal or pelvic floor muscles to turn on
The physiotherapists at Sydney Spine and Pelvis Centre have a particular interest in helping women through their pregnancy, and post birth, particularly in relation to low back pain, pubic pain, pelvic or sacroiliac symptoms, sciatica, and the effects of childbirth on lumbo-pelvic muscle activation including the pelvic floor. We take an hour for our initial assessment in order to fully assess your problem and determine the best way we can help, whether that be muscle retraining, exercise therapy, or manual treatment.
If you require further information about the treatment we provide at Sydney Spine & Pelvis Centre, please call us on 02-97199114, Monday to Friday.