pelvic Girdle Pain....what is it and what can i do about it?
Many pregnant women experience the uncomfortable symptoms of 'pelvic girdle pain' (PGP) which was previously referred to as symphysis pubis dysfunction or SPD.
It is believed to be as common as 1 in 5 pregnant women experiencing some degree of symptoms, either in the sacroiliac joints at the back of the pelvis, the hip joints or the pubic joint at the front of the pelvis inbetween the legs. The symptoms can vary in severity considerably and are not necessarily progressive in nature. How do I know if I have it and what are the symptoms?
There is no 'test' as such for PGP but it can be diagnosed on the basis of your symptoms. Women usually report pain in the locations described above, associated with activities that involve standing on one leg, for example walking, climbing the stairs, getting in and out of the car/bath/bed and getting dressed. Also they can have difficulty crossing legs and turning over in bed. Women may also experience clicking or grinding of the pelvic joints. It can have a major impact on your life and mobility as it can affect most activities of daily living.
Why does this occur in pregnancy?
Historically it was believed to be hormonal and even now some healthcare professionals can regard it as a normal part of being part of being pregnant which will disappear as soon as the baby is born. Recent research however, has indicated that it is associated with asymmetry of the pelvic joints and as such is more of a mechanical joint problem...NOT normal, DEFINITELY treatable!
It occurs as a result of a number of different co-existing factors including:
- uneven movement between the pelvic joints,
- reduced muscular support for the pelvis whilst the abdominals stretch and gluteals weaken,
- laxity of the pelvic ligaments under hormonal control in preparation of delivery of the baby.
What can I do?
There are a number of helpful things you can do to reduce pain and improve mobility/function. For example: - try and keep body weight even through both legs ALL THE TIME, for example get dressed sitting down so you don't stand on one leg,
- keep climbing the stairs to a minimum, - but when you do.....go up stairs one at a time, good leg first and come down bad leg first,
- sit very upright with some lower back support rather than slouching or twisting,
- keep active and exercise as much as possible within the limits of your pain,
- put shoes on sitting down,
- make turning over in bed easier by wearing silky nightclothes, or lay underneath your hips a silky sheet so you can slide easily in bed,
- sleep with a pillow between your legs in order to align your legs in parallel,
- get in the car bottom first and bring both legs in together keeping the legs closed, do the opposite to get out.
Wearing a pelvic belt can be helpful to give the pubic and sacroiliac joints extra support, for example a Serola belt worn low around the hips. Bump supports are popular too but in true PGP a pelvic belt is advisable. If pain is severe and walking is very restricted crutches may be needed in order to reduce the body weight going through the pelvic joints.
It can also be helpful to try to avoid the following, or at least keep to a minimum: - standing with weight shifted to one side,
- sitting with the the legs crossed,
- carrying a toddler/heavy weight whilst walking/going up the stairs,
- any activity which aggravates your pain.
The important thing to remember is that PGP is a treatable, mechanical condition that your GP or Midwife can refer you to a specialist women's health physiotherapist for treatment of. Unfortunately this treatment is not always offered as there are a lot of myths and misunderstandings of the origin and nature of PGP, sadly even amongst healthcare professionals. The reality is that it can, on occasions, continue after delivery of the baby and it is therefore preferable to seek early treatment.
Manual therapy from a suitably qualified Physiotherapist can help treat pelvic asymmetry and they can prescribe specific exercise to help maintain pelvic support as pregnancy progresses. This can still be helpful if symptoms are ongoing postnatally. Physiotherapy for PGP is available with myself at St Judes Clinic in Leighton Buzzard. Feel free to contact me or the clinic about this. For more information visit... https://www.stjudesclinic.com/treatments/Antenatal-physio/ Physiotherapist led Mother Nurture Pilates antenatal incorporates exercises known to be highly beneficial for ladies with pregnancy related low back or pelvic pain. Learn exactly what Pilates movements are safe and effective for you to perform in pregnancy, each one adapted to suit your needs and growing bump. Watch out for upcoming dates for our next 4 week course in Leighton Buzzard.
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