By Samantha Cattach - Physiotherapist
Pelvic Pain is a common condition that a lot of women experience during and after their pregnancies. This is due to the numerous physical changes that occur in your body, most notably:
• Hormonal changes leading to ligament laxity (particularly around the pelvis).
• Increased load and weight around the abdomen as your baby grows.
Like everything in this world, you don't get something for nothing, and in this case, the trade off for more joint mobility during pregnancy is usually less stability and this can lead to pain if the surrounding musculature is too tight, or unable to provide adequate support to the joints. Without a strong, stable core, well functioning pelvic floor and gluteal muscles, the added load of a growing baby can pull your pelvis forward, out of an aligned posture and increase the stress on your spine and pelvic structures. The position of your baby can also be a factor if they are putting direct pressure on sensitive tissues and nerves.
The most common types of pelvic pain that I see as a Women’s Health and Perinatal Physiotherapist are:
• Sacro-Iliac Joint Pain (toward the back and either side of the spine and sacrum)
• Pubic Symphysis Dysfunction (pain right at the very front of the pelvis)
• Tailbone Pain (often most painful when sitting or getting up after sitting for a certain amount of time)
For some, the lower back, hip, and pelvic pain is very quickly relieved after baby is born! But for others, pelvic girdle pain can be a lingering issue that can have a huge impact on their lives as a new mum.
So, you may be asking yourself - I thought it was just supposed to happen during pregnancy! Why am I in pain postpartum?
Post-natally, the deep core muscles of the abdomen and the pelvic floor often need a bit of time and attention in order to recover from the incredible feat of carrying and birthing a baby. This can mean that your still extra-mobile pelvis (the hormonal effects of pregnancy on the ligaments can last up to 12 months or until you have finished breastfeeding) has potentially less stability at this time. In addition to this, there are a lot of new duties and often awkward positions required as a new mum - like lifting your baby out of low cots, car seats and prams, and carrying your little one (and the car seat AND the nappy bag all at the same time).
It is important to know that pelvic pain is not normal and does NOT have to last forever!
So, how do you fix it?
1. Move Well!
Learning how to move well and carry your baby in a way that facilitates a strong core is key. Try to set up your environment in a way that doesn’t require you hold sustained or awkward positions. For example:
• Ensure your baby’s changeable and cot is at an appropriate height for you
• Consider kneeling on the floor to change nappies
• Avoid trying to be superwoman and carrying everything from the car to the house at once - make separate trips for baby and for the car seat/carriers/groceries/nappy bag if you need to
• Avoid slouching or slumping while breastfeeding - find a comfortable set up that helps keep your spine long and neutral, and bring your baby up to you with pillows to avoid hunching down to them
2. Check Your Alignment!
Start to pay attention your alignment while standing and holding your baby:
3. Restore muscle function and strength
Specific exercises to help restore balance to your muscles and symmetry to your pelvis can also be very helpful in relieving pain, as can strengthening the muscles that help to provide support and stability to these joints. In my experience, a lot of women with pelvic floor issues and pain actually have muscles that are dysfunctional because the are too TIGHT, not that they are just weak. Therefore, simply doing pelvic floor Kegels and abdominal exercises is not necessarily the best way to strengthen your deep core muscles, and in some cases can actually cause more harm.
If you are experiencing pelvic pain, my recommendation is to see a Women’s Health or Perinatal Physiotherapist who can assess your pelvic floor and core, help you relieve your pain and restore your function effectively.
Please feel free to contact me with any questions by visiting my website here: www.bodyandbirthphysio.com
Sami Cattach is a Women’s Health/Perinatal Physiotherapist and Restorative Exercise Specialist who practices out of her studio, Body & Birth Physiotherapy in Paddington, and provides home visits around Brisbane. You can visit her website www.bodyandbirthphysio.com and connect with her on Facebook at www.facebook.com/bodyandbirthphysioaustralia and Instagram at www.instagram.com/samicattachphysio
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