SPD and Pelvic Girdle Pain in Pregnancy

Monday, January 20

Welcome to the next post in my series of the Pregnancy associated aches and pains that I frequently treat in my Physiotherapy Clinic.

Symphysis Pubis Dysfunction or SPD during Pregnancy, is now referred to as Pelvic Girdle Pain, alongside Sacro Iliac joint pain.

Source
Pelvic Girdle pain, especially over the symphysis pubis can be extremely painful for a number of  women during pregnancy.  

What does it feel like?

Ladies usually complain of a burning or bruised feeling over their pubic bone, which may also radiate into surrounding areas.  Walking, stairs and turning in bed are usually especially painful.

Why does it happen?

The pelvis is a ring of 3 bones which are held together by strong ligaments.  The bones come together to form 3 ‘fixed’ joints. These are at the front symphysis pubis and at the bottom of the spine, the two sacro iliac joints.  Normally these joints don’t allow movements.

However, when you are pregnant, the relaxin hormone that that is allowing everything to loosen to prepare for childbirth, can result in over stretching of these ligaments and causing pain. The most common sites of this pain are over the Symphysis Pubis in the front (your pubic bone), and over the Sacro Iliac joints in the lower back (the two dimples on either side of your spine), but it can also be felt in the groin, inner thighs, hips or buttocks.

I find that women that are already inclined to be hyper mobile, (very flexible), are usually more severely affected by this, and I've seen some ladies require crutches or a wheelchair during pregnancy as they are in so much pain that they unable to walk unaided. 

What can you do?

Wear a Support Belt.
A number of ladies report that their symptoms improve with a belt such as this one that helps to hold the pelvic ring more securely, to compensate for the laxity that has occurred with the relaxin hormone release.

Avoid:

You should avoid one legged standing activities, adjust where you can such as sitting down to put your trousers on, then stand up to pull them up.

Be especially careful with how you stand up and sit down get in and out of the bath and the car, try keep your knees together, as much as possible.
So to get into the car, reverse yourself to the seat, lower your self down with your knees together, and then bring both legs around to the footwell together.

Strengthen:
You need to ensure that you are doing your Pelvic Floor strengthening exercises, as well as strengthening your lowest abdominals (transversus abdominals) and doing pelvic tilting exercises to safely strengthen your rectus abdominals to improve your stability around your pelvis. Your Women's Health Physio can advise you on how best to do these. Please contact me if you would like me to send you a leaflet on how to do them!

Physiotherapy:
Your Women's Health Physiotherapist may recommend that you get a belt, will advise you on how best to do daily activities and may treat painful areas with massage or acupuncture and stretches.  Your Physio will also teach you how to 'brace' when rolling in bed.

The Physio may even prescribe crutches to help with reducing pain felt when weight bearing when walking.

Will it go away afterwards?

The good news is that for almost all woman, once their hormones have returned to more normal levels and you are no longer pregnant, the pain is usually completely alleviated.  However for a very small percentage of the very severely affected women, the pain can unfortunately be ongoing post pregnancy, and require ongoing management.

Thanks for reading this, pop back next week for another Pregnancy related post!

And please let me know if there is anything that you would like me to discuss?
 
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