I’m six months pregnant with my second child and recently I am getting so much pain in my groin and hip area that I have to take stairs one at a time and somedays I can’t pick up my toddler at all. I struggle to move around in bed due to the pain and getting in and out of the car is really painful …. I’m reaching the end of my tether what can I do?
As a Chartered Physiotherapist with a special interest in pelvis and spine problems I treat many women who have pelvic pain during pregnancy but suffer in silence because they don’t want to take medication that might harm their baby. Pelvic girdle pain (PGP) used to be called Symphasis Pubis Dysfunction and can occur any time during or after pregnancy and affects one in four pregnant and postnatal women.
They present with a wide range of symptoms and the severity can vary widely however PGP is a common and, in most cases, easily treatable condition. It can be treated very effectively at any stage during or after pregnancy by a Chartered Physiotherapist specialising in Pelvic dysfunction.
Although women are often told that PGP is caused by hormones, up to date research shows that it is usually caused by a pelvic joint problem. The pelvis is made up of a ring of three bones. They join at the Sacro-iliac joints (the dimple joints at the back above your bottom) and the Symphasis Pubis at the front. Normally these joints move a little to allow you to walk, turn over in bed and climb the stairs. In PGP one joint becomes stiff and stops moving normally and then the other joints have to compensate. As a result muscles may also be tight and painful. Often the joint causing the problem is not particularly painful, so treating the painful points doesn’t treat the underlying problem. By treating the stiff joint an experienced Physiotherapist can help the joints to function normally again and allow the irritation at the painful joint to settle.
It is increasingly recognised that PGP can also have a big impact on how you feel emotionally because coping with the physical challenges of daily life can be difficult leaving you feeling low and isolated. One of the problems is there is nothing to see with PGP – you’re not wearing a plaster cast and the pain isn’t visible to others. Women often feel cheated as they expect to be blooming and enjoying their pregnancy but, in fact, are struggling because they are experiencing pain that no-one can see. This is even worse in second and subsequent pregnancies as you are also having to care for at least one other child or toddler!
PGP can usually be treated effectively by a ‘hands-on’ manual therapist like myself. It really is treatable at any stage of pregnancy or postnatally as soon as you feel able to leave the house and your new baby for an hour. An individual assessment is very important to look at the position and symmetry of movement in your pelvic joints to find out which joints are causing the problem. I use my hands to gently reposition the pelvis and free up the stiff joint and I can do this with you lying on your back or on your side – whichever is easier for you. I will also teach you exercises to support the pelvis and prevent the problem recurring and you should walk out of each treatment feeling some improvement in either pain or function and preferably both. When I treat anyone I always write to the GP, with the patients permission, and during pregnancy we liaise with your Midwife too.
There are varying approaches to PGP, but the main things you should expect from your therapist are:
- The therapist will ask you about your PGP and how it affects you.
- They will ask you to undress down to your underwear.
- They will look at and feel how the joints at the back and the front of your pelvis move when you move (e.g. standing on one leg, bending forwards etc.)
- They will feel how symmetrically the joints move when you are lying down on your back and your front ( or on your side it you are very pregnant)
- They will discuss their findings and agree a treatment plan with you, explaining what they are going to do
- Treatment is likely to include realigning joints so they move symmetrically again. This may need to be done a few times until your muscles become strong enough to keep them in place without treatment.
- You should be given gently exercises to help your pelvic stability and as you recover the exercise programme will be adapted to suit your individual needs until you get back to normal.
If you would like to book an appointment to see me about any Pelvic or Spine pain problem – either during pregnancy or at any other time in your life please contact our reception team on 01706 819464.
Lynne Midwinter