Pregnancy is a time in life most of us hope to enjoy and savour. As life grows inside us, so often does our love for the little being we have not yet met. As a new year dawns, so does the promise of hope and transition towards a future of new beginnings. Nothing will be the same again. Our priorities, routines and focus will change as we take on the new identity of motherhood.
While growing tiny human beings can be exciting and full of hope, it can also be exhausting and draining. For many it can feel like years rather than months long. Words like blooming, radiating and joyful are replaced by exhausted, sore and fed-up. Guiltily, we can wish the precious time away. There can be many reasons for feeling like this, many of them physical. One reason is pain. Pain restricts our ability to perform basic movements and tasks. Frustratingly, activities we previously took for granted become impossible. Ironically, not moving also makes things worse. Its hard to know what to do. To make matters worse, we may not get a lot of sympathy from those charged with our care, who often disregard our complaints as temporary, inconsequential and of minimal importance. Often, we are told that nothing can be done about it and things will get better once baby is born.
Pelvic girdle pain (PGP) in pregnancy is any pain experienced around the joints and muscles that make up your pelvic ring. This includes the pubic joint at the front of your pelvis as well as the two sacroiliac joints at the back. While the reported incidence of PGP varies greatly, it appears that 1 in 5 women will suffer enough to actively seek help. (Wu WH et al, 2004.) As with any pain, it is wearing, upsetting and affects daily living in significant ways. It can occur at any stage in pregnancy and can affect any pregnant woman regardless of activity level.
A pregnancy related pelvic pain story might sound something like this:
- Pain is felt as a mild dull ache at times, while at other times it is more of a severe sharp, shooting sensation; Sometimes accompanied by a clicking or grinding sensation; At times, your legs might feel like they are giving way.
- Pain limits the distance you are able to comfortably walk, your ability to climb stairs, to rise up from a chair, to roll over in bed, to get in and out of the car and to even put your socks on. Your sex life comes to an abrupt halt.
Many myths exist surrounding pelvic girdle pain. Many believe it is directly caused by increasing levels of pregnancy hormones. If this is the case, pain should ease as soon as baby is born. Unfortunately, this is not the case for all women. Surprisingly, 8% of women still experience PGP up to two years after giving birth. Recent research suggests that while hormones are not the direct cause of pain, they may increase the sensitivity of the ligaments and support structures to pain. Other lifestyle factors increasing pain sensitivity include reduced sleep, higher stress levels during pregnancy and low mood.
Another common myth is that ‘my pelvis is unstable’, ‘out of alignment’ and needs to be ‘put back in place.’ The pelvis is inherently one of the most stable parts of the body and although comprising three bones, these bones are held together so strongly, with minimal movement possible between them. By believing this myth, we fear and then avoid general movement as something that will lead to further ‘damage.’ Consequently, we tense our muscle system further, resulting in more pain! Any apparent asymmetries are thought to be due to sensitised pelvic support structures and subsequent changes in pelvic and trunk muscle activity.
There is much that can be done to treat PGP. Physiotherapy treatment options include manual therapy and soft tissue release techniques to help reduce muscle tension, education & practical advice regarding movement strategies, individualised exercise / core strengthening programmes, pelvic support belts and mobility aids. While some may continue to experience some degree of pain throughout pregnancy, learning to manage symptoms can provide much needed relief.
Pelvic Physiotherapy helps restore more comfortable function and optimal movement throughout your pregnancy and in so doing can help make pregnancy the enjoyable and positive experience you were hoping for.
Debbie Fallows is Clinical Specialist Physiotherapist in Pelvic Rehabilitation at Strive Clinic Galway. You can make an appointment with Debbie for any of the pregnancy-related challenges mentioned above by calling 091 393 180.