For every mother to be, pregnancy should be a unique time. Whether you are expecting your first child or are a pregnancy expert, over the course of nine months you will experience many special moments.
However, as your body changes it is not uncommon to pick up aches and pains. In fact, the prevalence of low back pain and pelvic pain in pregnancy is 50-70%. Unfortunately; 14-22% of pregnant women develop serious pelvic girdle pain which can prevent them from carrying out activities of daily living, work, hobbies and social interests.
Pregnancy related pelvic girdle pain is common but not normal and it can be treated safely and effectively at any point during pregnancy and after birth. It is better managed with prompt identification, as soon as symptoms present.
Common areas to experience discomfort are: the lower back, sacroiliac joint (at the back of the pelvis), groin, thigh, and centrally at the pubic bones.
Why do we develop pelvic pain?
The pelvis forms a strong connection between the spine and the lower extremities. It has extensive fibrous connections in the form of ligaments which provide stability and support to the pelvic joints, namely the sacroiliac joint.
In pregnancy, women produce raised quantities of a hormone, relaxin, alongside an increase in progesterone levels. This causes greater laxity in the ligaments of the pelvic girdle (as well as the ligaments in the rest of the body), which has been shown to cause increased range of motion of joints. Some women can handle the greater range of motion from ligament laxity, while others suffer from decreased joint stability which can lead to pain if it is not compensated by good muscular control.
Alongside this, particularly into the third trimester of pregnancy, women will develop an increased lumbar lordosis (inward curvature of the lower spine) and forward tilt of the pelvis. This puts pressure on the back extensor muscles, tightens hip flexors and can weaken glutes, hamstrings and abdominal muscles.
How can Physiotherapy help?
An experienced Physiotherapist will perform a safe and comprehensive assessment of your posture, movement, joint stability and muscular control to determine the structures that may be at fault. They will consider positional precautions and pain to ensure that you and your baby are not at risk. Physiotherapy aims to promote physical and emotional health by controlling pain, improving range of joint mobility, increasing the strength of the trunk and pelvic girdle muscles, supervising you back to functional activity and preparing you for delivery.
This may include the provision of:
- Manual therapy (massage, joint mobilisation, muscle energy techniques)
- Equipment (pelvic support belts, crutches)
- Recommendations to hydrotherapy (up to 30 weeks)
- Postural and positional advice
- Taping techniques
It is important to note that early exercise advice and education can prevent symptoms from progressing so you can enjoy your pregnancy to its finest and fullest. The Thornbury Clinic offers both pregnancy physiotherapy, pregnancy massage and small size Pilates classes.
Finally, congratulations to anyone who is reading this article whilst currently pregnant. We wish you all the best with the remainder of your pregnancy.
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