If you are experiencing pain very low in your back, almost at the top of your buttock, over those “dimples” that you see over the sacroiliac joint, then you may have pelvic girdle pain. Pelvic girdle pain is the name for any pain that is in the pubic, sacroiliac, buttock or thigh region. It is more common in women, especially in the childbearing years during pregnancy and after baby. Usually women begin to experience it between 24 and 32 weeks into their pregnancy. If you experience it during pregnancy you may deliver and it goes away completely, or it may linger. The good news is physical therapy is a great treatment for it, and you don’t have to listen to the “well, you are pregnant” excuses from those around you. Especially after baby. Don’t let them convince you that you can’t expect to feel good after having children. You can! A women’s health physical therapist can get you there.
With the changes in hormone levels during pregnancy and after baby our musculoskeletal system is provided the ability to move and flex to allow for delivery of baby and whether you deliver vaginally or by C-section, you are still designed to be very flexible, which sets up the pelvic girdle for possible problems during this time in our lives. Ligaments must accommodate the joint laxity that the hormones provide. Mens, et all found that women who experience pelvic girdle pain have 32-68% more motion in the pelvic joint when compared to healthy controls. The muscles and ligaments are also under significant stress during pregnancy due to carrying 25-45 extra pounds. This changes our biomechanics significantly. Our center of gravity is shifted from a more central location through the pubic symphysis to a more anterior location, which pulls us forward and forces adaptations at the head and neck, spine, pelvis and hips and knees.
Often treatment for pelvic girdle pain is just 4-6 weeks of therapy. After evaluating your body and determining the cause of your pain, your physical therapist will design a treatment plan of care to fit your needs. This usually includes manual therapy to the joint and tissues that are involved. Strengthening exercises for the muscles found to be weak, and flexibility exercises for those that are tight and limiting normal body movements. We often provide a lot of education regarding labor and delivery positioning and pain management. Posture is important, and we will talk about that with you until we are blue in the face, but if you leave our clinic and go home and slouch all day you are undoing all our hard work!!! We will spend time discussing the importance of care of your scar if you had a tear or episiotomy. We will discuss posture, and body mechanics when caring for baby and breast feeding. We will help to develop a great exercise program to get your core back to a fitness level that you would like.
Rehabilitation after baby is not a hope and prayer that you are one of the fortunate ones who don’t have a loose flabby tummy, back pain, incontinence or pain with sex. It is up to you to seek out help for these concerns. Unfortunately, our standards in the United States have not reached those in Europe where every woman sees a rehab specialist after baby to rebuild that war zone we are left with. Our society leaves us feeling as though we are blessed we only leak a little when we sneeze and that well, what more can we expect? I will tell you for certain, expect to get back to running, cycling, walking, swimming, jumping…whatever you want! I can help you get there! Don’t let it go, it is a fun and easy process of bringing balance back to your pelvis and abdominal region and that body in the mirror doesn’t have to be a disappointing one.
–Sarah Dominguez, PT, MSPT, CLT, WCS
This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you. If you enjoyed this blog, check out our website at foundationalconcepts.net for more blog entries and to learn more about our specialty PT practice, Foundational Concepts. Follow us on Twitter @SarahpelvicPT or @Jenn_pelvic_PT and like us on Facebook at Foundational Concepts for updates.