What is Pelvic Girdle Pain
Pelvic Girdle Pain (PGP) is characterized by pain in the hips and/or pelvis that intensifies during certain movements like single leg standing, lunging, twisting or pivoting movements. The intensity of the pain can vary from mild discomfort to severe pain that can absolutely ruin your day... and night.
The pain associated with PGP is often localized in two specific areas: the front of the pelvis (known as Symphysis Pubis Dysfunction) or the back of the pelvis (known as Sacroiliac Joint Dysfunction). These areas are particularly susceptible to pain due to the high amount of loading they endure during physical activity.
Who gets pelvic girdle pain in pregnancy, and why?
Pelvic pain during pregnancy affects up to 1 in 5 women, although not all woman get it "bad". While it's not entirely clear why some women experience pelvic pain, it's believed to be linked to things like previous pelvic injury, uneven movement of pelvic joints, and the weight or position of the baby.
Notably, relaxin and progesterone hormones cause an increase in tissue laxity during pregnancy, and subsequently are often blamed for causing pelvic girdle pain. However, there is no data linking them to causing pelvic pain. Furthermore, pelvic pain has a significant biopsychosocial component, where a person’s worries, expectations, and pain history can greatly influence the way their brain interprets and responds to the changing loads and altered postural alignment during pregnancy.
You are NOT fragile (and other things to remember for labor)
Being in pain does not mean you are fragile, or that your labor will be worse. Your body is still amazing and capable of adapting and getting stronger. In fact, more movement typically helps people deal with their PGP, not less movement and definitely not not bed rest. You may also be worried about how pelvic pain could affect your labor and delivery. Fortunately, the positions that ease pelvic pain are similar to the positions that you may give birth in - such as been on all fours or side lying - long gone are the days of laying on your back to give birth! Also, pelvic girdle pain is likely to settle after giving birth (phew!)
Osteopathy for Pelvic Girdle Pain
Some woman will choose to see an Osteopath to help better understand and manage their specific experience of pelvic girdle pain. This is a good decision, as there are many things an osteopath can do to help with your pain. At TLC we would start with these 4 points.
1. A thorough assessment. This will last around 20 minutes and will consist of you telling us what is going on, what hurts, when does it hurt etc. From there we will ask you a few questions to complete the picture. There are then a few tests we do to make sure we know it is PGP that needs treating.
2. Hands on treatment. What this looks like will differ for everybody. But will likely include some combination of massage, stretch, acupuncture or dry needling, spinal manipulation and myofascial release. These will be directed around your pelvis, but also to other parts of the body that may be contributing to your pain. Be assured that what we practice is safe for both you and baby and we do not do anything that makes you un-comfortable.
3. Education and Exercise. It is important for you to understand what is going on in your own body. Therefor, we will explain to you what we think is specifically happening to you and your pelvis. This will include what positions/habits/posture to change and steps you can take to help manage your key struggles - such as where to put pillows for a good nights sleep. The exercises are again specific to the person. But often involve yoga poses such as cat camels and Pilates movements that target the glutes and core. 4. Extras - We like Tubi grip for PGP and offer this as required. This is a light material that wraps around the waist to help support your pelvis. 5. I should note, that our osteopath 'Jess' completed her masters thesis on Pregnancy Related Pelvic Girdle Pain. Accordingly, she is our local expert on hand to help out with this often tricky condition! (She is on maternity leave until December 2023)
Summary
Pelvic girdle pain is a reasonably common condition we see in our clinic. Our osteopaths in Hamilton help woman understand that the pain is manageable. Managing the pain often involves some hands on therapy in addition to modifying how they move, encouraging movement and providing useful exercises.
TLC osteopaths Hamilton Osteopaths Book Online Written By Darryl Jenkins
Darryl Jenkins is a friendly Hamilton osteopath and co-owner of TLC Osteopaths. His formal qualifications include a undergraduate certificate in Exercise science from Wintec, a degree in Human Biology from Unitec, and a master's degree in osteopathy from Unitec, where he also completed his thesis on human movement assessment. He also holds a postgraduate certificate in acupuncture from AUT and would like to be pursuing the postgraduate certificate in Pain Science at Otago Uni (awaiting spouse approval).
Comments