First you get nausea. Then fatigue. And now this?!
Everyone’s ride through pregnancy is different; from the joyous glowing mother-to-be, to the to-be-mum struggling to simply get out of bed; the experience can vary greatly.
Pregnancy related pelvic girdle pain (PRPGP) is one of those symptoms not every woman gets, and this too can range from a nagging nuisance, through to a debilitating problem impacting on exercise and activities of daily living like putting on your pants, walking stairs, or even just rolling over in bed.
So, is there anything we can do? Most Pelvic and Women’s Health physios are confident in treating PRPGP. We understand the biophysical, as well as the biomechanical changes happening in the pregnant pelvis. We have many treatment options we regularly turn to in order to manage symptoms related to PRPGP.
Let’s explore some of these options:
Hand on Treatment
From my experience, hands-on treatment can be highly effective in managing pelvic girdle pain. I often utilize techniques such as soft tissue massage and “muscle energy techniques” to realign the pelvis and optimize the forces acting on it, thereby alleviating symptoms. Typically, significant improvement is observed within the first 1 to 3 sessions. If this occurs, we know we're on the right track; however, if not, hands-on treatment may not be the solution.
Once we achieve this improvement, it's crucial to implement a strengthening program to prevent pain from returning.
Interestingly, current evidence does not endorse hands-on treatment for managing PRPGP. I believe this discrepancy stems from the differences in clinicians' approaches, and my background in musculoskeletal physiotherapy has enhanced my effectiveness in treating PRPGP.
Exercise Prescription
Research has demonstrated that properly prescribed exercise plays a significant role in managing pregnancy-related pelvic girdle pain (PRGPG). Notably, evidence supports that participating in Pilates twice a week can be particularly effective for this purpose.
For many women, the thought of exercising during pregnancy can feel daunting, especially when dealing with discomfort or medical challenges. Questions often arise: What types of exercise are most effective? Which ones are safe? Should I be doing more or less?
While some may benefit from one-on-one guidance in a clinical setting, many women discover that they can successfully follow a prescribed exercise program from home.
Belts
Support belts can be transformative in alleviating the symptoms of PRPGP. With a plethora of pregnancy belts available, each claiming to offer certain benefits. Selecting the right one will depend on the unique mechanical factors influencing your PRPGP.
In some cases, using K-tape or rigid tape can help to identify which belt would work best, or whether a belt would even work at all. Sometimes the tape may be a more effective solution. It’s definitely worth exploring these options before opting for a belt.
Does this mean you need to do an internal examination on me??
Short answer: NO!
However, persistent and ongoing pelvic pain can lead to spasms in the pelvic floor muscles. In such cases, it's essential to consider this before delivery. Typically, pelvic health physiotherapists will only avoid internal examinations or treatment if you have been instructed to refrain from penetrative intercourse.
In my clinic, I generally avoid conducting any internal examinations prior to 35 weeks of pregnancy. If I believe that internal work is necessary before this period, or if you have a high-risk pregnancy, I will send a "DVE clearance" (digital vaginal examination) form to your lead maternity carer or OB for approval. This process ensures they can decline the examination if they feel the risks outweigh the benefits.
If we determine that the pelvic floor is contributing to your pain, and you or your maternity carer prefer to avoid internal work, I will guide you in stretching and releasing the pelvic floor through a technique known as pelvic floor "down training." This method involves a series of prescribed exercises, deep breathing techniques, and pelvic floor coordination exercises.
Pregnancy WOF
A pelvic health assessment, or "pregnancy WOF", in your 3rd trimester is strongly encouraged for every pregnant woman, but even more so if you have had PRPGP and you are planning a vaginal delivery. It is important to check you have good coordination of your pelvic floor muscles, so that as baby descends down the birth canal, you are familiar with how to use your breath and coordinate the pelvic floor to open and relax in response to stretch.
Click here to read more about pregnancy and post natal wellness checks
SO! If you’re experiencing PRPGP, come see a Pelvic Health physiotherapist today!
Want to Know More? Book a FREE Phone Consultation
Schedule a free, no-obligation phone consultation with Anna today! This is your opportunity to ask any questions you may have about your condition or diagnosis, learn how physiotherapy can assist you, explore what to expect during an assessment, or discuss potential treatment plans. Feel free to inquire about anything on your mind! A scheduled consultation lasts up to 15 minutes.
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