Pre-Natal and Pregnancy Related Pelvic Girdle Pain (including pubic symphysis pain)
Over the course of pregnancy, the pelvis undergoes many changes to adapt for a growing baby and prepare for an upcoming delivery. For some women this can be an uncomfortable or even painful process. Most commonly, women seem to experience pain across the low back, hips and/or pubic bone. Pain can also occur in the buttocks, groin and thighs and radiate down the legs. This pain can be sharp, burning, achy or sore. It may come and go or be there almost all the time. It makes everyday activities like walking, standing, sitting, rolling over in bed, climbing stairs, bending and lifting very difficult or almost impossible.
Physiotherapy aims to improve movement, flexibility, strength and posture, while reducing pain. Exercises, education, manual therapy (the use of the therapists’ hands to help painful, weak or inflexible tissues), massage techniques and occasionally medical tape or maternity braces are used to relieve symptoms.
The stretching and separating of the abdominal muscles is called diastasis recti and is a normal part of pregnancy. After delivery, for most women, the muscles return to a position that allows for good strength, support and flexibility of the core.
However, for some women this does not happen on its own. Signs that abdominal muscles have not recovered well include a bulge or hernia with abdominal strain, a deep ‘valley’ between the muscles, low back or pelvic pain or a protruding abdomen that seems to worsen by the end of the day or after straining. A properly trained physiotherapist can assess the presence of diastasis recti, the degree that it is contributing to your symptoms and design an exercise program to help improve this condition.
After pregnancy and delivery, some women want help from a pelvic floor physiotherapist to make certain that their pelvic floor muscles are working as they should, recovering their strength, endurance and coordination. Some women want advice about returning to an exercise program – what should they do and when can they start? Others experience pelvic or genital pain and require treatment for their symptoms.
Whatever the issue, a pelvic floor physiotherapist can help give you more information about your pelvic floor and core muscles following your pregnancy and delivery.