Pregnancy and Pelvic Pain

As women, we’re often advised to practice our pelvic floor exercises, but it’s often not until pregnancy and the possible resulting pelvic pain that we start to take these suggestions seriously. It may seem that we’re simply hoping to control embarrassing leaks (aka stress incontinence) but did you know that looking after your pelvic floor will help improve your sex life, strengthen your abdominal muscles and prevent serious issues in the future, such as pelvic organ prolapse?

WHAT IS THE PELVIC FLOOR?

The pelvic floor is not just the muscles you use when you wee; it’s actually a group of muscles and ligaments which support the bladder, uterus and bowel, stretching like a hammock from the tailbone to the pubic bone. With the urethra, vagina and anus all passing through the pelvic floor, it’s clear why keeping it as strong as possible is vital. Without your pelvic floor, these organs would literally drop down. Additionally, it works with your abdominal, deep back muscles and diaphragm to stabilise and support your spine.

PELVIC PAIN DURING PREGNANCY

During pregnancy, the growing weight of your baby puts a lot of pressure on the pelvic floor (up to 8kgs in weight in fact) which can lead to a variety of aches and pains throughout your 40 weeks. Whilst your body naturally produces relaxin – a hormone which softens your ligaments, allowing your joints to move more freely in preparation for birth – it doesn’t always do what’s needed. This can be due to lower back problems, previous pregnancy pelvic pain or even the position of your baby. When this happens, your pelvic joints can become stiff or move unevenly at the back and front of your pelvis, leading to conditions such as PGP.

PPGP (Pregnancy-related Pelvic Girdle Pain), also known as SPD (Symphysis Pubis Dysfunction) is common, affecting 1 in 5 women during pregnancy. Whilst it usually disappears after birth, that doesn’t stop it being incredibly uncomfortable at best and genuinely debilitating at worst.

Symptoms include:

Pain when: walking, going up stairs, standing on one leg (for example, when getting dressed), turning over in bed, getting out of the car.
Pain in your pelvis area including over the pubic bone at the front, across one or both sides of your lower back and in the area between your vagina and anus (perineum).
Pain in the top of your thighs.
Clicking or grinding in the pelvic area – you may even be able to hear it.

Posterior Pelvic Pain (aka Sacroilliac Joint Dysfunction) can also be experienced in pregnancy, affecting up to 1:6 women. The sacroiliac joints are located at the 2 dimples of the lower back. The pain often feels deep within your lower back and can occur on one or both sides of your back. In some cases, pain radiates down to the buttock and the back of the thigh.

Symptoms include:

Pain radiating to the groin and thighs.
Worsening pain with standing, walking, climbing stairs, resting on one leg, getting in and out of a low chair, rolling over and twisting in bed, and lifting.
The pain improves when lying down.

WHAT TO DO IF YOU HAVE PELVIC PAIN

The most important thing is to speak with your doctor or midwife in order to discover the severity of the condition and for it to be kept in mind when writing your birth plan (as there are certain birthing positions not advisable). You will need to work with a physiotherapist or other healthcare professional to learn exercises and tips to help your day-to-day life be as pain-free as possible. Some things which can help relieve the pain include:

Practise those pelvic floor exercises 3 times a day, every day. The NHS Squeezy app is a great addition to your phone, with clear instructions on how to lift correctly, as well as handy notifications to stop you forgetting.

Get squatting (if pain allows). Squats have been shown to be incredibly effective at preparing the pelvic floor for birth as well as strengthening your gluteal (bottom) muscles, thereby supporting your sacroiliac joint and stabilising your pelvis.

Moving slowly and purposefully. For example, when getting up from bed, roll onto your side, bend your knees and gently move your feet onto the floor at the same time.

Pay more attention to your posture when sitting and standing. Correct alignment of your feet, knees, hips, back, shoulders and head will distribute your weight equally and take pressure away from the pain points.

Make time for gentle exercise to keep moving.Exercises that focus on core stability of the trunk and pelvic girdle are a good way to help reduce or improve symptoms. At Mama Wellness, we offer a number of different exercise classes which are specifically designed for pregnancy. Fit for birth and Aqua Bump are classes designed with pregnancy bodies in mind. Soft tissue massage therapies are also available from Mama Wellness. See the website for all of our services.

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