Pelvic Girdle Pain
PGP refers to pain felt either at the back of the pelvis, on one or both sides, and/or pain over the pubic joint. Pain is generally located between the top of the pelvis and the bottom of the buttocks. Pain may referred into the buttock, and/or down the leg, so is often confused with sciatica.
PGP involving the pubic symphysis joint can also refer pain to the groin, inner thigh, lower abdomen, and vaginal area.
There are many treatment options available to decrease the discomfort of pelvic girdle pain. Some of these might include Physiotherapy treatment, compression garments, education and/or exercise advice.
A pelvic support belt may be prescribed by your physiotherapist to improve your movement control. Pelvic belts need to be fitted to the individual therefore it is not a good idea to just “buy a belt” or borrow a well -meaning friends’ belt. Not everyone with pelvic pain will need a belt, and in some cases a belt can make your pain worse. An assessment with your physiotherapist is important to ensure:
a) you need a belt-you may not!
b) you have the right size belt fitted
c) you are instructed how and when to wear the belt
Tubigrip is an elastic tubular bandage that can be fitted to wear around your tummy, to give your tummy support. It helps to take some of the load of the baby’s weight off your lower back,and improves your tummy muscles capacity to get you through the day. You do still need to use your abdominal muscles to help support the baby, but the tubigrip means they don’t have to work so hard, and their ability to contract is made a little easier. There is also a variety of different support shorts and leggings available for purchase which can provide compression and support to your changing body. Talk to your Physiotherapist about which one might be best for you.
During pregnancy there are many changes that occur to your body that change the way it works. There are the obvious changes that include:
- Your growing tummy, which stretchesabdominal and stomach muscles,
- The weight of the baby sitting on your pelvic floor muscles for the duration of your pregnancy,
- Your centre of gravity, or balance point, which moves forward as your tummy grows, adding increased load to your back and pelvis. This will also change your balance.
The less obvious changes include the hormonal variations that occur from the first trimester. “Relaxin” is the hormone primarily responsible for this, creating “stretchiness” inthe supporting ligaments of the pelvis.This therefore means the muscles surrounding the pelvis need to work a little harder to maintain good control of the pelvic joints. Without this, the extra movement in the joints can result in inflammation and pain.
For further information about pelvic girdle pain download our free “Pelvic Girdle Pain e-book”
See Also “Pregnancy Physiotherapy”
Women with PGP are often told, “having the baby is the cure”. However, the cure is not immediate, and requires some work on your part to achieve. The relaxin hormone that helped soften the ligaments around the pelvis during pregnancy, is no longer produced after birth, however the effects remain for some time. For this reason, your symptoms (particularly pain) are generally much improved immediately after delivery, however the underlying mechanical challenge, of increased movement available to the pelvic joints, doesn’t start to reverse itself until approximately 3 weeks after birth.
The muscles you need to help control this increased movement, (particularly abdominal and pelvic floor muscles), have been stretched and weakened during pregnancy. Part of your post natal recovery will therefore need to include a strengthening program for these muscles.
See Also “Post Natal Physiotherapy”
Only a very small number of women who have PGP during their pregnancy go on to have persistent pain longer term. This is still very treatable, however requires a different approach to acute pain. This will require individual consultation with your physiotherapist to develop a targeted management plan.
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