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Demystifying the Pelvis & SIJ

 
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Pelvic Girdle Pain

Pelvic Girdle Pain (Pelvic Girdle Pain PGP) is not widely known or understood and we are still learning about the exact causes of pelvic pain but it is thought that this softening, along with postural changes, muscle weakness and differences in the movement occurring between the left and right pelvic joints can cause too much stress on the joints, ligaments and muscles of the pelvis. What are the symptoms of PGP?
  • the pain is often one sided and may be concentrated in the buttock area
  • or the pain can be a widespread deep ache & soreness across the entire pelvis
  • it can send shooting pains into your buttocks or down the back of the legs
  • pain can often be felt in the region of the coccyx
  • It is worth noting that if the pain is accompanied by pins and needles or numbness and extends further than the knee then there may be a greater contribution from the lumbar spine structures (such as disc and nerves) rather than a primary pelvic dysfunction
  • Pain is often experienced in the hips, one or both of your legs may feel very weak and you may not be able to lift your legs, particularly when lying down
  • If you experience pain in or around your pubic bone at the front, you may be suffering from Pubic Symphysis Dysfunction.
What makes the pain worse? The pain is usually made worse by lying on your back, turning over in bed, walking and standing or getting up from a sitting position. It is often worse at night and the degree of night pain you may experience will probably be related to how active you are during the day. Separating your legs especially when sitting or lying down can be painful. At what stage in the pregnancy does it occur? Pelvic region dysfunction and pain can begin as early as 8-12 weeks or as late as the last few weeks before delivery. If the pain comes on at the very end of pregnancy, it may be due to the baby’s head ‘engaging’ or moving down into the pelvis. If you experience pelvic related dysfunction in one pregnancy it is likely to reoccur in any subsequent pregnancy, and without professional advice or treatment, may be more severe. How is it diagnosed? It is important to see a physiotherapist who is experienced in treating pelvic joint complaints and in particular experience in treating pregnant women. At Spinal Synergy Physiotherapy we will assess the stability of your pelvic joints, examine your back and posture to make sure the symptoms are not coming from there, and take a detailed look at how the deep core stability muscles of your abdominal region, lumbar spine, pelvis and hip are working. How is it treated? Treatment at Spinal Synergy Physiotherapy uses gentle techniques which assist in mobilising the pelvis, lumbar spine and hips. We use specific soft-tissue type treatments to release tight muscles, correct any pelvic or sacro-iliac joint imbalances. Pelvic/SIJ stability belts are often used in the case of pelvic instability and provide for immediate relief and can be worn safely during pregnancy. In some instances the physiotherapist will apply tape directly to the pelvic region which can assist in restoring pelvic stability and control. Exercise for the deep core abdominal and pelvic floor muscles are a key part of treatment and are aimed at improving stability of your pelvis and back. We will provide you with corrective posture exercise and a program for strengthening the deep core stability muscles.  This can be either closely supervised one-on-one rehabilitation with the physiotherapist and we also recommend small group focused exercise classes. Here are some tips to prevent pain and injury during your pregnancy:
  • Avoid pushing through any pain
  • You may not feel the effects of what you are doing until later in the day or after you have gone to bed
  • Rest regularly, either by lying on your side or sitting upright with your back well supported
  • Avoid heavy lifting or pushing (supermarket trolleys can be particularly painful)
  • Performing regular pelvic floor exercisers and lower abdominal exercise can help to reduce the strain of the pregnancy on your back

The Pelvis Pregnancy

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