About a month ago, I visited our physio friends at Fitwise so that I could do some pilates sessions during the final 12 weeks of my pregnancy. As I discussed with my physio (lovely Claire) any concerns etc, I explained I’d experienced some mild lower back pain – particularly on days that I had carried Abi upstairs or across soft sand! She did some further investigating/assessments, and then explained to me that I had the start of pelvic instability (something I hadn’t considered! I thought I was just a little tight!!) Hence I thought I’d put some facts/information together on what it is, what the signs are and what you can do to manage it.

What is Pelvic instability or Pelvic Girdle Pain?

Previously referred to as Pelvic Instability, however now known as Pelvic Girdle Pain (they mean the same thing!) is a condition that causes pain around the joints of the pelvis (pelvic girdle) during and after pregnancy. The pelvis has 3 main joints, pubic symphysis joint (at the front) and 2 sacro-iliac joints (located at the base of the spine between the pelvic bones and sacrum).

In normal pregnancy a hormone called Relaxin softens the ligaments around the joints of the pelvis. This is a natural process which assists childbirth and does not usually cause lasting discomfort. For some women this natural process seems to go wrong, causing the joints of the pelvis to loosen too much. This can result in the pelvis becoming unstable or out of alignment. Pregnancy can also put strain on muscles of the back, stomach, pelvic floor, hips and pelvic girdle which may lead to the pelvic joints becoming less stable.

What are the signs of Pelvic Instability?

Unfortunately Pelvic Instability is sometimes misdiagnosed as ‘aches & pains of pregnancy’ and women can miss out on the help they need. If you think that you may have PGP, and the symptoms don’t improve after a few days of rest, you should see your doctor or a women’s health physio.  We highly recommend Fitwise Physiostherpay in East Melbourne and Women’s & Men’s Health physiotherapy in Malvern

Managing Pelvic Instability?

During Pregnancy

If you have any concerns, and think you may have Pelvic instability it is important you seek the advice and assistance of a trained physio. Physiotherapists who have experience treating this condition are usually able to assess whether you are experiencing Pelvic Instability. Some general do’s and don’t if you do have pelvic instability include the following:

Do

Don’t

  • Rest
  • Keep your legs together!! Particularly when   rolling over in bed.
  • Stand with your weight distributed on both   feet
  • Stand up (from sitting on a chair/floor) in a   squat position, not with one foot forward
  • Sleep with a pillow between your legs
  • Switch on your core (particularly your tummy   and pelvic floor muscles).
  • Ice your painful joints for 20minutes at a   time (repeat every 2 hours, until pain manageable).
  • Stretch – frequently stretch your gluts by   sitting on a chair, with one ankle resting on the opposite knee. Tilt from   the hips, until you feel a stretch through your gluts.
  • Stand on one leg
  • Don’t do exercises where you have weight distributed unevenly (lunges, one leg squats/calf raises, yoga poses such that require a lunge or uneven distribution of weight between feet.
  • Carry children on your hip (if you have to carry them, carry on your back/front). Try to avoid carrying them as much as possible
  • Step over things
  • Climb stairs
  • Push a shopping trolley
  • Walk/run as an exercise
  • Sit with your legs crossed!

In regards to exercise options if you have pelvic instability, it is important to avoid/limit walking. Two great options are swimming and stationary cycle classes, both of these allow you to enjoy cardio exercise – without causing any further inflammation.

Post-natally

Once your baby is born, you need to be careful during the first 3-6 weeks. The pelvic girdle needs this time to improve its control and stability mechanisms to support your pelvic. Pelvic instability usually resolves itself 3 months after giving birth (unfortunately for some women it can exceed the 3 month period).

Following the birth of your child it is important to still follow the Do’s and Don’ts above, until you can successful walk etc without pain. It is highly recommended that you continue to seek the assistance and advice of a qualified physio, to ensure your recovery and return to exercise is not hindered. For some women that have required a pelvic belt to assist with the management of pelvic instability, it is important that the pelvic girdle is able to rebuild its stability and strength to support the pelvis.

Source: Fitwise client information leaflet – ‘Pelvic Girdle Pain’,  PIA Australia – www.piaaustralia.com

Sally Muir – Personal Trainer

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