Pelvic Girdle Pain and Pilates

I have had the good fortune to be able to help lots of Mums-to-be and new Mums who have suffered with Pelvic GIrdle Pain, which can be a debilitating condition and wanted to write something other women to give them hope that there is lots that can be done if they are suffering with Pelvic Girdle Pain.

Pelvic Girdle Pain (PGP) has a wide range of symptoms; it can be specifically pain in the joints of the pelvis (sacro-iliac joint, pubic symphisis) or referred pain into the lower back, gluteal muscles and inner thighs (adductors). It is a common misconception that PGP is caused by hormonal changes in pregnancy – relaxin is released that allows the pelvis to soften as the baby grows which causes instability in the pelvis. However, this instability does not necessarily cause PGP – if it did every pregnant woman would be in agony – it just highlights existing imbalances in the pelvis and the posture, which can cause pain. In my experience, most women who suffer from PGP have some kind of significant imbalance in their body. I highly recommend visiting an osteopath who specialises in this area (if you are in St Albans Jo Day at hertsosteopathy.co.uk is fantastic). An osteopath can help to realign you so that when you come to movement work you are in good alignment and your muscles will fire more effectively. In Pilates we can try to address the asymmetry by strengthening your weaker side, releasing tension that may have built up due to the imbalance and helping to raise your awareness of how you are moving. There is a lot that you can do to help yourself by being conscious of your day to day movement patterns.

• Try not to stand on one leg or to favour one leg when standing still
• Be aware of your weight placement in your feet – are you sinking into your arches and therefore allowing your thigh bones to rotate inwards?
• Make sure you are using your legs evenly when climbing stairs and moving around day to day
• Ensure you are activating your gluts when necessary
• Be careful when getting out of cars, try and open the legs evenly or keep the legs together if necessary
• Try to avoid large twisting movements
• During your labour it is important to make sure you remain aware of these new ways to move. Tell your birth partner to remind you throughout, especially if you are on pain relief because this may make you feel like you have more movement than usual. You can even get a ribbon and measure where your pain-free movement allows you to open your legs to so that you are more aware of your limitations while your mind is elsewhere!

Before starting any new exercise regime when pregnant, you need to be given permission by your doctor. It is advisable to work with another health professional such as an osteopath or physiotherapist alongside using Pilates to support your PGP. Pilates is a great way to support any manipulation that you are having with another therapist but it is vital that you do the exercises correctly. I am reluctant to post lots of exercises on here for vulnerable women to do during pregnancy as I know how hard it is to get them right and they need to be practised carefully, ideally with supervision. I would advise you to try and see a Pilates teacher who specialises in this work (visit thecenterforwomensfitness.com or postnatalexercise.co.uk to find a teacher that is local to you) but if that is not possible then here is a gentle exercise that might help:

The Cat:

Kneeling on your hands and knees, with your hands underneath your shoulders, knees underneath your hips and your weight distributed equally between both legs. Breathe out to gently lift your pelvic floor, draw your tummy towards your spine and tuck your pelvis under, to gently round the spine. Breathe in to release back into a flat back. Repeat 6-10 times.

I hope that helps. Here are some other great websites that might be useful for you to have a look at if you are struggling with PGP:

www.pelvicpartnership.org.uk/

www.pelvicinstability.org.uk/

Remember you are not alone! Do get in touch if you have any questions.