What is Pregnancy-related Pelvic Girdle Pain (PrPGP)?

Pregnancy-related Pelvic Girdle Pain is a pain in and around the pelvis that can occur during or after pregnancy. It is reported that approximately 44% of pregnant women will experience some type of pelvic girdle pain throughout their pregnancy. It can persist into the postpartum period, but in most cases, it does resolve on its own after birth. It can be felt in the front or back of the pelvis, sides of the hips, buttocks, and groin and may radiate into the thighs.

What Causes it?

During pregnancy, the pelvis changes to accommodate the growth of the baby. There is an increased load on the pelvis and associated postural changes to accommodate this growth. Pain can then occur due to the new position and change of tension on muscles and ligaments across the joints and in surrounding areas. In the past, the hormone Relaxin has been implicated in causing pain by creating g ligament laxity, however, current research has indicated that although ligament laxity occurs during pregnancy, Relaxin does not play a role in this or the PrPGP experienced.

Some positions and movements can aggravate PrPGP, by increasing the load through the joints, including:

• Sitting cross-legged
• Walking up stairs
• Walking fast with long strides
• Standing with weight on one leg
• Getting out of the car or bed
• Rolling over in bed
• Standing on one leg (e.g. getting dressed)

Sleep 

Sleep is a big contributing factor in all types of pain. Disrupted sleep can create increased sensitivity throughout the whole body, and change how pain is perceived. This means that if sleep is disrupted during pregnancy, due to pain, feeling unwell, or difficulty finding a comfortable position with changes in the body, pain levels may increase, and may feel harder to manage. In such cases, it is important to manage sleep patterns, and seek advice on improving sleep.

How can Physiotherapy Help?

Physiotherapy can assist in the prevention and reduction of PrPGP, through a multimodal approach.

Exercise programs, specifically tailored to each stage of pregnancy, have been shown to reduce pain and associated incapacity. This is important during pregnancy, to maintain activity levels for the health of both mother and baby. Physiotherapists and Exercise Physiologists are able to tailor both pilates-based programs as well as Strength and Conditioning programs to address PrPGP, both antenatally and postnatally, for pain reduction and prevention. Stretches, mobility exercises, and strengthening can also be provided for self-management of PrPGP.

Other treatment options for PrPGP include manual therapy for pain management, as well as fitting a pelvic girdle belt and Dry Needling or Acupuncture.

Our Women’s Health Physios are trained in the treatment of Pregnancy-Related Pelvic Girdle Pain.  Call 3358 3915 to book a Women’s Health appointment.

Blog written by physiotherapist Nykeela

Motherhood is a journey filled with challenges and rewards. Amidst the sleepless nights and unconditional love, there’s an unexpected hurdle some mothers face: De Quervain’s Tenosynovitis. This condition affects the tendons in the wrist and thumb, causing pain and discomfort.

Understanding De Quervain’s Tenosynovitis

De Quervain’s Tenosynovitis is a condition that primarily affects the tendons in the wrist and thumb. It’s characterized by inflammation of the tendon sheath, resulting in pain, swelling, and limited mobility in the affected area.

The symptoms of De Quervain’s Tenosynovitis can be quite debilitating. If you’re a mother dealing with this condition, you might experience:

1. Pain and tenderness at the base of your thumb
2. Swelling and inflammation
3. Difficulty gripping or pinching objects
4. A “catching” or “snapping” sensation when moving the thumb
5. Pain that can radiate up the forearm

The Relationship with Motherhood

De Quervain’s Tenosynovitis can significantly impact mothers due to the demands of caring for a baby or toddler.

How it affects mothers:

1. Holding and Feeding: New mothers spend a lot of time holding and feeding their babies, which can strain the wrist and thumb.
2. Nappy Changing: Changing the nappy, especially while holding the baby’s legs with one hand and using the other to clean and fasten the nappy, can stress the affected tendons.
3. Lifting and Carrying: As children grow, mothers often need to lift and carry them, which can be challenging with De Quervain’s Tenosynovitis.
4. Household Chores: Mothers often juggle household chores alongside child care, which can further strain the wrist and thumb.

Preventing and Managing De Quervain’s Tenosynovitis

Preventing and managing De Quervain’s Tenosynovitis is crucial in order for mothers to remain active and involved in their child’s life without pain.

Here are some strategies:

1. Rest and Immobilisation: Give your wrist and thumb the rest they need and use a splint to immobilise the thumb.
2. Ice and Anti-Inflammatories: Apply ice and take over-the-counter anti-inflammatory medications to reduce swelling and pain.
3. Ergonomics: Pay attention to your posture and hand positioning when holding, feeding, or carrying your child. Use proper techniques to reduce strain on your wrist and thumb.
4. Physiotherapy: We can provide exercises and techniques to strengthen the affected tendons and improve mobility.

Motherhood is a beautiful experience, but it can be challenging, especially when dealing with conditions like De Quervain’s Tenosynovitis. Prioritising self-care, seeking medical advice when needed, and adopting strategies to manage and prevent the condition is key.  A healthy, pain-free mother is better equipped to care for her little ones and cherish every moment of motherhood.

If you have any further questions, feel free to give us a call on 07 3358 3915 to book an appointment with one of our Physiotherapists who can help.

Written by Cathryn Prout

During pregnancy, many changes are occurring in your body, including an increase in abdominal diameter and weight in your pelvic floor due to the growing baby. These changes could affect your abdominal muscle strength and your pelvic floor muscle endurance and coordination despite the mode of delivery.

What symptoms might you have after birth? 

The most common symptoms after a vaginal or cesarean delivery are:

• Urine leakage: having involuntary loss of urine when you cough, sneeze, or lift your baby, etc. This is called stress urinary incontinence (SUI) and it can range from a single drop of urine to a full gush. Also, not making it to the toilet and having some drops of urine before you sit down is considered urge urinary incontinence (UUI).
• Vaginal heaviness: feeling like a badly-positioned tampon is inside your vagina or the sensation of something coming out or a bulge is a symptom of pelvic organ prolapse (POP). This is more likely to happen after having an instrumental birth (such as forceps delivery) or giving birth to a baby weighing more than 4kg.
• Pain during intimacy: having stitches, either in your abdomen or perineum (vulva or vagina area) can leave this area more sensitive than before. Hence, you might experience discomfort, or even pain, while being intimate with your partner.

How can this impact your life?

• Returning to exercise or work: some women find it difficult to return to their preferred sports, especially if they include jumping and running, as they leak during their training sessions or games. Also, women who have to lift weights at work find it hard to return to their usual roles.
• Relationships: experiencing vaginal heaviness or pain during sexual intercourse can be very challenging and results in some women avoiding intimacy with their partners. This can put pressure on a relationship or how couples interact with one another.

How can a Women’s Health Physiotherapist help you? 

Just as you would go to a physiotherapist for rehabilitation of any other muscle weaknesses and pain, you can visit a women’s health physiotherapist who has further training in women’s health issues.

Some things that a Women’s Health Physiotherapist can help you with, include:

• Identifying if there has been any perineal trauma, such as tears or muscle detachment, and tailor a specific exercise program for your pelvic floor muscles.
• Assessing abdominal separation and abdominal strength to guide you on your way back to fitness classes.
• Treating any painful areas including scars from perineal stitches or abdominal stitches, and soreness/stiffness of the neck or back from feeding or carrying your baby.
• Helping you with self-management strategies.
• Helping you reach your fitness goals.

The economic cost of pregnancy and childbirth can be significant. However, what is being recognised (and thankfully discussed) more and more by new mums, is the long-term financial and personal costs that can result from a delayed return to work, exercise, or intimacy due to the changes that many women experience following childbirth.

To encourage new mums to take positive action towards recovery after childbirth, The Body Refinery (located in New Farm) has created a Postnatal Pack that makes visiting a Women’s Health Physiotherapist more affordable and accessible to all Brisbane women; including 1 initial assessment, 1 one-on-one Exercise Physiology session and 5 pre/postnatal classes.

Written by Women’s Health Physiotherapist, Pilar.