POSTPARTUM PELVIC PAIN
Your pelvic girdle is a ring of bone at the base of your spine. With their muscle & ligament attachments, they support the trunk & link the spine to the legs.
During pregnancy, hormones tend to soften all our ligament & connective tissues in preparation for birth. This can be a big problem in the pelvis, as you lose much of the rigid support they provide. Couple this with the weight of a growing baby & changing dynamics of posture & movement can result in instability & pain. Commonly you may have groin pain, lower back pain, buttock pain & even pain radiating down your legs.
Please ignore those who will pat you on the shoulder & say “Don’t worry, it will go away when you have the baby”. This may not be the case. We have seen many women 2 to 3 years later still having problems & finally giving up on waiting for it to go away.
If you have a problem in movement that is not addressed in the early stages it becomes a not very helpful pattern that persists & takes a lot of work to correct. Therapy will help to ease the pain & educate you about the right patterns of movement & exercise.
Pelvic Floor Muscle Exercises
Regardless of how you delivered these exercises are recommended for reconditioning these muscles following the stress of pregnancy & delivery.
- They can be commenced from 24 hours post-delivery or when your catheter has been removed if you have had one.
- You may lie, sit or stand to practise but lying or sitting may be easier initially. As you breathe out gently squeeze the muscles from your pubic bone to tail bone and lift up. Imagine you are resisting a tampon being pulled out. See if you can hold for a few seconds then release and rest for 5-10 seconds. See if you can repeat this a few times, aiming eventually for 10-second holds and 10 repetitions.
- Try not to squeeze your buttock or upper tummy muscles while you do this exercise.
- A gentle tightening across your lower tummy means that you are also beginning to strengthen your core (deep abdominal muscles).
- Make sure you breathe as you hold the contraction.
- You may practise these lying on your back or on your side if you are uncomfortable or struggling to feel the contraction in sitting.
EXERCISE TIMELINE
0- 2 WEEKS
- Pelvic Floor Muscle Exercises.
- Basic exercises as described overleaf.
- Walking for cardiovascular exercise.
2 - 4 WEEKS
- Progress walking/pelvic floor muscle/core exercises.
- Consider gentle controlled squats, lunges and bridging.
4 - 6 WEEKS
Low impact exercise such as static cycling or cross trainer, swimming.
6 - 8 WEEKS
(see our Women’s Health Physio for a Postnatal Pelvic Floor Assessment) postnatal exercise class, power walking, increased duration/intensity of low impact exercise.
8 - 12 WEEKS
Continue to gradually increase as per 6-8 weeks.
12 WEEKS AND BEYOND
If planning a return to high intensity/impact exercise visit our Women’s Health Physio for an assessment of readiness before attempting. Graded return to running or other high-intensity/impact exercise.
