Pregnancy affects the body in many ways. One of the most noticeable ways is it changes your posture and biomechanics of movement. Some feel the effects while they are pregnant, some after the pregnancy and some many years later are left with niggly pain that is intermittent.
There are basically three main factors that play a role in pelvic dysfunction in pregnancy.
1. Hormonal Changes
During pregnancy, your body releases a hormone, relaxin which loosens the ligaments of your pelvis to make it easier for the baby to pass through the birth canal. This means that there is more play in the pelvic joints.
2. Additional Weight
As the baby grows in the womb it changes the centre of gravity of your body. The extra weight and shape will move your centre of gravity forwards, often causing an anterior tilt of the pelvic bones. So, your pelvis rotates forwards.
3. Increase Demand On The Pelvis
Most of us have a dominant side, so one leg is better at standing and one leg is better at kicking. This means that the demand on the pelvis is sometimes asymmetrical, which can cause one side of the pelvis to rotate forwards more than the other side.
In combination, these three factors change the biomechanics of the pelvis. Why this is important is that the pelvis is the coupling joint between the spine and the legs. If the pelvis alignment is correct, then it gives stability for your legs to move with ease. If there is an imbalance of the pelvis it will change the length and the recruitment of certain muscles. This results in abnormal mechanical stress and strain on various structures. If overloaded beyond the tissue’s tolerance, it results in pain and dysfunction of the structures.
Symptoms Of Pelvis Dysfunction
The symptoms can range from:
- Tight and painful hamstrings or buttocks.
- Pain on the outside of the knee, groin pain, hip pain, back pain, sciatic pain.
- Pain when turning in bed at night and getting stuck when standing up.
Excessive Muscle Tone Can Cause Pelvis Bones To Rotate And Flare
The change in the biomechanical movement of the joint causes a greater demand on the muscles that stabilizes the joint, and the muscles will become overstimulated. In normal muscles during a contraction, an impulse will cross into the muscle fibres, which contracts and shortens. The muscle fibre pulls on the bone. The bone moves. The muscle fibre then relaxes and elongates again. When too many impulses cross into the muscle fibres it causes too many contractions of the muscle fibre too quickly. In other words, the muscle fibres stay in a state of contraction, which means the muscle cannot relax and elongate, this is excessive tone. This can cause the pelvis bones to rotate and flare.
Therapist Can Release Your Muscle Tightness To Improve Your Pelvis Pain
Excessive tone is always present where there is a joint dysfunction. When the pelvic bones have moved out of their ideal position, they have to be mobilized or manipulated by a therapist back into position and the muscle spasm needs to be released.
Releasing the muscle tightness equalizes the forces on the joint so that a balanced movement can take place and the muscles can be recruited in the correct pattern and it will decrease the inhibition of the other muscles.
Regular Stretching Can Maintain Your Ideal Pelvis Position
Individuals that have had their pelvis corrected should initially stretch regularly to maintain the new position, while the muscles that have been inhibited get a chance to retrain. It is more effective to stretch gently for a longer period of time (2-5 minutes) when releasing tight muscles. The stretch should be slightly uncomfortable, but not painful. Specific muscles should be targeted before a general pre-exercise stretch is done. For example, if in treatment it is found that your left hip flexor is much tighter than the right, it should be targeted. A good stretch program is of value to everybody, not only during and after pregnancy. It is also important to strengthen your core muscles to maintain a good posture and good alignment. These muscles need extra training after being pregnant.
If during pregnancy you experienced low back pain or sciatic pain, it is a good idea to have your pelvis assessed before starting a vigorous exercise program. Post pregnancy pelvic dysfunction is very common and is usually very easily treated.
Stretches That May Help With Pelvic Pain
If pain persists there may be other factors involved which need to be dealt with. Consult with your local physiotherapist for advice.
Mel is an experienced physiotherapist based out of the Prohealth Sports And Spinal Physiotherapy Centre on Wellington Street, Central. She is an expert in pelvic dysfunction, back pain, getting the core going after pregnancy, post-mastectomy and abdominal /cosmetic surgeries, lymph drainage for cancer patients, as well as acute sports injuries and post surgery rehabilitation. Outside of the clinic, she is a formidable netball player and is active in the Hong Kong Netball Association.