That's a bit one sided

Post natal Pelvic Joint Pain

During my first pregnancy I took the time to exercise every day. I conducted pregnancy and postnatal exercise classes and continued working on the maternity ward so I was surprised to find myself with some right-sided pelvic joint (sacro-iliac joint or SIJ) pain within the first few days of going home from hospital.

My first baby was probably 6-7 days old and I was looking forward to going for a walk with the new pram, but I couldn’t. Getting around the house and up and down our stairs was enough to feel the joint pain, and I knew that this was not something to push through. So I contacted my physio friend, who then strapped my SIJ for me to provide some support and some relief. Looking back it just took a few weeks before I was able to go for walks again, building up steadily, using the great pram so carefully chosen for being able to exercise with.

Interestingly, about 6 months ago, I had the experience of some right sided SIJ pain again with walking. This time just mild, but I experimented with a few things to help it to go away.

Firstly I tested and found that my glut medius, the muscles at the side of my hip were stronger on the left side than on the right and so I started to use the clam exercise to work on being able to even out the muscle tone, action and strength from one side to the other, focusing more on my right side.

PF1-2-A5Handout2.jpg I also worked on some one-sided pelvic floor work, even lifting the right side of my pelvic floor a little when walking (very tricky I know), but it stabilised and at times seemed to reduce the mild pain that I was feeling after walking for a little while.

Studio-Session-Dianne-232.jpgWhen I combined the two, separate to walking, I would lie on my left side, lift my pelvic floor and hold it, and then do  the
clam lift exercise. Each time I would stop and relax to start with, after each rep. Then I became able to do several of the clam reps in a row, before fatigue of my pelvic floor.

The problem went away when several other strategies were applied with this ‘simple’ but also very specific and skilled coordinated contraction, which came from knowing and tuning into my inside fitness. I restored the balance both inside and out, and this changed what was happening and prevented the problem from becoming more serious. There was also interplay with the deep hip muscles and I found that crossing my legs or sitting with my leg rolled out would also trigger the pain at times. When I applied the principles of symmetry, sitting evenly and not crossing my legs, I was able to avoid the onset of pain.

I also used Sports Recovery Shorts which I was trialling at the time, and the compression and support around my pelvis did give immediate relief. One day when I was going for a walk and noticed the problem in the first 50m, I turned around and went back to trial the shorts for the walk, and I was able to walk for 20 minutes comfortably at the time.

The interesting thing too, was that in recently demonstrating with the pelvis, how the baby’s head moves through the pelvis during birth, I was reminded that often one side of the pelvic floor may become more stretched during a vaginal birth than the other side. This more recent episode of SIJ pain, the one sidedness of the pelvic floor strength needing attention and the link right back to the weeks post birth make for an interesting connection.

How connected are you to your pelvic floor, it’s lifting, holding and coordination ability, let alone it’s one sidedness, where you become aware that there are two sides to your pelvic floor?

This is what a Continence and Women’s Health physiotherapist can check for you if you are unsure, feeling on the inside the tone and also assessing the strength of your muscles, together with your hold time. Then a specific treatment and recovery program can be developed for you to help you on your own road to recovery, post pregnancy and childbirth.

It was talking to a CWH physiotherapist at a conference 2 years ago and also listening to one of the CWH specialists speak about some of the work that they are doing paying particular attention to one side of the pelvic floor that made me more aware of this issue.

Can you do with some extra help to determine the specifics of your inner fitness? If so, contact your local Continence and Women’s Health Physiotherapist, which you can find by looking at the directory on Find a Physio on the Australian Physiotherapy Association website.

You can also use our pelvic floor resources to help you understand and know your pelvic floor better.



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