I want to start this post by making it perfectly clear that this is not intended to serve as medical advice to anyone. If you are having pain or issues, please consult your health care provider (not just Dr Google, and certainly not random blog posts). This is simply an account of my experiences.
From about 12 weeks into my pregnancy I started getting lower back pain. It came and went, always on the one side, more in my hip than in my back.
After about a month of dealing with it, I decided enough was enough and asked my midwife what I should do. She straight away referred me to the maternity physiotherapist at my hospital, and I booked an appointment for a few weeks time.
This week I finally had that appointment, and I’m so glad I went!
I’ve never been to a physiotherapist before, so didn’t really know what to expect. I did some research of what to wear and what might happen – basically wear comfy, loose clothing and be prepared to possibly be down to your underwear depending on where they need to assess. For me I wore my gym clothes (which somehow still fit! but not for long…), and all she needed to do was lift my shirt at the back and lower my shorts a bit so she could clearly see my hip. She asked permission for everything she did, and made me feel comfortable throughout the whole experience.
After experiencing the pain for a while, I was able to clearly tell the physio what was going on. I get intermittent pain that ranges from a sharp pinpoint, to more of a radiating dull ache. It always starts from a single point in the back of my right hip, close to my spine, and doesn’t appear to be triggered by any particular activity or posture. It doesn’t travel down my leg, but sometimes does spread across my lower back. You can see the spot highlighted in red in the diagram below – the pinpoint is pretty much exactly where the line is pointing for the sacroiliac joint.
After explaining my situation, the physio felt various parts of my hips and back while I performed a few different activities like raising one leg, balancing, lying down and standing.
She had two students with her, so she paused every now and then to discuss what she was doing and what they thought it all translated into. It was very interesting to hear them talk (especially as I’m a high school teacher myself, so seeing her work with university students was great), and the physio was careful to also explain everything clearly to me.
Apparently my legs are pretty much exactly the same length, my hips are good and square, and everything is in really good alignment. I even surprised them with my range of hip movement – I think they were looking for one of these things to be the root cause of my problem.
Pelvic Girdle Pain – My Suggested Treatment
Eventually they came to the conclusion that I have the early stages of pelvic girdle pain. Basically, the ligaments (as you can see them in the diagram above) are too relaxed, causing the bones to grind at the same time as causing the associated muscles to overcompensate.
She said it was great that I’d come in at this stage, because it can quickly advance to being extremely painful and damaging. They are hoping that I’ve caught it early enough that it won’t progress too much further, but unfortunately I’m stuck with at least this level for the rest of my pregnancy and possibly a bit beyond. I guess lucky for me that it’s one sided, intermittent, and even when it’s really bad I can still walk (or at least limp).
We went through some postural fixes, which are outlined here. I am really going to have to work at these, posture is something I’ve never been terribly great at (thanks in part to being one of the taller girls at school). In particular I’m going to have to be extra conscious of the sitting and standing postures – I’ve asked my husband to correct me if I’m not sitting or standing squarely, and will tell my students the same thing! I have a habit of putting my weight on one hip or leg, crossing my legs when I’m sitting or standing, and generally being out of alignment. Asymmetry is my new enemy; symmetry is my new best friend.
She also gave me a bit of a remedial massage, releasing specific muscles in my glutes. We then went through the assessment exercises again, and straight away I could feel the difference!
We then moved on to practical things I can do to strengthen and release the appropriate ares to help control the pain and reduce flare-ups. I am to do clam exercises four times a week, proper pelvic floor exercises at least three times a day, and use a tennis ball or trigger ball to release a particular muscle in my glutes at least twice a day.
She also suggested aquatherapy for general fitness, and Pilates for core strength. Lucky I enjoy Pilates, now I have been told I need to do it! The maternity sector of the hospital run aquatherapy classes, so I’m going to try getting into some of those (hello school holidays!).
Interestingly enough, she explicitly told me to stay away from Yoga. She said the exercises can promote asymmetry (at the very least while you’re doing them), and over-stretching will exacerbate my pain. I really enjoy yoga, and had started to do some pregnancy yoga in the hopes of easing the pain, so I guess that ends now!
Pelvic Support Belt
The physio gave me a version of a pelvic support belt. This one is simply a tube of constricting, stretch material, rather than a structured belt.
She said I don’t need to wear it all the time, but I should wear it on days/times I will be standing or walking for long periods. If I’m sitting for long periods I don’t need to have it on, and if it get uncomfortable or too hot in the summer, only wear it when I really need to.
The idea is it compresses my hips together a bit while providing support to the joints, ligaments, and muscles. It is light and stretchy, but you’ll probably still be able to see it under my clothes. I don’t really care about that though, I’d rather not be in pain!
Sometimes you just need to go see your doctor
In the end I’m so damn glad I mentioned my pain to the midwife and booked this physio appointment. I’m lucky in that I didn’t pay a cent for the entire thing (thank you universal health care!). Even though I’m stuck with the pain, hopefully moving forward it will be more manageable and won’t progress to being worse.
I think this whole experience has really highlighted for me the importance of seeing a health care professional when things are going wrong, rather than just trying to suck it up and deal with it myself. In this case I could have ended up in hospital because of the pain, and certainly would have made things worse for myself by trying to self-diagnose and treat it. I had actually done a bit of Dr Google-ing (as we all do) and ruled out pelvic girdle pain because it wasn’t travelling down my leg – the physio assures me if I hadn’t come in it would have eventually progressed to that point!
Please look after yourself! If you have a suspicion you need to go talk to a doctor about something, just go and do it. Your health is worth it!