Antenatal Backpain? Physiotherapy can help
Are you suffering with antenatal backpain? Or sciatica, back ache, leg pain? SPD, PGP?
Antenatal backpain and pelvic problems during pregnancy can seem very different and individual presentations vary enormously.
Some people find they stand up, walk 2 steps in agony, then are actually ok once they are on the move. Others are absolutely fine until they walk more than 100m? Some people dread turning over in bed or picking up their toddler. A support belt or tubrigrip might feel wonderful……or makes everything worse……? There can be numb hands, bladder leaks, doming abdominals and rib pains too. Pregnancy is not always blooming!
But the good news is that the majority of problems can be unpicked, sorted through and issues completely resolved or made very manageable.
Pain is an “unreliable witness”
Though a pain pattern gives clues to a problem, a full assessment of the back, pelvis, muscles and nerves is needed to work out the true cause of the problem and guide you what to do (or not) to help.
For example a stiff upper back can cause lower back ache
Unexpectedly, end of the day low back ache is often due to a combination of a stiff mid back (thoracic spine) and weak abdominal support. Stiff bits usually don’t hurt much so a tightened mid back creeps up on you. You may only have noticed that you can’t turn to parallel park!
With time the load shifts to the lower back and then the lower back aches and complains by the end of the day even though it is the upper back that is actually the criminal.
In this case physiotherapy treatment would first include manual therapy to loosen the upper spine and restore alignment. We can modify treatment positions for pregnant women so that you don’t have to lie on your front, you can lie on your side or lean forward seated on the gym ball so that we can still properly apply manual therapy techniques but you and your baby are comfortable.
As experienced and passionate pilates instructors we would then teach you safe and effective exercises to maintain the new improved movement and stretch out the whole spine each day. We also have clever ways to keep your abdominals strong and toned through your entire pregnancy, for good spine support and a rapid postnatal recovery.
PGP is the new name for SPD.
Medicine does love a TLA (three letter abbreviation). Pelvic Girdle Pain (PGP) is a fairly new term used for antenatal backpain which encompasses the traditional SPD (symphysis pubis dysfunction) but allows for the understanding that the pelvis is a ring made from 3 separate bones with problems able to originate in one place but be felt in another. That “pain is an unreliable witness” statement again.
A common complaint is to find that after sitting down for a while, quite fine, your first few steps on standing are agony, then you are ok again. This is usually a problem with one or both sacroiliac joints (SIJ if you want the TLA). Loose and open when sitting, they struggle to connect quickly as you stand and the brain tries to stop you taking weight through them with pain.
Physiotherapy treatment aims to use connective tissue massage (also know as fascial release) to change the imbalance, manual therapy to align the joints and then exercise to strengthen your ability to hold this position unaided. Sometimes support belts are needed until your muscles have a chance to develop.
That’s why a sheet of exercises or being told to ‘strengthen your core’ might not have worked for you
If you have moderate to severe antenatal backpain – it is best to get assessed and understand the problem you are trying to correct through exercise. If your pelvic alignment is wrong, then strengthening your core, at best won’t help and more likely will make you feel worse as you tighten your joints poorly aligned. Similarly, if you have already tried tubigrip or a support belt and found them to be more uncomfortable than helpful, this is a clue to seek a full musculoskeletal assessment.
Once you have alignment and imbalances sorted out abdominal, gluteal and posture exercises are absolutely wonderful for all pregnant women. Nicola Day and I are Qualified Pilates Instructors and fans of yoga, barre work, and free weights too! We will work with you to develop the exercises that YOU ENJOY to ensure that they will be beneficial, safe and effective.
You will find lots of articles by Amanda about caring for your body before and after delivery on her information site www.propelvic.com
Please do contact us by phone or email if you would like to discuss your personal situation further.