Pelvic pain in pregnancy. A functional perspective!
This blog post is all about my wife and our upcoming baby due in September.It has been very interesting to observe my wife’s change in movement over the course of her pregnancy.
She has suffered from some pelvic pain recently, something that many women suffer from in pregnancy. It has been very obvious why, when we look at the biomechanics from a functional perspective. As we should all be aware by now our pelvises move in all three planes. As the baby house as I like to call it grows, it may rotate the pelvis to the anterior as it has done in my wife’s case. It should be noted however that some women might rotate the pelvis to the posterior due to the changes in centre of mass and the law of individuality.
The anterior rotation of the pelvis will reduce the amount of extension that can be gained in the sagittal plane. The lack of sagittal plane motion will also reduce the amount of transverse plane motion available as well. The reduced stride length in the sagittal plane will reduce the amount the pelvis can rotate over the femur. This leaves us with the frontal plane as the least compromised plane of movement. However what if the woman is not all that great moving in the frontal plane?? That maybe where problems start! I think that my wife’s problem maybe compounded by my sons love of hanging out on the left side of the womb. It is very obvious as she stands that she displaces her weight onto the right hip, maybe to act as a counterbalance for the weight of the baby on the left side. This would tighten the right hip capsule in the frontal plane. With it already limited in the sagittal and the transverse I think this spells trouble. She has complained of pain on the lateral left hip. With the right hip adducted, the adductors and medial capsular ligament will limit abduction on the right hip and therefore adduction, both rotation and translation, on the left. This will not allow the lateral abductors on the left to lengthen and may become irritated as I believe is happening. It may also compromise the SI joints on both sides and also the lumbar facet joints. Both structures rely on compression and decompression in all three planes for healthy pain free operation.
My solution to this problem has been to hit the anterior capsule on the right side. I would dearly love to hit the posterior capsule on the left but due to her size at 6 ½ months that is proving problematic. I have then followed this up with a more dynamic strategy to restore extension/rotation/abduction on the right and adduction on the left. It seems to have made a world of difference so far but she needs to perform the stretches quite regularly to stay pain free. The movement dysfunction will not go away until late September when the baby house, fingers crossed, turns into a beautiful bouncing baby boy!!!