Pelvic Girdle Pain

Written by Cierra File-Murby

It’s really common to confuse pelvic girdle pain (PGP) with low back pain because of the close proximity of where you are feeling the pain. If you’re experiencing pain anywhere from the two bony bits just above your glutes down to the bottom of your glutes or around to the front of your pelvis, then you’re likely experiencing PGP.

Pelvic girdle pain is very common and can affect up to 45% of all pregnant women at some stage throughout the pregnancy. It is also common to experience residual pelvic girdle pain even after you have delivered your baby.

What are the symptoms of PGP?

PGP can be mild too severe but is treatable at any stage in pregnancy and the sooner it is treated, the more likely you are to feel better. It is more common later in pregnancy.

Symptoms include:

• pain in the pubic region, lower back, hips, groin, thighs or knees

• clicking or grinding in the pelvic area

• pain made worse by movement, for example:

1. walking on uneven surfaces/rough ground or for long distances

2. moving your knees apart, like getting in and out of the car

3. standing on one leg, like climbing the stairs, dressing or getting in or out of the bath

4. rolling over in bed

5. during sexual intercourse.

The reason a lot of women experience pain is because of the hormone ‘relaxin’ that your body produces when you’re pregnant. This hormone makes the ligaments in your body looser in preparation for birth. This change may cause a small increase in the range of motion within the joints of your pelvis. As you can imagine, the pelvis is responsible for carrying the load of the baby, if this increase in motion is not met with an increase in the muscle control, it’s likely that this can cause some pain.

Is there anything I can do to help manage the symptoms at home?

The following simple measures may help:

• keeping active but also getting plenty of rest

• standing tall with your bump and bottom tucked in a little

• changing your position frequently – try not to sit for more than 30 minutes at a time

• sitting to get dressed and undressed

• putting equal weight on each leg when you stand

• trying to keep your legs together when getting in and out of the car

• lying on the less painful side while sleeping

• keeping your knees together when turning over in bed

• using a pillow under your bump and between your legs for extra support in bed.

You should avoid anything that may make your symptoms worse, such as:

• lifting anything heavy, for example, heavy shopping

• going up and down the stairs too often

• stooping, bending or twisting to lift or carry a toddler or baby on one hip

• sitting on the floor, sitting twisted, or sitting or standing for long periods

• standing on one leg or crossing your legs.

If that doesn’t help or you want immediate relief see a physio!

While 100% of your PGP during pregnancy may not completely go away, physiotherapy can make a big impact in making you a lot more comfortable. Its really important to get an assessment from a physio, as there could be a few different potential factors causing your PGP.

In some cases, a compression belt around your pelvis can help to provide that additional support. In other cases, some therapy techniques to help reduce some muscle spasm could also reduce a lot of pain. If you are experiencing any sort of PGP or have any questions please give us a call on 03 9913 8986 or book an initial physiotherapy appointment online with Kath, Cierra or Dawn here

Spinal Health Week: Why am I getting back pain?

Our team of physios in Richmond are seeing an increase in back pain presentations since the COVID lockdown!

Spinal Health Week raises awareness for the importance of spinal health, which can have a huge impact on improving our overall health and wellbeing. At some point in your life it’s likely you will experience back pain.

Let’s talk about the Spine

An interconnected system of bones, nerves, muscles, tendons and ligaments – your spine is central in how the body operates. With 31 segments, your head at the top, your pelvis at the bottom, the spine is immensely pivotal in normal human functioning. It is involved in everything we do! This week is Spinal Health week and we would like to share with you what we are currently seeing in our clinic and how we can best help you to optimise the functioning of your spine and in turn help to improve your overall health!

The spine continues to be a major cause of grief for individuals. The Australian Institute of Health and Welfare reports the following:

• Over 4 million people reported significant back problems in 2017-2018
• Back problems are the 2nd leading cause of disease burden in Australia
• 86% of the population will experience pain at least once per week.

During this unprecedented time of COVID, self isolation and social distancing, we have seen varied presentations of spinal pain.

These include:

• postural related injuries

• osteoarthritis flare-ups,

• disc degeneration,

• neural compromise

• and many more…

What can cause back pain?

There are so many factors that contribute to these presentations. Age, physical fitness, weight, type of work are a short list of things that can influence an individual’s spinal pain. What we see clinically is that most people who present with spine-related pain have a significant inability to function. Whether it is getting a good night sleep, applying themselves to work or study, exercising or simply doing daily chores, spinal related problems have a significant effect on our day to day lives.

A little insider tip for you – your spine is a robust structure of your body. If you really think about it, if it is involved in everything we do then surely it is built to withstand quite a bit of stress. The key is figuring out what we need to do to build this robustness. To put it simply we may need to work on one (or a combination of the following):

• How can we get you managing your pain better so your day to day activities are not severely affected?
• Can we get you moving better so you can actually do the things you want to do?
• Do you have enough strength and stability in key muscles and joints so that your movements are optimal and not placing too much strain on your spine.

Whether it is one on one physiotherapy, group rehab sessions incorporating clinical pilates or strength and conditioning principles, we are here to support your overall spinal health and ensure you can continue to function to the best of your ability. If you are experiencing back pain and you think it’s your spine, book in to see one of our team members here

KP is the Head Physio at Harlequins Rugby Club, Scotch College Rugby and the Physiotherapist for the Melbourne Rebels Under 18’s.

KP treats a wide range of conditions and is incredibly passionate about helping people understand why they are experiencing pain and how to overcome it.

KP has a special interest in tendon conditions.

In his spare time KP enjoys coaching basketball!

COVID Running got your knees aching?

COMMON CAUSES OF KNEE PAIN

RUNNERS KNEE

Where it hurts? Pain under your kneecap, feels worse after running and when you go up/downstairs

Why? Occurs when the patella (kneecap) undergoes significant stresses that are beyond its capacity to tolerate

How do I treat it? Reduce running, stretch glutes, foam roll quads (DONT stretch quads- this will increase the compression of the patella on the femur) and TFL (pocket muscle), shorten stride length/ increase cadence

Prevent it! Strength train, foam roll regularly, shorten your stride

PATELLAR TENDINOPATHY

Where it hurts? Pain below your kneecap and at the top of your shin, will hurt going up and down stairs and pain will increase when running.

Why? The patellar tendon may have too much force going through it, in a short amount of time, compared to what it is able to absorb

How do I treat it? Reduce running, a physio may recommend a patellar strap or alternative measure to offload the tendon, load management is key!

Prevent it! Strengthen key muscles around the knee, stretch your quads & hamstrings, foam roll, manage your running loads to within the tendon’s capacity to tolerate load

IIiotibial band sydrome

Where it hurts? The pain will be on the outside of the knee (location where physio Bryan speaks about in the video), will come on quickly and subsides when you finish running.

Why? The ITB runs from your hip to your knee, a fluid filled sac called a bursa sits between the ITB and the outside of your femur. When the ITB compresses this bursa, it causes pain.

How do I treat it? Reduce your KM’s, foam roll your glutes and TFL (NOT the ITB itself), consider if your shoes are right for you.

Prevent it! Strong glute and core muscles are the key, so a strength program will help. Foam roll glutes, quads and TFL and shortening your stride may reduce forces at the knee.

If you would like one of our experienced physiotherapists to diagnose your knee pain and provide the correct advice and strengthening exercises make an appointment now.