Dealing with pre and postnatal Symphysis Pubis Dysfunction (SPD) and Pelvic Girdle Pain (PGP)

Pregnancy can be expensive.

Yes your maternity care is free under the Maternity and Infant Scheme and the prenatal vitamins don’t cost too much. You’ve got 9 months to save up for the baby and work out a budget for when the little bean arrives, but one thing we neglect to include in that budget is our pre natal and post natal well being.

Of course, every pregnancy is different, many women sail through. But one in four women suffer from Symphysis Pubis Dysfunction, Pelvic Girdle Pain or both.

I’ve always suffered with my back and saw my osteopath regularly as well as practiced Pilates to manage my scoliosis and back pain. I knew that I’d most likely suffer to some extent if I ever got pregnant, but I’d never heard of SPD or PGP.
As soon as I reached 12 weeks in my pregnancy, and the relaxin hormone kicked in, I started experiencing problems in my hips, back and my pelvic floor.
It was recommended that I see a Chartered Physiotherapist who specialises in Women’s Health Physiotherapy.
From the get go Laura from Live Well was great.
After my initial assessment I learned how to adjust my stance (I locked my knees when I was standing, this put strain on my back which contributed to the pain in my lower back, hips and knees) and how to use all of my foot when I walked (Yes I learned how to walk, properly)
I also learned how to engage my core and to exercise my pelvic floor the right way (You’d be surprised just how wrong I was doing it)

After a couple of months of Pre Natal Pilates Classes, Physiotherapy, daily stretches and massage as well as regular visits to my Osteopath, I was able to walk better towards the end of my pregnancy, than I could at 12 weeks, I found that alternating between Physio and Osteopathy worked great for me. It was worth every penny. But it did stretch us a bit thin and surviving on one income at the time wasn’t easy. We had to dip into baby fund a few times.

In this post I’m going to give you advice on how you can look after yourself, no matter what your budget or time constraints are, and provide links to some great websites full of information.

**Make sure you get your medical professional or midwife’s go ahead before attempting any types of exercise or stretching during pregnancy and before your 6 week post natal check-up.**

SPD and PGP, what are they?

SPD:
Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction (SPD) is a condition that causes excessive movement of the pubic symphysis (See diagram above) as well as associated pain, possibly because of a misalignment of the pelvis. -Wikipedia

PGP:
Pelvic Girdle Pain

Pregnancy related pelvic girdle pain (abbreviated PGP) causes pain, instability and limitation of mobility and functioning in any of the three pelvic joints- The two Sacroiliac Joints and the Pubic Symphysis. – Wikipedia

What causes SPD and PGP?

During pregnancy the hormone relaxin is produced. This causes the ligaments in the pelvic region to relax and stretch in preparation for labour.
Unfortunately there’s no magical cure for the pain, but there are ways that you can manage it.

It’s important to know that the vast majority of women suffering from SPD and PGP will recover fully, more or less straight after the birth, but for some it can take months, even up to a year for the pain to subside.

1. I recommend that you go and get a one on one assessment by a chartered physiotherapist who specialises in Women’s health. Be it private or public, the assessment will enable you to know what’s causing the pain and your physiotherapist can advise you on different ways that you can relieve it..

2. Buy a support pillow for sleeping, there’s so many option out there. I’ve heard great things about the Dreamgenii pregnancy pillow but they can retail anywhere from €60-80 depending on where you buy it.
Alternatively you can buy a triangular pillow, the midwife at my antenatal class recommended them. They’re way more affordable that the Dreamgenii and work just as well. I picked mine up in Guineys.
Whichever one you go for, make sure to pick up a spare pillow case.

3. You may need a support belt which helps to support your bump by taking a bit of the weight off of your hips and helping to support your back at the same time, some of them can even be used post pregnancy. The downside is that they can be quite expensive and they don’t work for everyone, so enquire about trying one before you invest. You can get one free from the public physio or your private physio will give you one to try before you consider buying one. If it works for you then it’s definitely something worth investing in, it can be a long 9 (10) months and chances are you’ll use it for subsequent pregnancies and in your post natal recovery.

4. Maternity Briefs/Shaping Underwear
Having the right support during and after pregnancy can help greatly. Maternity briefs are so comfortable (Albeit not the most flattering) You can pick them up in penneys or alternatively Here and Here. They help to support your bump and relieve back pain.
Regular shaping underwear and vests will help to support your abdominal and pelvic floor muscles weakened after pregnancy, the compression helps to shrink your uterus and speed up recovery and they can also offer great support and comfort if you’ve had a cesarean section. You can pick them up, again, in Penneys, here or here

5. Pre-Natal Pilates or Yoga?
Pilates is more about strengthening your core (abdominal muscles) and increasing the stability of your back and pelvic floor. All really important during pregnancy.
Yoga helps to keep you flexible and relaxed (the stretches and pulls can help loosen all the tight muscles that come from carrying a tiny human) it can also help to fight fatigue and nausea! Get advice from your doctor or Physio on which one would be better for you. But remember, there’s no law that says you can’t do both.
Shop around for different classes in your area and find a time and price that suits you, whether it’s a morning or evening class, most pre and post natal classes run for blocks of 6-8 weeks. Some classes you have to pre-pay for, but there are loads of instructors who run pay per class sessions too, if work and other commitments mean you don’t have a lot of free time.

6. Download an app! There are countless apps out there that specialise in wellbeing and most of them are free. It’s a cost effective way of looking after yourself during and after pregnancy.
One of the most useful ones I downloaded was the Pregnancy Pelvic Floor Plan App from Continence Foundation of Australia
You can read tips on looking after your pelvic floor, bladder and bowel during and after pregnancy. You can also learn how to do pelvic floor exercises and schedule reminders (Super helpful, because baby brain is indeed a thing) and the information in the app is divided into key pregnancy milestones, so the info you receive is tailored to whatever stage of pregnancy you’re in.

7. The Contincence Foundation of Australia also have a 36 page guide on pregnancy. It’s a great booklet full of invaluable information and covers a range of topics including abdominal muscle bracing, sex before and after, pelvic floor, prolapse etc. you can read it here.

8. Youtube it!
There are countless workouts/self help videos on youtube. One that I found particularly helpful were these four videos from Gary Crowley on relieving Pelvic Girdle Pain.

9. Babycentre.co.uk is a great site and their app to track your pregnancy and your babies development is fantastic. Here’s a post on Pelvic Girdle Pain.

**Again make sure you get the go ahead from your physiotherapist or doctor before attempting any exercises.**

If you’re in pain don’t ignore it, there are ways that you can get help without breaking the bank. Knowing where to start can be a bit daunting, but hopefully this list and the links will help.

Did you suffer from SPD or PGP? How did you manage it during and after your pregnancy? Feel free to comment below

A x