The best thing you can do is rest and listen to your body.

Please also remember that there is A LOT of healing going on that you won’t be able to see for the first 6/8 weeks. The wound in your uterus will be healing from where the placenta was attached and your uterus will be slowly shrinking back down to its original size – amazing! Your pelvic floor has been supporting the extra weight of the uterus for 12 months and will need lots of attention and love.

0-3 weeks postnatal

– REST, REST, REST!!

– Gentle pelvic floor exercises, at this point it may just feel as if you are trying to connect back in with them. Only do them about 3/10 in strength.

– Gentle, short walks.

3-8 weeks postnatal

– It is recommended that you wait until your 6 week check before starting a group postnatal exercise programme (8 weeks for abdominal births).

– Walking

– Swimming (once bleeding has stopped)

– Pelvic floor exercises

8-12 weeks postnatal

– Following the guidelines for 3-8 weeks but gradually increasing your intensity and weights.

12-16 weeks postnatal

– Consider visiting a physiotherapist for a postnatal abdominal muscle check and pelvic floor muscle testing before returning to high-impact exercise, running or abdominal exercising programs.

– If you experience any heaviness in the pelvic floor or backache after exercising then take a one or two week break and focus on pelvic floor exercises.After 16 weeks postnatal

– You can return to previous activity levels provided your pelvic floor muscles have returned to normal and you are not experiencing any back pain, vaginal heaviness or urine loss after or during exercise. Seek further advice from a health professional is symptoms persist.

The post Returning to Exercise – The Guidelines appeared first on Bloom Yoga Bristol.

The term Pelvic Girdle Pain (PGP) is used to describe pain experienced in the front and back of your pelvis. You may have previously heard the term Symphysis Pubis Dysfunction (SPD) used; however, PGP is now the accepted name for this condition. 

What is PGP? 

PGP describes pain in the joints that make up your Pelvic Girdle; this includes the Symphysis Pubis Joint (SPJ) at the front and/or the Sacroiliac Joints (SIJ) at the back. 

The discomfort is often felt over the pubic bone at the front, below your tummy, or across one side of your lower back, or both sides. 

You may also have: 

• Difficulty walking 

• Pain when standing on one leg (e.g. climbing stairs, dressing, or getting in or out of the bath) 
• Pain and/or difficulty moving your legs apart (e.g. getting in or out of the car) 
• Clicking or grinding in the pelvic area – you may hear or feel this 
• Limited or painful hip movements (e.g. turning over in bed) 
• Difficulty lying in some positions (e.g. on your back or side) 

• Pain during normal activities of daily life 
• Pain and difficulty during sexual intercourse 

With PGP, the degree of discomfort you are feeling may vary from being intermittent and irritating to being very wearing and disabling. 

What causes PGP? 

Sometimes there is no obvious explanation for the cause of PGP. Usually, there is a combination of factors causing PGP including:  

• The pelvic girdle joints moving unevenly  

• A change in the activity of the muscles of your tummy, pelvic girdle, hip and pelvic floor, which can lead to the pelvic girdle becoming less stable and therefore painful 
• A previous fall or accident that has damaged your pelvis  
• A small number of women may have pain in the pelvic joints caused by hormones  
• Trauma 
• Occasionally, the position of the baby may produce symptoms related to PGP. 

General Advice 

If you experience any of the above symptoms you should speak with your midwife, GP or physiotherapist. 

You should: 

• Use a rucksack, rather than a handbag for symmetry and ease of movement.  

• Sit down to get dressed and undressed; avoid standing on one leg 
• Try to keep your knees together when getting in and out of the car 
• Place a pillow between your knees when sleeping on your side, and when turning over, keep your knees together as much as possible 
• Practice pelvic floor exercises regularly 
• Move from sitting to standing symmetrically  

• Take the stairs one at a time (lead with your less painful leg when going upstairs, and downstairs, lead with the more painful leg) 
• Keep feet no wider that hip width apart. 

Where possible, avoid activities that make the pain worse, which may include: 

• Standing on one leg 

• Bending and twisting to lift, or carrying a toddler or baby on one hip 
• Crossing your legs 
• Sitting on the floor 
• Sitting twisted 
• Sitting or standing or long periods 

• Lifting heavy weights (e.g. shopping bags, wet washing, vacuum cleaners and toddlers) 
• Vacuuming 
• Pushing heavy objects like supermarket trolleys 
• Shuffling things across the floor with the side of the foot 
• Slow down and don’t walk so far  

• Avoid breaststroke if swimming. 

This is not an exhaustive list. 

Treatment

The good news is that, because PGP is a mechanical joint problem rather than a hormonal problem, it can usually be treated effectively by ‘hands-on’ manual therapy from an experienced physiotherapist, osteopath or chiropractor.

PGP is treatable at any stage of pregnancy, or after your baby is born as soon as you feel able to visit a manual therapist. The therapist gently uses their hands to release stiff or ‘stuck’ pelvic joints and relieve painful muscles, restoring normal movement to your pelvis and reducing your pain.

Exercises, mobility aids and pain-relieving medication can help you to manage some of the symptoms of PGP but they do not address the underlying cause of your pain, your pelvic joint dysfunction. Often, a high degree of pain prevents muscles from working properly so, regardless of how much you exercise, your muscles are unlikely to function correctly. However, once your pelvic joints and muscles are treated with manual therapy and move more freely (normally), you should experience less pain. Exercises are important to help to strengthen the muscles supporting your pelvis, and mobility aids and pain relief can help to manage symptoms between treatments.

A support belt can be used for walking and sitting throughout the day, to support the pelvis and help reduce any pain. This is usually only beneficial once the pelvis has been realigned. 

Safe Poses in Yoga 

• Practice pelvic floor exercises regularly to strengthen the structure from the inside out. Whilst doing this you can use props and the wall to lean against for more support in sitting (not in easy pose, better in kneeling, legs straight, janu legs or mermaid) 
• The mermaid sequence is particularly effective for stabalising this area and bringing it into alignment usually. If uncomfortable it can be easier to do on a chair or ball. Can combine this with pelvic floor exercises 
• Pelvic tilts and circles can ease pain whilst improving alignment and building strength and stability – these can be done in all fours or sitting 
• Sitting on a birth ball and slowly inhale and lift one foot off the floor and holding it and exhaling down, alternating feet. This is very strengthening 

• Ensure transition to floor or standing with knees touching at the same time to support the pelvis evenly 
• Janu-Legs sequence  – with pillow under bent knee and focus on pelvic floor strengthening and breathing 
• Cat pose. 

Yoga Poses to Avoid

• No easy pose (better in kneeling, legs straight, janu legs or mermaid) 
• No butterfly pose 
• No sitting cross legged 
• No wide legged sitting – keep legs hip width, pillow under knees 
• No standing on one leg (no balance poses) 

• No deep squatting – only one down one or two inches 
• No super mama pose. 

Local Contacts 

Helen Foster 

Helen has a special interest in treating women with pregnancy related back and pelvic pain and has completed research investigating the effectiveness of treatment for this group of patients. 

References 

https://pogp.csp.org.uk/system/files/publication_files/POGP-PGP%28Pat%29%28UL%29.pdf

http://www.eastcheshire.nhs.uk/…/Carpel%20Tunnel%20Syndrome… 

https://pelvicpartnership.org.uk/treatment/

The post Symphysis Pubis Dysfunction (SPD) / Pelvic Girdle Pain (PGP) appeared first on Bloom Yoga Bristol.