It has been too long since I last did a blog post, but one (of the many…) resolutions for 2019 (how can that be in just a few weeks?!) is to blog and film more consistently, so this is the start of (another) new me…
After the launch of our new Pregnancy Wellness course in November, I got some excellent questions on Facebook about why do we call them Hypertonic pelvic floors and also some insightful questions about the potential minefield of misinformation that is known as Pregnancy Related Pelvic Girdle Pain. In order to avoid writing a 500 word essay on my phone, I decided to record a short video, which hopefully will be helpful but here are some of the key points:
- THE PELVIS IS NOT UNSTABLE!!! IT CAN’T GO OUT OF PLACE!!! Sorry for the shouty caps but I do feel quite strongly about this! Unless you have experience major physical trauma, like a car crash, your pelvis is very stable. It can however become sensitised during pregnancy, and this sensitisation can be exacerbated by stress, poor sleep, poor nutrition, overactive pelvic floor muscles and overactive transverse muscles and of course by clinicians telling women that their pelvis is unstable (don’t do this)
- Professor Sinead Dufour writes about this wonderfully well in her article ‘Pregnancy-related Pelvic Girdle Pain: Embrace the Evidence and Move beyond Biomechanics’ (2018): she writes: …The cause of pregnancy related pelvic girdle pain is complex and multifactorial. Evidence has shown an alteration in motor control in pregnant women, and more recently central pain mechanisms have been considered and implicated.
- I’m a big fan of Gregory Lehman’s work – to paraphrase, we want to calm things down (using non nociceptive manual therapy for graded exposure and return to confident movement, stress management eg mindfulness, ergonomic strategies to avoid irritating sensitised structures eg avoiding one legged standing for dressing, good sleep hygiene (esp during the last months of pregnancy – using ALL the pillows to get into a comfortable position, bed mobility and transfers) as well as good nutrition and good gut health) Then we move on to build things up – getting good glute and upper body strength to deal with increased weight and changing centre of gravity – essentially we need to calm down the brain and nervous system and build confidence in movement – RESILIENCE!!
You can watch the full interview I did with Dr Dufour in our Pregnancy Wellness course and if you enroll before the end of December, you also get lifetime access to Jenny’s ah-mazing Pelvic Flow and Freedom course (fabulous for overactive pelvic floors ) and my Perinatal Athlete, which is a module from my new Female Athlete course, looking at the effects of menstruation on exercise, RED-S and fertility, Exercise during Pregnancy and Return to Sport/Exercise postnatally…but these bonuses are only available if you purchase the course by December 31st (you’ll have lifetime access to them of course!)
Other references I mentioned in the video:
‘The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study’ Mens et al 2017
‘Vaginismus, a Component of a General Defensive Reaction. An Investigation of Pelvic Floor Muscle Activity during Exposure to Emotion-Inducing Film Excerpts in Women with and without Vaginismus’ Van der Velde et al 2001
Until next time,
Onwards and Upwards!