The Pelvis
The adult pelvic girdle (also called the hip girdle) is composed of 2 hips bones and 3 joints; the pubic symphysis connects the front, and the sacroiliac joints (where the bones attach to either side of the sacrum) connect the back. Where these bones meet allows for movement to occur. The bones are held together and infulenced by many ligaments and muscles. All together the pelvic girdle functions to support the spine, but it also serves to protect organs such as those of reproduction and the urinary bladder. For the pregnant woman, it also protects the developing unborn fetus.
Pelivic & Low Back Pain in Women
Differences exist between the pelvis of men and women. The male pelvis is physically larger and more narrow while the female pelvis is more delicate and has a wider space between the hip bones. The purpose of this is to allow for pregnancy and the delivery of children.
Hormones also influence the female pelvis. Stability of the pelvis and lumbar spine occurs from the passive stiffness of ligamentous structures and the active stiffness of muscles. During pregnancy, hormonal changes alter the inherent stiffness of the ligaments making them more lax or loose. This allows the body to prepare for the birthing process by permitting greater mobility. However, this means that the muscles of the pelvis become even more important in stabilizing the spine and the pelvis. If weak, the woman may develop lower back pain (LBP).
The muscles of the pelvis are referred to as the "core." They form an internal muscular corset that works together to stabilize the spine and pelvis. You may visualize this as a box: the abdominals in the front, the spinal muscles in the back, the diaphragm as the ceiling, and the pelvic floor as the bottom.
Physical Therapy Can Help
A physical therapist can show you how to correctly contract and strengthen the core muscles. This may ultimately help to reduce and alleviate LBP during and after pregnancy by directly influencing the following factors:
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Hormonal changes (ligaments become loose)
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Increased weight gain
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Postural changes (influences the entire spine)
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Altered movement patterns
Research now suggests that women who have stronger core muscles may also experience an easier birthing process and recovery from pregnancy.
Getting Results
With permission from your physician, a physical therapist will evaluate your condition and tailor a treatment intervention appropriate to you. At New Horizons Physical Therapy this may include:
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Preparing the core muscles and/or resolving pregnancy muscular imbalances
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Designing an excercise program that incorporates safe aerobic fitness, flexibility, and strengthing for your stage of pregnancy
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Education for posture and body mechanics
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Identifying factors that contribute to your pain with safe corrective measures
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Fitting you with equipment such as a back support if needed for later stages of pregnancy
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Assessing and correctively assisting pelvic alignment and the influences upon the sacroiliac (SI) joint
Our physical therapists follow the American College of Obstetrics and Gynecology guidelines for exercise during and after pregancy. They are trained in exercise and musculoskeletal problems and are knowledgable in these specific needs of the obstetrical patient.
