Pregnancy and Osteopathy

Pelvic instability is a term that refers to multiple types of pelvic pain during pregnancy. Really what you can expect pelvic instability to mean is that you are having pain somewhere within the joints of your pelvis. One of the main reasons we get this pain in the pelvis when pregnant or in the post-partum period is our body is dealing with a host of postural changes and hormones that affect our joints. We have a hormone that is released during pregnancy that’s called relaxin. This affects the ligaments of the pelvis helping prepare the body for a growing baby and giving birth. Our ligaments are strong connective tissues that keep our joints stable, so you can imagine that as these ligaments soften in reaction to relaxin this is going to change the load on our joints and surrounding muscles. This change can cause pain in some pregnant patients.  

One of the joints affected by pelvic instability is the pubic joint, which sits right at the front of your pelvis. This pain can be local or sometimes it travels into the groin or thigh. Some people find that the pain within this joint during pregnancy can be so severe that even simple tasks like walking, going up stairs, or putting on a pair of pants can become difficult. Osteopaths treat pregnancy-related pubic pain by looking at how the rest of your pelvis and spine are functioning. We use manual therapy to encourage quality movement and can help you with exercises to strengthen muscles and keep joints moving well.

The sacroiliac joint is another joint in the pelvis that can be affected when you have pelvic instability. This joint is at the back of your pelvic between your pelvic bones and the sacrum which you may know as a part of your tail bone, the big flat part up the top. When you have pain here it can also refer into other areas on the body, you might find it extends into your glutes, or that you get groin or thigh pain too. The things that can make your pain worse are like pubic pain. You might find yourself sore when standing on one leg, getting in and out of the car, rolling over in bed, or simply putting on a pair or pants. Our goal with osteopathic care is much the same too, we look at how well the joints and muscles of the pelvis, spine and legs are working, then we use manual therapy to address the quality of movement and exercises to complement that.

When it comes to pain in the glutes, it can be a range of things – sometimes the pain might actually be coming from the muscles in the hip region, but other times its what we called referred pain. Referred pain means that while you may be feeling pain somewhere the actual problem is somewhere else. A super easy example of referred pain to remember is that left shoulder and arm pain can mean a heart problem.

So, if it’s not actually coming from the glutes where could the pain be coming from? Well like we just talked about. One of the places it could be coming from is the sacroiliac joint. This isn’t the only area you pain might be coming from though. If we travel a little higher into our low back we might also find that this causing your glute pain. When it comes down to figuring out why you’re in pain, osteopaths will assess the region itself – in this case to see if your glutes really are the problem. BUT they’ll also make sure to assess the other regions of your body that might be causing your pain. This way we get the best idea of what is going on for you as an individual. Then we can start managing your pain in the best way for what YOU have going on.

In the same way that relaxin can affect your ligaments and muscles in the pelvis, it can have a whole-body effect. One of the common ways we see this during pregnancy is with acid reflux, or GORD which stands for gastro-oesophageal reflux disorder. There is a muscle that contracts and hold everything in our stomach. The hormones that are released to soften the pelvic ligaments and muscles can also influence this muscle. So, what happens then is the contents on your stomach can come back up into your oesophagus, this is when we get a burning sensation in the chest and throat – also known as heartburn.

Osteopaths can treat you when you have symptoms of reflux, one of the things we take into consideration is how well your surrounding muscles are functioning. Another aspect we look at is the nerve supply to the stomach. The nerves come from a particular part in your thoracic spine (the mid-back). We work to make sure this is functioning as well as possible giving the body a chance to settle. Osteopaths can also offer some advice on what you can do at home to make dealing with your heartburn a little more manageable!

Not all pain in pregnancy is due to hormones, now don’t get us wrong – it can definitely have an impact on back pain as well during pregnancy BUT there’s more to it than just that. As you grow bub, your body must adjust to a new load. As your center of gravity shifts, what we see happen is the curves in your spine change, the low back curve becomes more pronounced especially in those later stages of pregnancy. As this happens it’s going to put some muscles into a stretched position, and some in a more contracted position, this can lead to discomfort and muscle tightness over time as well as some joint pain as certain structures are compressed more than usual. An osteopath can help to address the muscles that are tightened and tense, as well as treat the joints that can become stiff and compressed. Our goal is always to keep you moving as freely as possible throughout your pregnancy so that you can spend more time preparing for bub rather than worrying about back pain!

Sciatica is something you may have heard of before. It’s not a condition that is exclusive to pregnancy, but this is one of the times we can see it crop up. Just like what we talked about above, when our body is adjusting to the growth of bub and preparing for birth, we see the structures change and in response some joints can become compressed, and some muscles can become tight. This may lead to what we call sciatica. Which essentially refers to the compression of the sciatic nerve leading to pain that radiates down the leg into the knee. Just like with back pain, an osteopath can help identify what muscles and joints aren’t functioning as well as they could be and help stretch tight muscles and improve the joints movements. This can reduce the pressure on the sciatic nerve and help ease the pain.

In the same fashion and back pain and pelvic pain, the hormone relaxin can also play a role in your rib pain! As the joints and muscles loosen there’s added stress, and this can cause discomfort. The other thing to remember is that some hormones released during pregnancy can also influence your heart and breathing, which can lead to the feeling of shortness of breath.

Don’t forget that outside of the hormones during pregnancy, you’re also growing a person! That takes up space in your abdomen. The bigger bub grows the less space there is for your other organs. Bub can end up pressing against the diaphragm the biggest muscle we use in breathing. This can make it feel like it’s hard to take a full breath as there’s less space for the muscle and your lungs to expand. Bub can also press into your ribs – not just when they’re kicking either. This added stress can lead to your rib pain and discomfort.

As the uterus grows and expands, the ligaments that support the uterus have to lengthen with it to continue giving support. The ligament we’re talking about here is the round ligament.

The round ligament has to cope with some very significant changes that are happening very quickly. Because of this, it can be prone to irritation. The round ligament can spasm, and it can cause pain in a few areas, one being the ribs! While it might actually be the ribs, the location at the top area of your uterus can make it feel like it’s coming from your ribs. We can also get pain in and along the hips or down toward the pubic bone.

Why you should check in with your health professional

Rib pain might not seem like a big deal, but it’s definitely something worth getting checked by your health professional. The number one reason being that you shouldn’t have to put up with pain if there are ways to manage it, and the other we want to make sure nothing else more serious is going on!

Some of the conditions and area of the body that can cause or refer pain to the ribs or shortness of breath include:

• Preeclampsia
• Heart issues
• Lung issues
• Liver problems
• Gallstones

Mastitis is a post-partum problem right?

Unfortunately, not always!

During pregnancy, your body is preparing for your new baby, not only is it changing and adapting while your bub grows it changes to prepare for when they arrive too. This means throughout your pregnancy your breast tissue is adjusting and changing, your milk ducts are maturing in line with what your bub needs.

During this process, just like when you’re actually breastfeeding the ducts can become blocked. This can result in a pink or red, painful and tender lump in the breast. Usually this will resolve in a few days time but it can progress to mastitis if it’s not dealt with. You can read more about mastitis HERE.

Don’t forget when you do find a breast lump, it’s always best to book in with your health professional. They can assess the lump and help you figure out what is going on!