Written by Helen Lo, Physiotherapist

What is it Related Pelvic Girdle Pain? 

Pregnancy-related pelvic girdle pain is a specific category of pelvic pain that impacts women during pregnancy. 

It is characterized by pain in the lower back, hips, and/or pubic area that can be exacerbated by certain activities such as walking, climbing stairs, or even just standing for long periods of time. PGP can have a significant impact on quality of life.

The cause of this pain is multi-factorial and is often influenced by biopsychosocial factors. This is essentially the fancy name for any pelvic, hip, and/or low back pain during pregnancy!

How Common is This?

It is reported that between 25-65% of women experience pelvic girdle pain during pregnancy! It is most common for this pain to develop during weeks 14-30 of gestation. 

Risk factors for developing PRPGP

There are a  wide range of risk factors for PRPGP, including:

– Previous pregnancy
– Previous history of low back pain
– Increased BMI
– Smoking
– Work dissatisfaction
– Previous trauma
– A lack of belief of improvement

A Change in Perspective

Previously, the messaging delivered was that the hormones released during pregnancy caused widespread relaxation of our ligaments leading to instability of our joints and thus causing pain. 

Research now is showing that the hormones don’t cause widespread instability and instead increase the sensitivity of our tissues causing the sensation of pain. It is important to understand that pain is an experience, differs from person to person, and can occur in the absence of any structural tissue changes. 

How Can Pelvic Floor Physiotherapy Help?

Although common, we don’t want pelvic girdle pain to dictate your pregnancy and slow you down in any way. 

Pelvic floor physiotherapy is an approach to treatment that can target some of the root causes of this pain and help facilitate an action plan to make you feel better.

Pelvic floor physical therapy (PGP) is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. 

It can be used to treat a variety of conditions, including urinary and fecal incontinence, pelvic organ prolapse, chronic pelvic pain, sexual dysfunction, and postpartum rehabilitation.

Physiotherapy treatment could include:

1. Manual therapy including joint mobilization and/or soft tissue release both internally and externally
2. Introducing pain free movement
3. Taping for the low back or belly for increased support
4. Support belts

Consider Trying This: 

The Fitsplint 

This product is a great way to help relieve lower back pain, pelvic pain, or bladder pressure. It is lightweight, breathable, and can be used during exercise! You can find the fitsplint at any Peak Health location and a therapist would be more than happy to help fit you for the correct size. 

Don’t Let Pain During Pregnancy Stop You! 

Pain is one of the most common symptoms reported during pregnancy but it doesn’t have to be. With the help of a pelvic floor physiotherapist, you can learn many strategies to help reduce your pain and remain active throughout your pregnancy. Book your discovery call today to learn more about how Peak Health physiotherapy in Calgary can help. 

Resources

1. Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: Physical therapy clinical practice guidelines linked to the International Classification of functioning, disability, and health from the section on Women’s health and the orthopaedic section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102–125. https://doi.org/10.1097/jwh.0000000000000081
2. https://www.recorefitness.com/maternity-fitsplint

Written by Helen Lo, Physiotherapist

For anyone out there wondering if it is safe to exercise during pregnancy, let me be the first to tell you YES, and it’s encouraged! 

Traditionally, medical advice during pregnancy included reducing exertion and avoiding strength training out of fear of causing potential harm to the baby and injury to Mom. 

New research1,2 has proved the complete opposite; showing that there are actually a wide range of benefits to exercising during pregnancy including:

1. Improved aerobic and muscular fitness
2. Promotion of appropriate maternal weight gain
3. Facilitating labour
4. Preventing gestational glucose intolerance
5. Preventing pregnancy-induced hypertension

In fact, not exercising during pregnancy has been associated with risk of:

1. Loss of muscular and cardiovascular fitness
2. Excessive maternal weight gain
3. Increased risk of gestational diabetes
4. Increased risk of pregnancy-induced hypertension
5. Pelvic floor dysfunction
6. Varicose veins
7. Deep vein thrombosis
8. Higher incidences of low back pain
9. Poor psychological adjustment to the physical changes of pregnancy

Guidelines for Physical Activity During Pregnancy 

1. All women that are deemed medically safe to exercise should be physically active throughout pregnancy.
2. Physical activity should be accumulated over a minimum of 3 days per week, however it’s encouraged to be active everyday.
3. Incorporate a variety of aerobic exercise, resistance training, and yoga or gentle stretching for maximum benefit.
4. Pelvic floor muscle training on a daily basis to reduce the risk of urinary incontinence.

The Goal of Exercise During Pregnancy 

Keep in mind, the goal with exercise during pregnancy is to maintain your current level of physical health. Avoid trying to reach peak fitness or train for an athletic competition. If you have never exercised before, a great place to start is 30 minutes of walking daily. 

Below you will find some recommended exercises for pregnancy. The parameters are generalized, and should only be used as a guide. If you are uncertain about how these exercises may work for you, please call to chat with our Peak Health physiotherapist and we can get you on the right track! 

Please speak with your doctor to obtain medical clearance before participating in any physical activity. 

Try These 3 Exercises to Get Moving 

Squat with a Ball 

Starting position: Place the physio ball against the wall and stand with your back supported by the ball. 

Execution: Squat down moving with the ball, return to standing position. 

Parameters: Sets: 1-2 sets, Reps: 10-12

 

Birddog

Starting position: Start in a crawling position on your hands and knees, ensure hips and shoulders are at 90°. 

Execution: At the same time, lift one arm straight out front and lift the opposite leg straight back, return to the starting position and repeat with the opposite arm and leg. 

Parameters: Sets: 1-2 sets, Reps: 6-8 per side

 

Leg lifts

Starting position: Sidelying. 

Execution: Lift the top leg up towards the ceiling, hold for 2-3 seconds, lower leg back down.

Parameters: Sets: 1-2 sets, Reps: 8-10 per side

Next Steps 

Exercise during pregnancy is safe, recommended, and with the help of a pelvic floor physiotherapist, can ensure maintenance of your current fitness level and overall health. 

Book your discovery call today to see how pelvic health physiotherapy can support you throughout your pregnancy!

References 

1. Barakat, R., Refoyo, I., Coteron, J., & Franco, E. (2019). Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Brazilian journal of physical therapy, 23(2), 148-155.
2. Vargas-Terrones, M., Nagpal, T. S., & Barakat, R. (2019). Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview. Brazilian journal of physical therapy, 23(2), 164-169.
3. Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the Section on Women’s Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102-125.

Written by Helen Lo, Physiotherapist

 

Contrary to popular belief, good pelvic floor health is a lot more than “just doing kegels”. Sometimes, it is even the opposite and there is a large focus on pelvic floor relaxation. 

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a specialized area of physiotherapy that requires additional training to assess the strength, tone, and function of the pelvic floor through internal and external examinations. 

The pelvic floor muscles collectively form a bowl at the base of your pelvis. These muscles work together to support your organs, control continence, provide stability for your low back and pelvis, move fluid through the pelvic girdle, and increase blood flow to the organs that control erection and orgasm. 

Key Terms

Stress Urinary Incontinence: Uncontrolled urine leakage when you cough, sneeze, or jump

Overactive Bladder: The feeling of a frequent urge to empty your bladder

Pelvic Organ Prolapse: The feeling of heaviness or pressure in the vagina due to 1 or more organs dropping down as the muscles and tissues in the pelvic region are no longer able to support them

Dyspareunia: Pain with intercourse either before, during, or after

Rectus Diastasis: An observable bulge through the abdomen due to the separation of the “6-pack” abdominal muscles that can commonly occur during during pregnancy or postpartum.

Would You Need Pelvic Floor Physio?

1. Do you struggle with uncontrolled leakage of urine or stool (incontinence)?
2. Are you constantly feeling the urge to pee (urgency)?
3. Do you feel a heaviness or pressure in your pelvic region?
4. Do you experience pelvic pain, low back, hip pain, or painful intercourse (dyspareunia)?
5. Have you received a diagnosis or experienced symptoms of endometriosis?
6. Did your abdominals separate (rectus diastasis) during or after pregnancy?
7. Do you experience pain when passing stool or infrequent bowel movements (constipation)?
8. Does your child wet the bed?
9. Prenatal care
10. Postpartum care

If you answered yes to any of these questions, or if you fall into the pre or post natal window, you are a perfect candidate for pelvic floor physiotherapy! Although many of these symptoms are very common in the general population, it does not mean it’s normal or that you have to settle for these symptoms. Pelvic floor physio can help! 

So…Who Should See a Pelvic Floor Physiotherapist? 

The short answer is anyone! A Pelvic Floor Physiotherapist can help whether you are pregnant with your first child, a competitive olympic weightlifter experiencing leakage with each lift, a child that is missing sleepovers due to wetting the bed, or someone experiencing pain with intercourse. 

What to Expect at Your First Appointment:

During your first visit, expect a comprehensive 60 minute 1-on1 assessment between you and your therapist. Your pelvic floor therapist will start by taking the time to listen to your concerns, medical history, and goals of treatment. Following this, you will be taken through the hands-on portion of the assessment which could include an external and internal examination (if deemed appropriate and agreed upon by you). 

Although an internal examination (vaginal or rectal) is considered the “gold standard” to assess the pelvic floor, your therapist will meet you at your comfort level and walk you through each stage of the assessment. Don’t worry if you choose not to have an internal examination, there is still plenty of valuable information that can be gained from an external assessment! There are even times when an internal exam is not recommended such as when working with kids. 

At the end of the first appointment, your therapist will review their findings and provide you with a detailed plan of action tailored to you and your goals.

FAQ

What does an internal pelvic exam entail?

An internal exam consists of a digital exam conducted either vaginally or rectally.

Is it safe to see a pelvic floor physiotherapist while pregnant?

Yes, we actually recommend all women come in for an assessment after their 1st trimester. This helps us to obtain a baseline of strength and can help guide you through a comfortable pregnancy. If your doctor or midwife has advised you against sexual intercourse, we will proceed without conducting an internal examination. 

Can I still come to my appointment if I am on my period?

Yes! If, however, you are uncomfortable with coming in during this time, you can reschedule your appointment. 

How soon after delivery should I come to pelvic floor physiotherapy?

6 weeks after delivery. We usually recommend coming in for an internal exam following your 6 week check-up with your doctor or midwife. However, if you are experiencing significant pain, bowel concerns, and/or bladder or urinary dysfunction, feel free to come in sooner. 

Don’t Let Your Pelvic Floor Limit You!

Many people may tell you your pelvic floor symptoms are normal but they are not! Your pelvic floor physiotherapist is here to prove to you that although leaking urine and prolapse may be common pelvic floor concerns, there is hope and it can get better with professional help. Click below to book an appointment and take back control of your pelvic floor!

By: Blair Milne, Physiotherapist

 

When you’re a patient in physiotherapy, the sessions are generally set up to be once-a-week appointments for a certain amount of time. During those appointments, your physiotherapist will dig into whatever issues you’re dealing with that day, whether it’s pain in your knee or weakness in your hip. And then you go home again and have another appointment the following week.

Once you leave your initial period of physiotherapy though, things get trickier. How often should you have physiotherapy from this point onward? Is there an ideal frequency?

To answer this question (and many others like it) we reached out to some experts on the topic: physiotherapists! Here’s what they had to say about how often you should have therapy after finishing your initial sessions:

How often should you have physiotherapy?

This will actually depend on two things: the injury or ailment you’re working on and your physiotherapist’s recommendations. Why the injury? Well, different injuries require different amounts of therapy. A bad sprain, for example, will more likely require longer appointments than a torn rotator cuff.

Why the physiotherapist’s recommendation? Let’s say you have a torn rotator cuff. Your therapist will likely prescribe intensive, longer-term care. However, if you’re back to normal activities after a few weeks, then a few times a month might be sufficient.  Once you’ve had an initial assessment, your physical therapist will recommend a treatment plan that matches your physical activity and health condition.

After an injury or episode of pain.

If you’ve just had a spell of pain or an injury that caused you to see a physiotherapist, the best course of action is to continue to have physiotherapy services. This is the perfect time to get some long-term care. You want to keep the therapy going to make sure any lingering issues are treated and that you’re strengthening and stabilizing your injured areas. Most likely, your physiotherapist will want you to come in as often as you can so that you can make the most of the sessions. (If you’re in some sort of work-related pain, though, you’ll want to check with your employer to see if you can take the time to go to therapy. It’s up to your company to decide how much time off is fair.)

To prevent re-injury and strengthen your body.

If you’re just trying to maintain your current health, you probably won’t have to go to therapy as often. You might just want to go once every couple of months to make sure all systems are go. If you recently had surgery or you’ve been recovering from a knee injury or crunched-up shoulder, though, you’ll want to keep up your Physiotherapy in Calgary South. Injury prevention is the goal here. Your body is weak and unstable after an injury, and you’ll want to go and have your physiotherapist help it get back to normal strength. You can also have your physiotherapist put you on a “preventative” maintenance plan so that you can go less often but still keep the risk of injury low.

To address chronic pain and muscle weakness.

If you have chronic pain or weakness in your muscles, you’ll want to go to physiotherapy as often as you can. The therapy sessions can help prevent the pain from becoming worse, and the physiotherapist can help you do exercises in your day-to-day life that might help alleviate pain. You’ll also probably want to see a pain management doctor so that you can get some medications that can help manage your pain. And, if you have weakness in your muscles, you’ll want to go to physiotherapy as often as they recommend you go. Your physiotherapist can help you strengthen your muscles by prescribing exercises you can do at home, and they can teach you how to move your body in a way that helps put your muscles in the right place.

Bottom line: It’s up to you!

Really, the frequency of your visits is up to you and your experienced physiotherapist. You can go as often or as infrequently as you want (within reason). You don’t want to go so often that it feels like a chore, but you also don’t want to go too infrequently and fall behind on your treatment. It’s entirely up to you and your physiotherapist to figure out how often you should be going.  Call Peak Health & Performance and get started on your Peak Health Physio treatment plan today.

By: Blair Milne, Physiotherapist

You might think of physiotherapy as something reserved for people with broken bones or other serious injuries, but it’s so much more than that. From sprained ankles to frozen shoulders—there are many common conditions that a physiotherapist can help you recover from that will improve your quality of life.

A physiotherapist is a muscular specialist who helps treat people with different types of injuries or conditions on a daily basis. Their role is to assist patients in relieving pain and regaining strength and mobility after an injury or surgery, while also identifying risk factors for future injuries and helping to prevent them from happening again.

This article outlines 9 common conditions that can be treated by physiotherapy:

1. Sprained Ankles

Sprains are overuse injuries that can happen to anyone, at any time. They occur when the soft tissue that connects your bones to your muscles (ligaments) is overstretched, which leads to a tear. This can cause swelling and severe pain, which can make walking or running very difficult—if not impossible. Depending on the severity of the sprain, you can usually recover in a few days to a few weeks.

A Peak Health physiotherapist can help to speed up your recovery by providing you with targeted exercises or stretches for your specific injury. Exercises are a great way to help strengthen your joint and surrounding muscles, making it easier to lift and push your foot off the ground when you walk. Sprained ankles can also be treated with a variety of different taping techniques that can help support your joint and keep it in proper alignment.

2. Frozen Shoulder

A frozen shoulder is also known as adhesive capsulitis. It causes your shoulder joint to stiffen, which leads to pain and limited range of motion. Frozen shoulder is more common in individuals over 40 and women who have had children.

A physiotherapist can help you manage your symptoms and regain range of motion by stretching out your tight muscles and providing you with exercises to help improve your strength and joint mobility. They may also use heat therapy, cold therapy, or ultrasound to help speed up the healing process. A physiotherapist can also assist you with a shoulder massage technique called joint mobilization, which helps increase the range of motion in your shoulder, while also reducing pain and stiffness. If your shoulder is frozen, it’s important to see a physiotherapist as soon as possible.

3. Scoliosis

Scoliosis is a curvature of the spine that causes a side-to-side imbalance in your spine. It is a common childhood condition, but can also develop later in life.

A physiotherapist can help you manage your symptoms and improve your posture with a special exercise called a “posture correction exercise”. This exercise can help reduce your scoliosis symptoms, improve your posture, and help you feel more comfortable while sitting and standing. If you have scoliosis, it’s important to see a physiotherapist to determine if you need to wear a back brace. A physiotherapist can assist you in choosing the right type of back brace for your condition. They can also help you fit and wear your back brace properly.

4. Knee Pain

Knee pain is a common complaint that often comes from overusing your joints, which can happen if you are a runner or someone who does a lot of heavy lifting. This can cause your knee joint to be overworked and lead to inflammation of the knee.

A physiotherapist can help you manage the pain and reduce inflammation with ice, heat, and other treatments. They can also help you with a number of different exercises, such as squats and lunges, to help strengthen and stretch your knee joint. If you have knee pain, a physiotherapist can help you determine if you have a torn meniscus or a knee ligament tear, which requires a different treatment plan. They can also test your knee joint mobility using a variety of different tests, such as the leg length test, to determine if you have knee joint restrictions.

5. Exercise Intolerance

Exercise intolerance is a condition that has to do with your heart and lungs. It makes it difficult for your body to get enough oxygen, which can cause you to get out of breath very easily. If you have exercise intolerance, you might find that you get out of breath quickly when climbing stairs or walking up a hill. This can make even the most basic daily activity difficult.

A physiotherapist can help you manage your symptoms and improve your overall fitness by prescribing a physical therapy and fitness program. They can also help you learn how to use an inhaler properly, if you have asthma. A physiotherapist can also help you make sure you are safe when exercising. They can assist you with a fitness assessment to determine which exercises are best for you, or find ways to modify exercises if you are at risk for injury. They can also help you find a safe way to exercise at home, if you have a physical impairment.

6. Chronic Back or Neck Pain

Back and neck pain are common conditions that can be caused by a number of different things, such as poor posture, heavy lifting, or an injury.  Some back and neck pain resolves by itself after a few days or a week, but persistent back or neck pain may make daily living difficult.  Some pain can only be relieved with the help of a physiotherapist.

A physiotherapist can help ease your chronic pain by creating a personalized exercise program designed for your specific condition. They can also help you improve your posture by identifying and correcting any bad habits or muscle imbalances in your upper or lower back. This can help reduce your chronic pain and put you on a path to reclaiming a pain-free life. If you have chronic pain, a physiotherapist can determine your pain levels and assist you with a specific exercise program to help you manage the pain. They can also help you identify any potential injury or cause of your pain, and help you avoid re-injuring yourself. If your pain is chronic, it is important to see a physiotherapist as soon as possible, as waiting too long can make it harder to recover.

7. Sciatica

Sciatica is a painful malady that’s caused when the sciatic nerve is irritated. This vital nerve runs from your lower back, through your hips and down to your legs. It can be caused by a number of different things, such as a herniated disc, degenerative disc disease (DDD), or a spinal stenosis.

A physiotherapist can help you manage your pain and improve your mobility with a combination of targeted stretches and exercises. They can also assist you with heat therapy, cold therapy, and joint mobilizations. If you have sciatica, a physiotherapist can help you determine if you have a herniated disc or DDD, which affects your sciatic nerve, versus a spinal stenosis, which does not. If you have sciatica, it is important to see a physiotherapist as soon as possible, as waiting too long can prolong your recovery period.

8. Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common wrist problem that occurs when your carpal tunnel swells, which causes pressure on the nerves in your wrist. This can lead to pain, tingling, and numbness in your hands and wrists.

A physiotherapist can help you manage your pain, improve your strength, and create a safe exercise program, as many people with carpal tunnel syndrome have trouble exercising. They can also help you with a number of different exercises designed specifically to reduce your pain, regain strength, and improve mobility in your wrists and hands. If you have carpal tunnel syndrome, a physiotherapist can help you determine if you need surgery to relieve pressure on your nerves. They can also help you recover from surgery and avoid re-injuring your wrists when you’re done healing.

9. Rotator Cuff Injury

A rotator cuff injury is when one of your shoulder muscles is injured.

A physiotherapist can help you recover from rotator cuff injuries, such as tears, by teaching you how to properly use your shoulder. They can also help you with a number of different exercises designed to improve your strength, range of motion, and help you avoid re-injuring your shoulder. If you have a rotator cuff injury, a physiotherapist can also help you determine if you need surgery to repair the injury, or assist you with managing your pain with other treatments. If you have a rotator cuff injury, it is important to see a physiotherapist as soon as possible, as waiting too long can make it harder to recover.

Wrap Up

Peak Health and Performance is a physiotherapy practice that has successfully treated these conditions and others in the Calgary community for years.  Our caring, professional staff can guide you with an initial assessment that will diagnose the source of your problem and offer a personalized treatment plan designed to help you recover soon.  Call Peak Health & Performance today to learn more about how physiotherapy can help you.