Common injuries we treat from the pelvis
Pregnancy pelvic girdle pain (pubic bone and sacral)
Pregnancy is a common time that pelvic joints become painful and irritable. The changing physique of the spine and pelvis posture with growing bellies and the actions of the pregnancy-related hormone relaxin are the cause. Relaxin softens the soft tissues about the pelvic joints, allowing some give to otherwise very stiff joints in preparation for birth.
Common complaints here are pain into the buttock, coccyx and pubic bone areas. Activities such as rolling over in bed, stair walking, getting up out of a chair and long periods of sitting are problematic.
Physiotherapy management of these pregnancy related pains can vary from gentle joint re-alignment techniques to massage and core stability exercises for the pelvic muscles. Some women find that wearing a sacral pelvic belt under their clothes can bring significant relief as it offers a gentle compressive support to the pelvis at this time of increased joint softness.
The best thing about this pain is that studies have shown that more than 70% of women with this pain in the buttock will have no lasting effects after 2 months of their baby being born. As the relaxin hormone leaves the body, the joints return to their pre-pregnancy state.
Sacro-iliac joint pain
The sacro-iliac joints (SIJ) are complex pelvic joints located near to your buttock regions. It is now widely accepted that these joints are thought to be involved in more than 50% of people presenting also with lower back pain. The SIJs are largely load bearing joints in your pelvis and rely not only on their shape, but also on the actions of all the muscles, ligaments and soft tissue about for good alignment when moving and rotating the trunk.
Typically SIJ pain feels like very lower back pain, radiating often into the buttock on one (usually) or both sides. Pain can also feel ‘deep seated’ and can radiate into the side of the upper leg or into the scrotum or labia. Rolling over in bed, first steps from sitting and negotiating stairs pain free are all common problems.
Due to the complexity of the joint, physiotherapy treatment needs to focus on the entire abdominal, lower back, pelvis and hip region. Joint re-alignment and good movement of thee areas, muscles weaknesses and movement control need to be addressed. Core stability and strength of the deep muscles about the abdomen, pelvic floor and hip region needs to be the focus. Excellent assessment, diagnosis and strengthening programs are needed for a good outcome.
Pelvic floor muscle dysfunction
Very common, but not often spoken about is the pelvic pain and dysfunction called chronic pelvic pain syndrome (CPPS). This can include rectal, genital, abdominal and lower back pain. There is usually an increased discomfort and pain sitting down, during or after sexual activity and often involves problems with urination and defecation. In the majority of cases, all physical tests, scans and investigations come back normal, giving no physical explanation for the cause. This can equally effect men and women.
Management of these syndromes is highly complex and falls under the umbrella of ‘women’s health’ and ‘men’s health’ physiotherapy. We offer women’s health physiotherapy at The Fix Program and can refer onto a men’s health physiotherapist in the area if needed.
Referred pain from lower back and hip
Pain into the pelvis and abdomen can often originate from the lower back or hip. Thorough assessment of joint alignment, nerve tissue and muscular tissue at the lumbar spine is needed to rule out or find probable sources of referred pain.