Episode #20 - Tips to manage pelvis pain in pregnancy and postpartum
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In this episode, Rhonda and Dayna talk about all things SPD (symphysis pubis dysfunction, aka pelvis pain or lightning crotch)!
We discuss:
🔹 What is SPD and potential causes of it
🔹 Our own experiences with SPD in pregnancy
🔹 How can you continue to exercise with SPD?
🔹 Ways to roll in bed and get in/out of the car with SPD
🔹 Possible strategies to minimize pelvis pain
We’re excited for you to listen to this episode and hope you find some of these tips helpful. Let us know in the comments!
➡️ Click here to learn more and purchase Rhonda’s 2 for $22 Strong at Home Membership Trial! (Doors open for purchase March 2). Click here to get on the waitlist to stay in the know.
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Episode #20 - Tips to manage pelvis pain in pregnancy and postpartum
Hey everyone, Rhonda here. Just a little announcement before we get into the episode today. So if you are listening to this episode live, it is Monday, February 28th, and I have a pretty cool deal coming up this Wednesday, March 2nd, which is my 2 for 22 trial for my Strong at Home membership. So what that is?
It's two weeks, um, no strings attached trial for 22 for my strong at home membership, which is for you if you are six weeks to many years postpartum and you're looking for some accountability and a plan with getting back into exercise with me. And that is through a free app. Called True Coach and I will guide you each step of the way and be there for you to modify your workouts as needed and help you feel really strong.
So I would love to have you join that two week trial. Like I said, no strings attached, so you don't necessarily need to stay on with a membership afterwards if you don't want to. If you do, that's awesome. So that trial itself will start right after March break, which will be. March 21st is the Monday so that's the date that the trial will begin that will run for two weeks and then again after that if you want to be done and just sort of if you're lurking and curious about the membership then that's awesome.
If you love it and you want to continue then your membership would start right at the beginning of April. So check that out again, that's going to be open for purchase as of this Wednesday, March 2nd, I'll put the link in the show notes here. And also you can check out the link in my bio on Instagram at Rhonda Chamberlain PT.
All right, let's get into the episode.
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Hey everyone, welcome to episode 20 of the Pelvic Health and Fitness Podcast. Our topic today is going to be about SPD and what that stands for is Symphasis Pubis Dysfunction, which is a mouthful. I always get that mixed up when I say it.
Um, another term for it, you might have heard is lightning crotch. super painful condition that many, um, people go through either during pregnancy, even postpartum. Um, and yeah, we're going to talk about that today, what it is and how we can work on strategies to help it feel better. So do you want to just get into what it actually is, Dayna?
Yes, for sure. So this is something I know, uh, we were just chatting about this. We see this all the time. with, uh, pregnant ladies. Um, and so essentially what it is, is this really intense pain in the front of your pelvis. So right where your pubic bone is. Um, yes. Well, if you Google it, you'll often see the term lightning crotch come up, which I feel like is such a bang on description.
So it's this really sharp can be very intense pain right in the front of your. pelvis or your pubic bone. Um, it can radiate down into the groin depending and it tends to be with certain types of movements. Um, any like getting in and out of cars, clients will often describe the pain when they get up from a chair and take that first step or going up and down steps.
So if that sounds like you, then you're going to want to keep listening. The old way of thinking or was sort of that it was Definitely related to the ligament in the pubic symphysis and that because you have this release of a hormone called relaxin during pregnancy, particularly in the later stages, that that ligament was softening and maybe we were getting a little bit more movement through that ligament.
And that was what was causing the pain. I think more research is starting to show that it could be more of a protective mechanism from the central nervous system and a little bit of nerve irritation, perhaps involving some pelvic floor, uh, tightness as well. So I think The way I think of it personally is a little bit of all of those things.
And, um, you know, our central nervous systems are really smart at protecting particularly the pelvis. And so I think what's really important and what we want to focus on here is just helping you develop some strategies on how to move because movement is important, right? Even with pain. Yeah, and I think that, did you experience it, Dayna, in your pregnancy or postpartum?
I did. Mine was a little bit different. Typically when you experience pubic symphysis dysfunction, it tends to happen later on in pregnancy. Especially the first time you experience it. And that is what happened with me with my first, but then it can be a little bit more prevalent and come on sooner with subsequent pregnancies, which I did not experience.
I had the weirdest, I kind of giggle because I remember myself working as a 30 plus pregnant woman and I would get up from, I would, it was when I got up from a chair, like if I had sat charting for a while and I'd get up to go see a client or something, it was like this stabbing in the front of my pelvis.
But I found if I could take a step backwards first and then turn around, it somehow seemed to help settle things. And I was able to go forward. So that was my experience with it. Interesting. Yeah. I. Had it in my first pregnancy and it was actually during an anti Anthony low course, and I hadn't been feeling any pain until the course.
And it was my own doing. So he had us doing some running drills. So you had to kind of change directions quickly. And I was. I think I was like six months pregnant. And so I was like, yeah, I'll try it. And my pelvis was not happy with me because I am not a runner and I wasn't running during that pregnancy.
So I think it was just that particular activity. My body wasn't adjusted to do that activity and my pelvis did not like it. And so even something as simple as putting on my socks and shoes in the morning was mega lightning crotch, super painful. And yes, I was that indication of the second pregnancy. see it coming back sooner.
So I think midway through my pregnancy with Tegan or a bit earlier, I had it. And it's funny that way too. And which makes me think it is more a nervous system thing. I had it for maybe a month in that pregnancy and then it magically just went away. So you would think if it was that relaxing thing, it would just be worse, worse, worse, worse until you deliver.
But it was like a good chunk in the middle of my pregnancy and then it, and then it went away. Yeah, for sure. And even with your first with, uh, Sadie, you, you start doing all these new movements and your, your brain goes, Whoa, what are you doing there? Cowboy? Yeah, this is different. This is not the greatest right now.
Let's just take it. Let's take a beat. So our central nervous system is very good at protecting us and When there is pain, we often become afraid or more afraid to move because we're afraid of pain, understandably. Nobody wants to feel that pain. So what are, what are some of the things that you chat about with your clients?
Right off the bat. Yeah. So I'd say first and foremost, let's, you know, your particular story, let's get into what are the movements that irritate you? Cause it's going to be different for everybody. And so again, thinking back to my pregnancy, the biggest things with me were. Um, putting on shoes and lunges.
My body did not like lunges for most of my pregnancy. And so I, you know, would tell my clients, let's figure out what those things are. Another big one is like rolling in bed. So just like rolling over to one side, to the other, um, getting in and out of the car. So let's sort of hammer down what those things are.
And can we, again, we want to encourage our clients to keep moving because movement is great for us. Motion is lotion, but can we modify how we're moving to make it so it's not super painful? So for me, in terms of lunges, I just. Took out lunges for a good chunk of my pregnancy and focused on squats instead.
When I would get my shoes and socks on, I would modify that by sitting on the bed and put them on that way. Um, rolling in bed. And I know, um, Anita Lambert, holistic health physio has a couple of good videos on this, um, just modifying how you roll in bed. So whether that's like, it's hard to show or talk about it, but like plant.
foot and kind of roll that way like have a foot planted on the bed and then roll or put a pillow between your knees and keep your knees together. Um, that would help as well. So just finding, and again, it might be a bit of trial and error for your specific body, but finding ways to modify those painful activities so that you can keep moving, but not making those symptoms angry.
And in general, and I think most of those things that you described, it does tend to be those splay type movements in through the pelvis, through the legs. So think about taking your legs front to back or apart, like in a jumping jack type position. Um, it's funny cause you were saying, I was like, Oh, I didn't have it my second pregnancy.
I totally did. I couldn't take, you know, how you, you're going to take off your shoes and you can't bend down because you're pregnant and you try to. Take the back of your shoe off. Oh yeah. I could not do that. That would just light my pelvis on fire. So that was a painful one for me. I think that's a common one.
Yeah. Yeah. I'm lying. I totally had it the second time. Yeah.
Um, another common one I hear is getting in and out of the car, uh, being super painful. So if that is you, one strategy that I often talk to my clients about is to Sort of move your feet out slowly. Like you're rotating your bum in the seat. So your feet are outside of the vehicle and then stand up with your feet, both outside of the vehicle.
Instead of that typical, like, I'm going to put my left foot out and weight shift onto that left, but my right foot still in the car type splay. Same thing. If you're going to go sit in the car, depending on your vehicle, it's a bit harder if you have a higher, but sit your bum down and then slowly walk your feet in together, kind of keeping them more at a hip distance.
Yeah. Yeah. And stairs, if stairs tends to be aggravating for people, you know, we typically go up like right, left, right, left, I will say do a step two pattern on the stairs. So if you're having a day where you're pretty flared up, you're going to step up with your life, bring your right foot up to that same step, step up with your right, bring that left foot up to the same step.
Is it tedious? Yes. Does it decrease the lightning crotch if that is an aggravating movement for you? Yes, it does. Yes, for sure. Yeah, I was going to just add to that too because it came to mind with the rolling in bed. I know my pelvis also was angry just in general with sleeping. I found it hard to get comfortable.
certain points of my pregnancy. And so one trick that is really awesome and works with a lot of clients. So usually people will be told to have a pillow between their knees or have like a body pillow, make the pillow between your knees even thicker. So instead of like one pillow have like two pillows, even three pillows, if it's comfortable, something about having a bit more space between your legs, whether that just kind of opens up the pelvis into a better, more comfortable position, whatever that is.
Um, and it. I think that's what we're saying. Find what works and then use that because that when we have pain, anytime you get into any sort of movement, that's remotely similar to the first time you found pain, your brain sort of marks it. And then you become a little bit more sensitive to it each and every time you're in that position.
So if you can find movements and positions that are more comfy. That. Cut hits the safe button in your central nervous system and decreases those alarm bells a little bit. Yes, for sure. So obviously the pelvic floor, pelvic floor and hip mobility is a big one. Um, doing some down trainers or down regulation exercises.
I think we've talked a little bit about reverse Kegels, basically just a little bit of a meditative breath too, if that's in your practice. thinking about those nice big inhales, relaxing your tummy jaw and bum as you do that can be really helpful if there is a pelvic floor tension and tightness component to your SPD, that can be really, really helpful.
Um, and doing any sort of hip mobility ones, um, like a good old fashioned figure four where you cross your ankle onto your opposite knee and let that knee fall to the side. Um, for some people, Child's pose or a supported child's pose, although that one can be aggravating for some as well. So I say do that one with caution.
What are some of the ones that you like to give? Yeah, so those are good ones. I would say, um, I call it the half frog or like an adductor rock back people call it, but again, that's, it might be touchy for people because your leg is fully out to the side. Um, so again, it's just going to be. Based on your individual pain situation, um, some positions might feel really great to just open up your hips a little bit.
And again, just remind your nervous system, remind your body that it's safe to move in different ways. So again, just as we always say, just get curious about your symptoms, try things. And again, like try it, you know, in a way that's not going to cause a sudden jolt if you can just ease into it. Um, and just.
experiment and kind of figure out what feels good. And I would say to just to go with the down training, um, again, because we mentioned how there is that nervous system component, um, the pelvic floor tightness is likely going to be there for you. So just having strategies like Zed lying, or, um, even lying on your tummy with that, the pillows between your legs, like using that as a pain control position and a way to just work on that deep breathing, work on relaxing the pelvic floor.
floor, just have that as a practice, you know, one to two times a day. If you are dealing with that pain to just help settle that nervous system and set all the, um, tightness. Yes. We're all about efficiency here. If you have multiple children or this is your first and you're low on energy, combine some of these things, make it easy.
So get in your position and do your breathing. Don't, uh, don't feel like this is a laundry list of things. Um, general strengthening program, I think is really important. Um, just during pregnancy in general, but sort of under this idea that. Movement is good. Our, our bones, our ligaments, our muscles, our tissues are made to move.
And that includes during pregnancy. The important thing is that we find movements that are comfortable for us. So you had a beautiful, um, Um, I was gonna say option example, pardon me. It's been a long day, um, of lunges weren't comfortable for you. So you just sort of modify, you do some squats or some bridges.
Uh, so just playing around with your lower body strengthening. I think having strong glutes in general is a benefit, but we always want to pair this sort of lower body glute strengthening with some of that down training as well. So we're always balancing out work with. Rest. Yes. Yeah. Yeah. We always repeat the saying that we love motion is the lotion.
So just keep your body moving in a way that's not super aggravating. And I think again, just reminding the body, reminding the nervous system that it's safe to move in multiple ways throughout. pregnancy. So again, just exploring movements that feel good is just going to help contribute to hopefully minimizing the symptoms.
Um, and then just to go along with that. So just being mindful of just techniques and habits that you might have with, if you are, uh, doing some dumbbell work or barbell work, um, basically any type of lifting, even if you're going, if you have a, an older child and you're experiencing this pain and you're going to lift the child.
Um, a good strategy to think about is blow before you go, which, um, Julie Wiebe, who's a physiotherapist, um, coined that. Basically what that means is just remembering to breathe when you lift. Um, it just helps your pelvic floor and sort of your core system to keep you supported when you're doing that lift.
So what you're going to do is if you're going to lift up, say you have an older child, So, uh, breathe in, breathe out, and then do the lift. And again, that's just going to help support that system and hopefully minimize some of that pain before you lift. Mm hmm. I love that one. Mainly sticks in people's heads.
Yep. A little before you go. A little before you go. And I think too, I always just say to clients, Slow down. Yeah. I know it seems super obvious and it is not easy if you're chasing a toddler, so I'm obviously outside of that, but as much as you can, it is okay to just be, in general, a little bit more mindful about your movement.
Slowing your walking pace down shortens your stride, so that can just ease some of that discomfort and still keep you comfortably walking pace that you used to to get like a cardio. element out of it. Um, and I think too, I, as I said, going up the stairs, more of that step two pattern, like you're just slowing it down, particularly in those later stages of pregnancy can make, can make you a lot more comfortable.
Just be a bit more mindful of your movement in general. Yep. All movement counts, right? It doesn't have to, it doesn't have to be a speedy walk. It can be a nice, slow, leisurely walk and still be very beneficial. Do you remember trying to put your toddler in the car while pregnant? Oh, I have, yeah, nightmares about that.
Right. That's one of the funniest moments I've ever had in my life. Uh. Yeah. Yes. No, not fun. Then come home and do your breasts in balance. It's all about balance. Yes. So do you, with your clients, do you have them try, um, S S I belt? So sacroiliac belts, which is basically a supportive belt around your pelvis.
Um, do you incorporate that with your clients? I do try them. I tried them, or just a belly band, which tends to be a little bit more of a flexible support. It's like anything, they work like a charm for some, and not at all for others. And I do find them a bit, um, more so the sacred iliac. belts, they tend to be a little bit more cumbersome and not at all comfortable when you have to sit.
So if you're somebody who's still working, um, and you work at a desk or maybe you're up and down a lot, the sacroiliac belt can be kind of tricky when you put them on. It should feel like almost instant relief. And that's the same if you have a sacroiliac belt, you should feel almost like instantaneous relief.
So if you, if you try it and it doesn't really help you, um, At least tried. Yeah. Like I said, they can be gems for some people and not at all helpful for others. So it didn't work for me. I tried one. Yeah, it didn't work. What did work for me is, um, I just had, uh, one of the other physios at my clinic. Do leuko tape so you can do like a taping technique.
So, um, she would actually leuko tape my SI joints and then I would do rock taper, uh, like a kinesio tape on my belly and whatever that was. I feel like tape can kind of be this like magical mystical thing, but just having, I think it's just having external feedback. I always say it's almost like, you know, if you stub your toe and you just sat there and rubbed it, it felt better.
So I think it's just giving different nervous system feedback to the area. For whatever reason that did wonders for my pain. A hundred percent with the belly tape. Was it underneath your tummy? Like sort of a lift or across a bit of a lift. And then, yeah, I had like an X across my back, basically across my SI joints.
Yeah, so some people find taping really, really helpful. Um, I always just caution if you're going to tape your tummy, that you're extra aware of your skin integrity. Yeah. Um, just because the skin is, if you are somebody who tends to have any sort of irritation to tape or band aids or any sort of adhesives, you want to be careful, obviously.
But then the skin on your tummy is stretched a bit, so I do find people who aren't. sensitive usually can be suggest but it can also be super helpful and it moves a little bit more than a band or a belt. Right. Yeah. Don't underestimate just you know using your hands cradling that tummy and giving yourself a very gentle lift even if it's only briefly as well just to take some pressure off that pelvis and that pubic bone that can feel amazing in the moment too if you're standing in line at the grocery store and you just need a little bit of help and support, just try to gently hug that baby up for a moment and that can be really helpful as well.
That's good. Yeah. And then we'll add to the end here, which we, um, repeat often that if you are able, and if you do have the means to book in with a pelvic floor physiotherapist, super beneficial just to, Figure out what is actually going on internally with your pelvic floor, and whether there is any internal work that might be beneficial to help with the symptoms as well.
And then along with that, so even just working with an orthopedic physiotherapist or um, a pre postnatal fitness coach like myself that has sort of the experience and the knowledge to help you keep moving in a way that's not aggravating the symptoms. Um, along with that, if you're someone that sees a chiropractor, if that is a beneficial treatment for you and you get relief from that, that can really help and massage therapy.
Um, just massaging, you know, in around the back and around the glutes can be super helpful. Just thinking back to my own pregnancy is when I did have. Um, now that I'm remembering too, I had a bit of SI joint pain along with the pelvis, um, the lightning crotch and having the massage therapist work on my like glute tension and a massage was always so helpful.
Um, with that too, like, I don't know if you have used, um, yoga, tune up balls. So I, I had a couple of yoga, tune up balls. So basically it's like a. softer lacrosse ball. Lacrosse balls are pretty, um, aggressive. So it's a little bit more forgiving and just, I would spend time just sort of massaging in around my SI joints and around my glutes.
And that always gave some relief as well. Absolutely. And I. tend to recommend that sort of thing for pregnancy in general, because if you release some of the tension in your glutes and your low back, you help manage some of the natural increase in tension that happens during pregnancy as the pelvic floor sort of adapts to carrying that heavy and growing baby.
Um, So if you are listening to this and you're like, can I prevent SPD? Maybe. Yeah. Um, if you try the yoga, tune up balls, do all these things ahead of time. I mean, obviously don't limit your movements. If you aren't having pain and if you move in a comfortable way for you, but, um, Yes, if it's not happening to you, let's keep all those muscles nice and happy.
Yes. Mm hmm. Yes. Beautiful. Well, we hope you found this helpful. Um, let us know in the comments and reach out if you need any further help. Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review, or subscribe to anywhere that you listen to your podcasts.
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