The aim of manual therapy treatment is to assess the position and the symmetry of movement of your pelvic joints, especially the sacroiliac joints at the back of the pelvis. Find out which one is causing the problem, and then treat it. The treatment is not usually painful, so it is nothing to be worried about, and you should expect to feel an improvement or some relief of your symptoms after each treatment. Keep going until you are completely pain-free after you have had your baby. We get a lot of calls from women who only had a few niggles in their joints after one pregnancy but just put up with it because it was much better than it had been, then develop symptoms very early in their next pregnancy because the underlying problem has never been resolved. This can be prevented or at least minimised by making sure that you are pain-free through getting treatment after your baby is born.
Gentle hands-on techniques are used to treat PGP and these focus on making sure that the joints are moving symmetrically and normally, rather than focussing on treating pain. This treatment is offered by physiotherapists, chiropractors or osteopaths with training and experience in treating PGP. Treatment involves a combination of joint realignment or mobilisation and soft-tissue or muscle treatment including myofascial release, muscle energy techniques and trigger point release with or without the use of dry needling. Joints will need to be mobilised if they are stiff or 'stuck' and are not working symmetrically. Muscles supporting the pelvis are also likely to become tight or go into spasm if they are trying to compensate for the pain in one or more of your pelvic joints. This muscle tightness will often need to be released as part of the treatment to allow the joint/s to move normally and prevent the problem from occurring again.
There are varying approaches to treating PGP, but the main things you should expect from your therapist are:
- The therapist will ask you about your PGP and how it affects you.
- They will ask you to undress down to your underwear.
- They will look at and feel how the joints at the back and front of your pelvis move when you move (e.g. standing on one leg, bending forwards etc).
- They will feel how symmetrically the joints move when you are lying down on your back and your front (or your side if you are very pregnant).
- They will discuss their findings and agree a plan of treatment with you, explaining what they are going to do.
- Treatment is likely to include realigning joints which have moved slightly, so that they move symmetrically again. This may need to be done at each visit, until your muscles become strong enough to keep them in place without treatment.
- You should leave each treatment session feeling better, with either improved function such as being able to walk without your crutches or stand on one leg, or reduced pain (or hopefully both).
- You will be given gentle exercises to help your pelvic stability once the pain has reduced. Exercises on their own if you have a lot of pain are usually not effective as the pain stops the muscles from working properly, and exercises do not make joints which are in the wrong position or are stuck move normally.
- As you recover, your exercise programme will be adapted to suit your individual needs until you get back to normal. For more information about exercise and PGP please click here.
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