Some women need just one session to get better, but some need regular hands-on treatment throughout their pregnancy as the joint realignment and position cannot be maintained. There are various possible reasons such as a delay in starting treatment, tight muscles which the therapist is finding difficult to treat and, later in the pregnancy, the size of your growing baby. If you have had pain for a long time, your muscles may pull your joints back out of alignment (compensation) which is why the treatment may make you feel better at first, but it gradually gets worse again over the next few days. Do not despair if this happens to you. It sometimes takes some time to work out why these compensations are happening and stop them, so do persist with treatment.
Usually, the realignment of the joints will need to be combined with releasing tight muscles, often using trigger point therapy or acupuncture or dry needling as part of the session. Acupuncture or dry needling alone may help with pain but is not effective in realigning joints, so it should usually be done as part of a session for muscle release, not the whole treatment. Some women find that they can maintain the corrections with home exercises. Postnatally, you need to carry on with treatment until you are back to normal and able to do all the things you used to be able to do. This takes varying lengths of time. However, you should expect to make continuous improvement and if this stops at any stage, discuss it with your therapist or seek another opinion, but never be reassured that you “just have to wait” for recovery – there is always a reason why things don’t move forward, and usually something can be done to get recovery back on track.
Pelvic floor and PGP
One of the classic things that can have an impact on recovery is pelvic floor over-activity (see our Pelvic Floor and PGP page for more information). The pelvic floor attaches to the sacrum at the back and round the pubic symphysis at the front, so if the pelvic floor is tight or painful, this can pull on the joints and have an effect on recovery. This is also very treatable, so if you are not making progress with your recovery, it is well worth having your pelvic floor assessed by a women’s health physiotherapist.
Pain, exercise and PGP
As with other activities, if a treatment or exercise increases your pain, it is usually not helping. Pain is known to stop the muscles from working properly and this is called inhibition.
We are often contacted by women who have been given lists of exercises that hurt and have continued to do them for months, and can’t understand why they are not getting better. This is because the pain and/or the incorrect joint alignment and compensatory muscle pull stop the muscles from working properly (inhibition of muscles). So you usually need some manual treatment to make sure the joints are working together properly before you start on exercises. Pain relief and pacing activities can also really help here as it allows you to function more normally and lets the muscles start to work again. However, pain which feels like the normal muscle tiredness after an exercise class is fine.
Visit our pain section for more information about pain relief available.
Click here to read more information about Exercise and PGP.
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