What links PGP and a weak pelvic floor?
As readers of the Pelvic Partnership website and blog will be aware, PGP affects a great many women during pregnancy (up to one in five (Albert, 2001)). In many cases, the pelvis becomes hypermobile (i.e. the joints of the pelvis move easily beyond the normal range expected for those particular joints). This increased movement can in turn produce a lack of stability so the muscles that are connected to the bones of the pelvis (the sacrum, the coccyx, the hips and the lumbar spine) may become stressed trying to compensate for this. As a result, the muscles here may tighten up considerably and develop trigger points that can be very painful.
In most cases of PGP, research suggests that there is an asymmetry between the two sides of the pelvis such that it becomes ‘hypermobile’ (too mobile) on one side and ‘hypomobile’ (too stiff) on the other side and this asymmetry is a major cause of pain.
Research has also shown that the muscles of the pelvic floor are also adversely affected by the asymmetry in PGP between the two sides of the pelvis. The pelvic floor tries to compensate for the increased hypermobility and instability of the pelvis and this can add to the levels of pain experienced. The pelvic floor also starts to work very hard to offset the pelvic instability and as a result the muscles of the pelvic floor become more and more taut and therefore weaker.
So unfortunately, if you are prone to PGP and your pelvis becomes asymmetric as the crux of the problem, then you may also find that you are susceptible to a weak pelvic floor because the muscles are working so hard to compensate and to create stability. Unfortunately, the stress experienced by the pelvic floor muscles doesn’t automatically cancel out once your PGP is treated. So women find that they are left with a weak pelvic floor and one that may prone to leaking urine.
Thanks to Maeve Whelan’s website for the background to this article. Maeve Whelan is a Specialist Chartered Physiotherapist in private practice in Dublin with over 25 years experience in Women’s Health. You can visit Maeve’s website which provides more information about muscle tension within the pelvic floor.