If you haven’t already read part 1 click here. Part 1 discussed pain of the low back and the ribs during pregnancy. Today’s article is going to focus on 2 new areas; sciatica and hip/groin pain during pregnancy. As mentioned in part 1 there are several reasons why you might experience pain while you are pregnant depending on where the pain is, the intensity of the pain and the type of pain. If you are unsure of why you have pain (i.e. it’s a unfamiliar pain), if this is your first pregnancy or if your pain is intense, sharp, shooting, throbbing or deep you should see your doctor or specialist before all else. Once you have the all clear that it is musculoskeletal pain then you can try following some of the suggestions in today’s blog post or seek some treatment from a trusted Myotherapist, Physiotherapist, Osteopath or Chiropractor. Make sure to ask them if they have experience and qualifications for treating during pregnancy.
Sciatica is very common during pregnancy. It can come from the lower back or from a deep muscle in your bottom called the piriformis muscle. Sciatica is distinguished by a pain starting around the bottom or hip area and travelling down the leg past the knee, sometimes as far as the ankle or the foot. During pregnancy the hormone relaxin increases making the ligaments soften. This increases the amount of load placed on your muscles, sometimes the muscles can cause the problem, other times you can end up hanging into new postural positions and putting a lot of strain on the joints especially around the lower back and hips which can aggravate the discs or nerve spaces in the lower back. We treat sciatica a lot in the clinic. Try the following exercise for the back and see if it helps.
4 point kneeling – The rock back
- On your hands and knees make sure your hands are under your shoulders and your knees are under your hips. Also make sure you are in neutral spine (no dip, no curve).
- Gently rock back towards your feet about half way then slowly return to the start position.
- Repeat 10 -20 times remembering to maintain neutral spine the entire time.
There are several things that can cause hip and groin pain during pregnancy depending on where the pain is therefore it is essential that you get a proper diagnosis before progressing with any exercises or stretches to help. A more serious causes of pain in this area is a DVT or deep vein thrombosis which is a type of blood clot. Some other things that can cause pain in this area are the round ligament, osteitis pubis, pubic symphysis irritation or inflammation and referral from the lower back.
In the clinic we mostly see people with pain relating to an imbalance of muscles around the pelvis and low back. Due to being right or left dominant in stance and exercises we tend to be a bit stronger on one side. As the relaxin hormone kicks in these muscles have to support your pregnant body more and more. If some muscles are stronger than others they start to play a game of tug of war which can cause pain in many different areas. We get people in who have already been diagnosed with things such as symphysis pubis, osteitis pubis, lower back disc irritation and round ligament pain just to name a few. Most people we see have more general aches and pains through the glutes, hips and groin and have not yet had a musculoskeletal diagnosis. We find either way, it comes back to this imbalance of muscles so our assessment, treatment and prescribed exercises will revolve around loosening off the tight muscles and strengthening the weak muscles. If there is inflammation we might use taping to help support to give the area a chance to heal. Taping is very safe during pregnancy unlike many anti-inflammatory medications.
One of the most common exercises I give to pregnant women is to strengthen their glutes and hamstrings. If you are still comfortable lying on your back try the first exercise, otherwise try the side lying exercise.
Pelvic Curl with Thera-band
- Tie the band firmly around your thighs and lie on your back.
- Place your knees and feet approximately hip width apart. Make sure your knee heights are the same before continuing, we want everything in alignment.
- Next imagine dots on your shirt and pants where your spinal segments are. What colour are your dots?!
- Press with 50% effort out into the band and peel one dot at a time away from the floor starting at the bottom and working you way up to your shoulders. This should take about a 5 seconds and is nice to do on a breath out.
- Take a breath in at the top to prepare.
- Breathe out to slowly return the dots back down to the mat, this time starting at your shoulders and working down towards your bottom, try not to skip the lower back and maintain the pressure out into the band if you can.
- Repeat 5 repetitions the first time you do it and see how you feel the following day. Slowly add an extra repetition each day until you are doing 20 a day.
Sidelying leg kick with Thera-band
- Tie the band around your thighs just above your knee and lie on your side supporting yourself with pillows particularly for the head and your belly.
- Lift your leg to hip height then keeping your body steady, squeeze your glute muscles to take the leg behind you about 5-10 cms depending on your flexibility.
- Slowly return it back to the start position and repeat 5 times each side. If you feel good the next day you can add 1 repetition each day until you are doing 20 each side.
I hope you’ve gotten something out of this 2 part series on pregnancy pain. Please remember that these are not tailored exercises for you specifically so if your pain persists or gets worse please come in and see us straight away providing you have already ruled out serious problems with your doctor or specialist. Here at Waverley Myotherapy Clinic we use a pregnancy pillow so you may be able to lie face down, a real treat during pregnancy! Once you are too big for the pregnancy pillow we will support you with pillows in the sidelying position. If you have any questions please contact us.