Pregnancy hormones result in increased flexibility of our joints and cartilage. Due to the complexity and high cartilage content of our pelvis, this increased flexibility is often most noticeable in our hips and pelvis. As a result, our body relies more on our muscles, in order to give us stability. If we have muscle imbalances prior to pregnancy, these imbalances might become more noticeable during pregnancy. If our body is unable to recruit muscles in order to give the joints more stability, pain often will occur.
The pubic symphysis is a cartilage plate that sits in the front of the pelvis and joins the two sides of our pelvis together (see picture below). Typically, this joint is very stable. However, due to its high cartilage content, during pregnancy, hormone changes can cause increased movement and thus pain, at this joint.
Often women will report pain is worse with any activity in which the legs are separated from one another. Activities that commonly will cause increased pain include:
Often, the pain is very transient and brief, however it can be extremely sharp. Many women become very cautious with moving due to fear that the pain will occur.
It is highly recommended that anyone experiencing pain in the pubic symphysis be evaluated by a pelvic floor physical therapist. It is important to assess muscle imbalances and joint restrictions that could be resulting in increased pain, as well as discuss activity modifications in order to decrease stress through the pubic symphysis. Sometimes, a therapist will recommend a stabilization belt which helps to give some compression to the two sides of the pelvis.
Remember, you shouldn’t have to live with the pain. Even if it is very common, pubic symphysis dysfunction can be managed and alleviated. If you are suffering with pubic symphysis pain and dysfunction, make an appointment with a pelvic floor physical therapist so that you can enjoy a happy, healthy and pain-free pregnancy!
Constipation could quite literally be, a pain in the butt. The inability to have a predictable bowel movement can cause a lot of angst and stress. This then creates a vicious cycle, and further inability to have a successful bowel movement. The first thing to combating constipation is to get yourself on a consistent schedule.
You want to start by having a consistent morning routine. I love my sleep, so I get the idea to stay in bed as long as you can and then rush around the morning like a maniac. However, if getting up earlier in the morning means that you can give yourself a little extra time to have a consistent morning routine, it might be necessary.
Diet can be a major contributor of constipation. You want to make sure you are eating between 25-30 grams of fiber from fruits and vegetables, per day, as well as drinking 6-8, 6-8 ounce servings. You want to also make sure that you are maintaining a consistently active lifestyle: walking is a great activity that can help get things moving. Mental stress can also be a major contributor to constipation and managing stress is critical in managing constipation. Meditation (even for 5 minutes a day) has been shown to help decrease stress levels which can help your body relax to allow a successful bowel movement. The key is consistency. Remember, you are teaching and retraining your body. Even though we think having a bowel movement is a natural process, we often have to teach our body how to do it successfully. This takes time!
There are many over-the-counter medications on the market. However before trying a bunch of things that may actually disrupt the natural microbiome (good bacteria) in the gut, I strongly advise that you have a good team of practitioners on your side. A Registered Dietician or Nutritionist can play a big role in helping manage constipation from a diet perspective, a Pelvic Floor Physical Therapist can help patients with mechanics and muscle control and a psychologist might be necessary to help manage the angst and stress that might be playing a role in your symptoms.