The SI joints are where the bones of the hip meet the lowest part of the spine. These joints need to move properly to be pain free. Too much or not enough movement makes them painful.
When pelvic alignment is off, and you have SI joint pain it’s recommended to see a chiropractor to normalize the movement in the SI joints. If you skip this step, the bones will continue to move too much or not enough and any strengthening you do will be reinforcing poor positioning and could cause more pain.
**Side note: if pelvic alignment is off and it’s NOT PAINFUL, I hesitate to correct alignment because it could cause pain by giving the bones too much movement. This is very case specific, but just want to put it in your head that having pelvic alignment that is off isn’t something that absolutely needs to be corrected.
Steps to help SI pain + alignment
1. See a chiropractor (one you know and love!)
2. Start doing the stretches shown 1-2 times per day. Repeat 2-3 times per side, holding 20-30 seconds.
3. Begin strengthening the core (diaphragmatic breathing with TA contraction, glute bridges, hip hikes + more!)
4. Use a pillow between the knees and/or under the belly while sleeping
5. Avoid movements that involve twisting or stepping on one leg if they are painful
**The top two stretches shown are safe for all of pregnancy, and the bottom two are only recommended until 20 weeks.
As always, contact me with questions or if you are unsure this is what is causing your pain.
This pain is sharp and occurs in the center of your pelvis. It’s common for it to begin in the second trimester and unfortunately, it can continue after giving birth.
If you have this pain, you know there are certain movements that make it worse. The biggest modification is to avoid stretching or moving in positions that cause the legs to be stretched to far apart (wider than hip distance). This pulls on the already painful pubic symphysis and makes your pain worse by over-stretching the already irritated joint.
Here’s a few ways to change your movement to avoid irritating the pubic symphysis.
Walking - take shorter steps
Stairs - go up/down sideways
Putting on pants - sit down and put both feet in together
Rolling over in bed - keep the knees together while you roll
Getting out of the car - keep the knees together and rotate your body so your knees point out of the car before you reach to step out
So, why does this happen?
With pregnancy, there’s a surge of hormones that tell the body to relax the ligaments so the hips can expand for baby to grow. The pelvis supports the majority of our body weight and when the ligaments relax, we need to increase muscular strength to support our pelvis. If we don’t strengthen the muscles attaching to the pelvis during pregnancy, our bones can move too much and cause pain, which is what happens with pubic symphysis dysfunction.
Here’s a quick rundown of which muscle groups to strengthen to reduce your pain and stabilize the pelvis. Focus your strengthening on the abdominals, hip adductors (inner thighs), glutes, lats and deep back muscles. If you want to see a change in pain, you’ll have to address all of these muscle groups, and not just one. The pelvis needs support from all directions.
Here’s some exercise ideas to get you started.
Posterior pelvic tilts
Ball squeezes between your knees
Women do very well with consistent exercise and movement modifications during pregnancy and postpartum to control pubic symphysis dysfunction.
Do these exercises 2-3 times per week throughout pregnancy, the sooner you get started, the better! Set yourself up with a strong body that's ready for your baby's growth, don’t wait until you have pain , do what you can to prevent it!
If you're a pregnant or postpartum mama, or any woman with pelvic pain, schedule a free phone consultation! You know you need physical therapy and you tell yourself you'll do anything to make the pain go away, so here's your chance-give yourself the tools you need to be more comfortable, you deserve it!