Using Massage to Manage Pelvic Girdle Pain

July has been massage month and to finish off our third blog post in the series we would like to raise awareness about Pelvic girdle pain, or PGP (previously known as symphysis pubis dysfunction or SPD).  This condition commonly affects women during pregnancy and just afterwards.

It is usually caused by muscular spasm in one or two muscles that attach the thigh, abdominal or low back muscles to one of the pelvis bones (of which there are three).massage for pelvic girdle pain

The consequence of the spasm is the sensation that something is both stuck, and very painful which can be frightening and stressful as well as preventing you from sleeping comfortably with the knock-on effect of feeling shattered!

What are the consequences?

Because the affected muscle is often in the groin, many women will limit their stride to tiny steps because a long stride hurts, which can cause other muscles to fatigue.

Some women will start limping badly by hitching up a hip to avoid swinging a leg too much.

Other women might reduce the amount of swing from both hips, and use their back to create side to side momentum to help swing each leg through when walking causing their back to become strained.

Why does PGP occur?

As your body produces the hormone relaxin to soften your pelvis ligaments in preparation for birth, your hip pubic and back joints open more which this causes the muscles moving the joints to shorten and tighten or spasm painfully.

How can you treat it?

Massage can be extremely helpful to relieve the target muscle strains and spasm in the groin, buttock or back as well as help to lengthen all the other muscles around the pelvis to help your body adapt to the increasing weight of your baby down through your pelvis.

Our massage therapists are both extremely experienced and are highly intuitive when it comes to identifying the strained muscles and using the right amount of pressure to release the muscle without causing you any pain (but providing a lot of relief).

If you would like to find out more about our massage services please contact us using the form below or call us on 020 7735 6813.

Our other massage blog posts are:  Sports Massage, Pregnancy Massage.

Pregnancy Massage

Pregnancy body massage is a term that identifies any hands-on treatment during or soon after pregnancy. The changes that women’s body encounters during pregnancy are mainly of two natures:

  1. biomechanical – to do with the increased abdominal size and change in weight bearing
  2. hormonal

How can pregnancy massage help?

Unfortunately there aren’t many scientific studies proving specific physiological changes established by massage during pregnancy. However pregnancy massage is thought to have the following beneficial effects:

  • reduce back and leg pain
  • promote muscle relaxation and reduce tightness and joint stiffness
  • improve sleep
  • reduce anxiety and stress by lowering the levels of the stress hormone norepinephrine and cortisol
  • increase levels of feel-good hormones such as dopamine and serotonin resulting in an overall improvement in mood

By promoting the physiological effects of relaxation massage facilitates well being during pregnancy and helps deal with the physical and psychological effects of pregnancy across all its stages.

Some practitioners would argue that any form of treatment should be avoided during the first trimester for the slightly increased chance of miscarriage. However, there is no scientific evidence to prove any links between massage and miscarriage.

During this delicate phase of a woman’s life is it most important that a qualified massage therapist with a specialisation in pregnancy massage carries out the treatment. They will be able to clinically identify contraindications by taking an upfront case history and discussing your health with you, pointing out the best course of treatment.

When should you see a pregnancy massage therapist?

  • struggling with back pain since your belly has started increasing in size
  • noticing increased swelling of your ankles at the end of the day (especially in this heat!!)
  • suffering from leg tiredness and fatigue
  • feeling stressed
  • just in need of some feel-good and relaxing time

If you would like to find out more about our pregnancy massage service please contact us using the form below or call us on 020 7735 6813.

What is Pelvic Girdle Pain?

Pelvic girdle pain (PGP) can be an extremely uncomfortable condition that causes acute (brief) or chronic (ongoing) pain in the buttocks, groin, lower back or pubic area. It used to be called SPD (or symphysis pubis dysfunction) but has been recognised to affect many more areas that relate functionally or anatomically to the whole pelvis.

It is normally caused by the strain of ligaments and muscles as your body produces a ligament softening hormone (Relaxin) to allow the pelvis to accommodate your baby during delivery. This can cause muscles that overlie the joints to work harder and even go into spasm. When the muscles at the back of the hip (buttock) or front of the hip (groin) tighten or spasm it will make you limp and find it difficult to bear weight on that leg.

Symptoms of Pelvic Girdle Pain

  • Limping
  • Pain / difficulty climbing stairs
  • Difficulty turning in bed
  • Pain transitioning to standing from sitting
  • Pain initiating walking
  • Standing on one leg

Occasionally, ligaments and muscles attaching the spine to the pelvis get strained or tighten up, giving you back pain and stiffness which can be very debilitating.

Physical and Emotional Effects of PGP

PGP is thought to affect up to 1 in 5 women. It can have indirect effect on your emotions, causing you more concern about your ability to have a natural birth, about burdening your partner or friends, not being able to manage older children and perhaps worrying about suffering pain after your baby is born when they need you most.

Some women might also wonder if the problem is their fault, may feel isolated as well as cheated of a joyful pregnancy.

How can PGP be treated?

To be clear, none of this is your fault. Osteopaths and physiotherapists are trained to identify specific ligaments, joints and muscles that are causing the problem and activities that might be limiting your body’s ability to recover. After identifying where the problems are, they are very well placed to use manual techniques to relieve muscle tension and joint stiffness and prescribe simple exercises that are adapted to your body and stage of pregnancy to help condition and strengthen the muscles that are overloaded.

If you are experiencing pelvic pain or some of the symptoms listed above during your pregnancy please get in touch with the team here at Kennington who will be delighted to advise and offer treatment to enable you to enjoy this special time pain free.

Andrea Rippe is an approved practitioner on the pelvic partnership website – use the form below if you wish to request an appointment.

**New Treatment**

Women’s Abdominal and Sacral Massage – also known as Fertility Massage

At Kennington Osteopaths we pride ourselves in the vast range of regular and alternative treatments we offer. One such treatment is Abdominal and Sacral Massage or Fertility Massage, designed specifically to benefit women who are experiencing gynaecological, digestive or emotional issues and want to improve their chances of becoming pregnant. Read on to find out more about the history of this lesser known treatment and how it may work for you.

Read more

Here at Kennington Osteopaths and Physiotherapy we like to think of physiotherapy as a journey. No matter which stage of your life you are at, whether you are a young professional with no strings or a soon-to-be parent with a lot of worries, a three day old newborn or an older retired grandparent, we can rehab you!

Read more

When do Home Visits Help?

Osteopathy home visitsWe are always looking at ways to improve our service and make our therapies available to all. Another beneficial service we offer is the facility to visit you in your own home when getting to the practice here in Kennington is just not straightforward. This isn’t solely to carry out a treatment in situ but also to understand your problem and to offer advice, support and solutions to getting you mobile again.

Here are a number of examples of when it’s a good idea to request a home visit:

  • You have suffered a sport/activity injury and you are bed bound but really want to have professional help as soon as possible.
  • You are an older person with restricted mobility who prefers to get treatment within the safety of their own home.
  • You have been discharged from hospital after musculoskeletal surgery and would like to get ready for rehab but you still have very restricted mobility.
  • You are preparing for surgery and would like a professional to assess your house environment and advise on ergonomics and safety.
  • You are at the very late stages of a pregnancy and your back really hurts.
  • Your baby was born 2 days ago, it’s very cold outside and you would like a paediatric osteopath to come and advice on colic pain.

Of course, there are many reasons why a home visit may be preferable so please call us to discuss your situation and we will endeavour to provide you with the best solution. Recovering from any of the above can take some time, starting as soon as possible shortens your healing time and optimises your outcomes.

Areas of Home Visits Covered

The areas that we cover are mainly Kennington, Lambeth, Vauxhall, Oval and Elephant and Castle. The fee is based on travel time plus treatment time and our reception team will be able to work this out for you and quote accordingly.

If you would like to know more or book an appointment please use the form below.  Or tune in next week for more insightful info on the type of services we offer.

Pelvic floor rehabilitation in women’s health 

– by Ana Aguila

Pelvic floor disorders are common in women, from young age until after menopause. Their dysfunctions include incontinence, pelvic organ prolapse, painful sexual intercourse and lower back or pelvic pain.

The pelvic floor is a diaphragm of musculature supporting the bladder, uterus and bowel, which are embraced by muscular walls. The side walls of the cavity are formed by muscles that assist hip rotation, but in pelvic floor problems, our focus is on the pelvic diaphragm. It is as a diamond shape sling of muscle attached to the pubic symphysis at the front and the coccyx and its ligaments at the back.
The main role of pelvic floor muscles is to support organs, to maintain urinary and fecal continence and to provide resistance and strength during maneouvres such as lifting. Also, well-conditioned muscles play an important role during sexual intercourse and childbirth.
Dysfunctions in the pelvic floor can be caused by childbirth, hormonal imbalance, fatigue and demanding activities such as lifting heavy weights.
Symptoms may include:

  • a sensation of a bulge or something coming down or out of the vagina, which sometimes needs to be pushed back
  • discomfort during sex
  • problems passing urine – such as slow stream, a feeling of not emptying the bladder fully, needing to urinate more often and leaking a small amount of urine when you cough, sneeze or exercise (stress incontinence)

During childbirth, the nerve that supplies the pelvic floor can be stretched or compressed and is especially at risk from with small pelvic size combined a large baby, assisted delivery and baby getting stuck. Nerve compression can be both extremely painful, and affect one of the muscles that prevents incontinence. Episiotomy during childbirth can also leave this muscle weakened and ineffective.
Prolapse of pelvic organs through the vaginal wall (pelvic organ prolapse) is common after pregnancy and childbirth due to increased abdominal pressure on the pelvic floor form the growing baby and pushing during delivery.
Muscles can repair and strengthen with training. However, before starting pelvic floor training we recommend achieving alignment and mobility of pelvis, lower back and hip joints. Once these structures are balanced, training can be established to strengthen the pelvic floor.
If you are able to perceive pelvic floor contractions and your weakness is mild, it is appropriate to start training with simple exercises.
The first exercise to help pelvic floor muscles strengthen would be simple contraction as in holding your urine in or interrupting urine flow. The contraction should be held for 5 seconds and repeated 10 times. Gradually, you will increase length of contraction from 5 seconds to 8 or 10 seconds as well as increasing repetitions to 12. It is important to avoid fatigue which is one of the factors causing urine incontinence.
However, when weakness of the pelvic floor is severe or you are not capable of contracting the pelvic floor, is advisable to use biofeedback which will help to engage the pelvic floor and train not only the muscles themselves but also helps you visualise which muscles to contract. With biofeedback you can learn about how to contract your muscles progressing onto further stages of rehabilitation.
In conclusion, an accurate physiotherapy assessment will provide you with the correct diagnosis to start rehabilitation and begin to create harmonious pelvic floor muscle stability.

1. Fonti, Y; Giordano,R; Cacciatore, A; Romano, M; La Rosa, R. (2009).Post-partum Pelvic Floor Changes. Journal of Prenatal Medicine. Volume 3(54-59)
2. Marques, A; Stothers, L; Macnab, A. (December 2010). The Status of Pelvic floor muscles training for women. CUAJ. Volume 4 (issue 6), 419-424
3. Rose Day, M; Leahy-Warren, P; Loughran, S; O’Sullivan E. Community- Dwelling Women´s Knowledge. (November 2014) British Journal of Community Nursing. Volume 19, (issue 11), 534-538.