Common Pelvic Pain Pattern after Birth

May 3, 2014 in Pelvis, Post Partum

We have some wrong ideas around our body and birth in this country.    We all assume after a birth that the body just goes right back to it’s pre-birth state.  What I have found in working with hundreds of post partum women is this is not necessarily the case!  At first I thought I was just seeing women whose births were a little more traumatic than “normal” births.  But what I’ve come to realize is even “normal” births still leave their mark on women’s pelvises and they tend to be affected forever.  Unless they get the energy of the birth released from their pelvis.

 

While I’ve already written about the trauma’s that occur in the pelvis from childbirth, see this article here, what I’ve come to find even more prevalent in post partum women is a common pelvic pattern that gets stuck in their body after birth.  In releasing these patterns woman have experienced profound relaxation and normalization of their body, they feel like themselves again!

 

What I find is the sacrum on the right hand side gets jammed superiorly and has decreased mobility when I try and move the sacrum in the sacroiliac joint.  The left side of the sacrum can move just fine but the right side has decreased mobility.

 

The sacrum a lot of the time is still in a nutated position with the tailbone more posteriorly than what is normal.  There is a jamming up of the sacrum into the ilia and vertebra and when I distract the sacrum and encourage the tailbone to move into a more forward or anterior position all the women give a huge sigh of relief.  Front of pelvis

 

There is also a decreased mobility or accessory play between the pubic bone and the sacrum.  While standing on the right side of a woman with my right hand underneath holding onto the lower part of the sacrum and my left hand on the pubic bone there is a decreased mobility of the pubic bone to be able to move to the right.  When I reverse this motion on the other side of the body the mobility is fine.

It’s like the lower aspect of the sacrum is shifted to the right in the body, decreasing the shearing like accessory play in the pelvis.

 

In the majority of these clients the mobility of the left side pubis symphysis and pubic rami are more restricted than the right.  The left ischium is more splayed out than the right like the baby’s head had more pressure against this side than the right.

 

Internally it is more common to find increased tension in the left side pelvic floor muscles and a shearing of the bladder tissue to the left.  When palpating the bladder tissues there is less space on the left side around the pubic bone internally than on the right side.  I’ll also feel a pulling to the left of the bladder near the bladder neck.  Most of these woman complain of bladder leakage and when the bladder is restored to it’s normal position their incontinence improves and goes away.

 

While I originally thought these patterns were associated with a more challenging birth, women whose birth would be considered normal or “easy” are still presenting with these findings.   It doesn’t matter how your birth goes, whether it was fast, easy, or hard, your body is affected by the process and remains imprinted with this pattern until released from the bones.

 

In palpating the bones you can feel a hardness in the pelvic ring where the bones have experienced more pressures than other areas.  Believe it or not our bones have a gentle give to them when compressed.  Where there has been excessive pressure or trauma the bones feel really hard and can’t give to compression.  Typically I find one side pubic rami, most commonly the left, has more hardness than the other and that side ischium tends to be more splayed out to the side when palpated.  Bringing the ischium back to midline and releasing the hardness in the bone allows for greater distribution of energy throughout the pelvic ring.

 

This is critical for women who are having symphysis pubis dysfunction in their second pregnancy when they didn’t have any in their first pregnancy.   It’s the birth trauma from the first birth that is causing the pain during the second pregnancy.  I find that when I release the hardness from the bone, the pressures around the pelvic ring are able to disperse easier and take the excessive pressure off the pubic symphysis.

 

The greatest help we can give post partum women is to make sure their ischiums have come back together into midline after birth.  So many women are walking around with one or both ischiums still in a splayed out birthing position.   By helping them come back into the center and balancing this new position with the iliums can help women find more balance in their pelvis, make it easier to feel grounded and simply relax their entire pelvic area.

 

While it’s important to work with releasing these patterns from the bone, the healing is not complete until you normalize the pelvic floor muscles internally.  It’s like an pancake you have to work both sides, outside and inside, to rebalance the pelvic structures.

 

Too many women are complaining of pelvic pain after birth.   It is my belief that many of them are walking around with this common post partum pelvic pattern or their pelvis is still in a birthing position.   Helping to release these patterns from their pelvis allows them to reclaim their body after birth!