QuestionI sustained an injury to my left hip during my first pregnancy in September 2008. My doctor at the time said the pain was normal and due to the amount of relaxin in my joints. The pain lasted until shortly after my son was born in November 2008 (after 37 hours of labor followed by an emergency C-section). Five months later I became pregnant again, and as the pregnancy went on the pain began to set in again. In February 2010 I had a successful VBAC, however I have not been able to lay down since. When I am in a subpine position my hip begins to hurt tremendously, and thus I am unable to sleep laying down. I have since visited a new doctor who sent me to radiology for x-rays. After laying down for 30 minutes during the x-rays, I was unable to walk and left the clinic in a wheelchair. The pain caused severe muscle spasms in my lower back. Upon reviewing the x-rays the doctor determined that I have repeated injury to my SI joint and gave me an SI joint support belt to wear. The belt doesn't seem to be helping and I am still in constant pain. I have two small children to take care of and need to be able to function. I am hoping that losing weight from the pregnancies will help relieve some of the strain on my joint, but am unsure of what exercises to avoid. I want to make sure I am doing the right stretches/exercises to heal my SI joint and be in optimal shape again. Your input is very much appreciated. Thank you for your time.
AnswerIt sounds like you have instability at the sacroiliac joint. Because the joint has too much movement, your muscles are trying to take up the slack. They are not designed to do this job, and so they go into spasm.
When you are in an acute phase, your joint will swell up too. So using an ice pack might help, along with taking anti-inflammatory medication. Ask your doctor what over the counter medications are safe for you to take at this time.
Chiropractic care can be very helpful, to reset the joint back into proper alignment. Look for someone who specializes in pre and post natal care.
Avoid all twisting movements, and movements that twist and bend the spine at the same time. When you need to lift and carry your children, make sure that you bend your knees, and don't let your spine flex, or make a "C" shape. Other movements that can stress the SI joint include sitting/exercising in the "tailor position" and sitting with legs crossed. Avoid all yoga moves that are designed to open the hips and lower back.
Start doing some very basic postnatal exercises that strengthen your Transverse Abdominis, which is the main muscle that provides core strength and stability to the spine. Don't do ANY traditional ab exercises like crunches or sit-ups. Focus on basic core exercises.
It can be tempting to want to stretch out the SI joint when you're experiencing pain there. But your injury is caused by too much movement, because your SI ligaments are too long and not providing enough support (this is caused by the hormones of pregnancy). So stretching the SI joint is not recommended.
Gentle stretches of nearby muscles, when they go into spasm is OK, but no deep stretches. Ligaments heal slowly, so you'll need to be very conservative in how you use your spine for at least several more months.
More information on sacroiliac joint dysfunction during/after pregnancy can be found at:
http://www.befitmom.com/discomforts.html
