It's normal, and it will get better. It may take weeks/months.I am not sure physio would help as there are no muscles that cross the midline that would help keep it together. :-) Just gotta give it time to re-fuse. Do activities that do not cause pain/instability.

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Two wheels good. Four wheels bad.

I feel your pain (literally as this kid is coming out any day now). With my first, the pain/feeling like my pelvis was falling apart lasted a good 6 months. I was in terrible shape though. After the second, it didn't last long - I was back to walking/running/biking within a few weeks. I didn't do anything specific to help, but I was overly cautious with progression and made sure to get adequate rest. With this one, the during pregnancy hasn't been too bad, but I'll take it slow afterward and be very careful about where I do my walking/running postpartum (I noticed surfaces w/any slant were killer).

Some people have found the postpartum support belts to be helpful. I've found Kegels and pelvic tilts helpful in general postpartum.

Good luck - hopefully it will get better soon.

Hey DrTrikat, you and some others had some great insights on SIJD and other pelvic girdle questions I posted last November (Birthin' babies and ridin' bikes), and I'm been reading up and learning more about this topic over time. It's been helpful knowledge to use in discussions in my bike fittings with ladies who have been pregnant or those who plan to be and still want to be active on the bike pre/post.

Curious to know what you think of this abstract: http://ptjournal.apta.org/...5/12/1290.full#app-2, specifically the suggestions in the Appendix for movement and exercise pre and post natal.

Thanks!

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Anne Barnes
ABBikefit, Ltd
FIST/SICI/FIST DOWN DEEP
X/Y Coordinator
abbikefit@gmail.com

Hello ABarnes

I'm glad that you found my insights helpful. I read the study/paper you linked. It is a decent study, that was done in New Zealand. It was randomized, blinded, adding to its value. It tells us that neither the rigid, nor the other support belt adds anything to exercise+education in the improvement of pubic symphisis dysfunction pain. I wish there was a placebo arm (no intervention) and an education (without exercise) arm. Recruitment may have been harder for that.

IMO, educating women that pelvic/groin pain is normal in pregnancy, and providing them with psychological support (about the fact that the pain is temporary, and will improve eventually), and providing simple exercises can likely improve the subjective well being of women. Not sure about New Zealand, but my gut feeling in the US is that the general population seems to have this weird idea that any pain is pathological and indicates some kind of a "disease" that needs to be "fixed". I find that many people/patients in general do not tolerate ANY pain, and are under the illusion that they should be pain free entirely. (don't even get me started on how Americans seem to believe they will never die……) As someone who has lived with pain every day over the past 20+ years, I think a little education goes a long way.

Good luck, and thanks for the extra mile you go for your clients!

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Two wheels good. Four wheels bad.

Agree about the perception that pain is pathological and treated like a 'disease'. I wonder if those exercises recommended are helpful, or if in your opinion to let hormones rebalance?
Or if both exercise and healing time go hand in hand? At what point is a general lack of pelvic core strength is the problem, not just having a baby?

I would say that Womens' Health in general over the millenia has been perceived as a 'problem' or 'disease' requiring treatment, rather than something natural. Even my mother referred to menstruation as 'the curse'. *ugh*. right?

BIke fit 'schools' do not address gender differences in fitting methodology per se; so few students (again, predominately male bike shop employees/owners) have any pysiology understanding of themselves let alone any human body. When presented with a woman, esp. those who have had kids, it challenges the best of us to understand what is going on in the pelvic structure. The only solution is 'fatter/wider/cutout' rather than examining the causality. I don't see a reason why a woman shouldn't be able to ride comfortably or at a level of competition that she expects of herself after babies. I certainly know a number of highly competitive ladies here in Chicago who are just as strong now as they were before they had kids.

Where much is said about pelvic rotation for cyclists, men can have a problem rotating the pelvis; I feel that some women can hyperotate the pelvis, causing the femur to splay out and increase soft tissue pressure.

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Anne Barnes
ABBikefit, Ltd
FIST/SICI/FIST DOWN DEEP
X/Y Coordinator
abbikefit@gmail.com

I have SPD but have never given birth. I just seem to have a lot of hip issues. So NOT fun! My SPD is actually due to an old (like 12 years ago) horseback riding injury and muscle imbalances in my right leg due to that injury and also a frostbite injury on my right foot in 2011 (long story). I see an amazing chircopractor that helps with stretching and also graston work around my adductors and hip flexor. It's extremely hard to form roll that area! Personally, I don't really have issues riding my bike with the pain, but it can certainly be painful. Hopefully your SPD is only temporary and will be back to normal in no time. But I highly recommend a chiropractor!

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So I tried a gentle short jog at 4 weeks post Partum and the SPD was really debilitating and I couldn't really run, so I spent the week walking. Then at my 5weeks pp appointment with the doc, I asked him if I could resume running. He said that since I had an easy birth and everything seems healed and back in place, then yes, I can. So I asked him about the pelvic joint pain and whether I can push through it (cuz most triathletes are masochists that looove pushing through pain). He told me that I can exercise up to the point of pain and that running (even if painful) won't make things worse, so I may as well run. He also said the pain may be there up to 6 months and after that I may have discomfort for the rest of my life!!!! So I went and ran a gentle 5k. It was painful from the get go but the pain wasn't there after I stopped running. So is this my new reality for the rest of my life???? Running in perpertual discomfort. Does everyone agree that running in pain won't make things worse or slow down the recovery as the doctor said???

I am not sure about what the doctor said. I am always in mild-moderate pain in at least 1 body part daily for the past 20+ years, so not sure what to say about "perpetual pain." It generally amazes me that some people live lives with little to no pain daily, and complain about every little ache!

Good luck on your continued recovery, sounds like you are off to a good start! Don't forget your Kegels!

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Two wheels good. Four wheels bad.

I am biased as a physical/physio therapist that works in women's health....Having said that...

I would have a full evaluation by either a women's health PT or women's health chiropractor to ensure that all the surrounding areas are taken care of (low back, lateral hips, adductors, etc). As mentioned by another poster, this does not have to relate to child birth and there are musculoskeletal treatments for the related tight muscle groups, muscle imbalances, etc. An evaluation can also ensure that you don't have muscle spasms/excessive tightness in the pelvic floor muscles that may increase and exacerbate pain if you do a lot of kegels. Finally, you may be able to sustain a kegel contraction, but can you do 10 in a row at the same power? These are important diagnostic data points that can help individualize treatment to you.

While I do believe that most of us live with some pain most days as part of a generally active life - this type of pain with a traumatic onset and is generally inflammatory is not the type of pain I like people 'just living' with.

my $.02.

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