Wednesday, January 23, 2013

Back, Pelvic, Pubis and Sciatic Pain in Pregnancy

This post has been a long time coming! For too long, I just directly responded to mamas who experience pain during pregnancy. After awhile, though, I noticed that I was handing out the same links and points, so I figured I should collect it here for better reference.

First, some background. I was a rough and tumble gymnast, pushed to nationals, who took my body for granted. Sometimes I wish I could travel back in time to slap myself silly and yell, "PREGNANCY!" Alas, hindsight is 20/20. I've hurt several ligaments in my legs and pelvis, I've damaged my SI joints, straightened out my lower curve and I even have slipped fluid along the posterior area of my hip joint. They are permanent injuries, that will mark me as an old lady when I complain about aches before a storm. In the meantime, I get to complain about pain during pregnancy. Especially at the end of pregnancy.

With my first pregnancy, I was unprepared for the level of pain I would experience and unaware of how to resolve it, or even why it was happening. I was simply a passenger on a terrible ride of random, horrifying pain. Towards the end of pregnancy, my partner would have to help me into the car, or physically place me onto the toilet. By the time I reached "term" in my pregnancy, I needed assistance to get in and out of bed and to put on pants. It was a debilitating experience not only due to the lightning strikes of pain from out of nowhere without warning, but also due to emotional aspects of losing control over my body and having to rely on others.

Even after I gave birth, my loose, out of sorts body would sometimes give out on me. I had to change positions frequently and walk gingerly, never sure if I would be struck with pain or find sure footing. What was wrong with me? Would I ever be normal again?

Cue intense levels of research and questioning sage mamas, sports therapists, chiropractors and back surgeons.

Here is a basic list of what I've collected that will point you in the right direction to achieving a pain-free experience during the end of your pregnancy. Since learning more and caring for my body to specifically improve pelvic balance, I've gone on to have two pain-free pregnancies with fast, organized labors. I have full confidence that you can, too!

1. GET THIS BOOK. I don't know the author. I'm not an advertiser. I stumbled across this book at my local library when I was reading everything I could get my hands on and this was the first book to 1) accurately relate my experiences and 2) provide step by step instructions on how to change my daily lifestyle to prevent pain. Rent it, borrow it, buy it. JUST GET IT.

2. IMPLEMENT DAILY EXERCISES. Don't fret, I'm not talking about an hour of exercise. I'm talking about making a commitment to firing off 5-10 minutes of carefully targeted exercises. What you need: a foam roller and a mat or towel if using a hard surface. You can pick up a foam exercise roller pretty much anywhere that has an athletic/exercise department, including Target and Walmart. For pregnancy, you will find the larger size to be easier to work with and to keep your balance.

What kind of exercises? Focus on the ligaments in the pelvis and legs. You want to release your piriformis daily, as many times as needed to feel comfortable. When first starting or if the imbalance is severe, you might need to sit down and do a release several times a day. But after continued focus, once in the morning or evening is adequate. Hamstring stretches, exercises to roll out your back, and methods that stretch each leg are also beneficial.

Here is the little video I watched that first started me on my pathway to freedom:

3. MASSAGE. Enlist a strong person or hire a massage therapist to manually release your ligaments. If you have the classic "sciatica pain" during late pregnancy complete with random strikes of pain and jolts that run down your legs, you most likely need help in the buttocks area, where you can't reach. The technique looks like this, but many women, myself included, prefer a partner with a deft thumb as opposed to an elbow. Your partner should feel a tight band if he or she is in the right spot and you might feel pain similar to a bruise:

4. TRUE CHIROPRACTIC CARE. It's easy to tell you to go find a chiropractor but it's much harder to find a chiropractor who is truly talented in this specific area. All chiropractors receive the same basic training, but you're looking for the one who is an artist. Most likely a woman, who has shown a focus on maternal and pediatric care and is certified in webster and myofacial release. The visit should be longer than usual and consist of more pressure and massage, and very little or no cracking at all. You might have to search through several chiropractors before finding one. Also try asking at your local LLL groups and midwife groups for a referral.

5. LECITHIN. Birth Faith already wrote a post about it so I'll give you the link to read instead of typing it all out. Seriously. GET SOME LECITHIN.

6. FOOTWEAR. This is a mix of not only ensuring 100% compliance with proper footwear but also plenty of time without shoes. I do NOT hear success when women ONLY change their shoes. You MUST spend most of your day without shoes...something very hard but all the more important if you stand at a job daily. Birkenstocks personally provided intense change for me, but I find it really depends on the individual's needs. You can also ask your chiropractor to measure your feet and order customized shoes. If you own a cheap pair of shoes, chances are they are HURTING you.

7. SPIN YOUR BABY. Go to this website and become accustomed with it. The information on this website fits seamlessly with developing a pain-free pregnancy. See, while you are fixing YOU, you might also have to straighten out your BABY. If you've had compromised posture and an imbalanced lifestyle, your baby is almost certainly in a position that might be causing you more pain or contributing to future birth complications. GO GO GO spin that baby!

8. BELLY BINDING. This can be done in a few certain ways during pregnancy (with care, as not all binding is safe). Binding during pregnancy is usually most helpful for those with pubis symphosis pain. And it's especially important after birth. Belly binding is actually a traditional practice that we've lost in our modern culture. You can purchase a product specifically made for this purpose, or you can use fabric to make your own. You can also use a woven baby carrier. I found the cheap, generic brand at Motherhood Maternity worked great, then I switched to a woven. I use my ergo during pregnancy. Here's a link to give you the 411 on belly binding along with product ideas:

The end of pregnancy often comes with many aches and complaints, but actual back/pelvic pain should NOT be part of it! I've come to learn from my own experiences that women CAN experience a pain-free pregnancy. I've even run mini-marathons and climbed through the hamster tubes at Chuck E. Cheese while 39-42 weeks pregnant.

If you have any other ideas to add to this list, please comment to share with other mamas! Let's all help each other to avoid that debilitating, demoralizing pain so we can enjoy the last moments we have before our babies arrive earthside!

Dedication to pelvic balance and following the steps I listed above WILL HELP YOU. I put my proof where my mouth is!  This is me, pregnant, on my "due date" (so 40 weeks) with my third child. I'm carrying my 35lb 3yo on my back and my 25lb 2yo on my front, without pain. Take, that, gymnastics!
Necessary disclaimer: my post does not replace or constitute medical advice and I always encourage my pregnant friends to seek guidance from a trusted medical assistant, or in this case a certified sports therapist or chiropractor as well. Don't do anything that hurts or feels wrong to you. If symptoms are severe or persist, be sure to rule out actual medical conditions.


  1. I also recommend seeing a physical therapist who is a board certified Women's Health Clinical Specialist (WCS). You can find one by visiting, clicking on Find A PT, and selecting women's health. (Disclosure: I am a PT but not a WCS.) I suffered a pubic symphysis separation during my first pregnancy and PT treatment got me back to normal in just a few visits. If there is no WCS in your area, then ask around for a therapist who has experience with pregnant patients. Aquatic PT is also very effective.

  2. I had SEVERE SPD in both pregnancies. Started at 20 weeks with the first, 13 weeks with the second. I could barely walk by the end. Was horrible. I did see a phsyio, would gave me a belt, and some exercises, but to be honest, was not much use. She told me I had to rest, no more than 15-20mins of walking a day (with a 3.5 year old who had to be walked to pre-school and back daily, no stairs (and we only have one toilet, you guess it, up two flight of stairs) and no swimming, and even banned me from doing my pregnancy Pilates. I plan on seeing an osteopath next time round, to see if that will help any. Fortunately it did all go away once the babies were born, but it was horrible at the time! Thanks for the information!

  3. I had incredibly painful SPD with both pregnancies. Started at about 20 weeks with both. I ended up almost unable to walk by the end. I saw a specialist physio who gave me exercises and a belt, but to be honest wasn't very helpful. She told me to rest (ha, with a busy 3.5 year old in tow) to only be on my feet for 15-20 mins a day (ha, again a joke) no swimming, no pregnancy pilates, and no stairs (we have one bathroom, up two flights of stairs!) I will be seeing a chiro or osteopath next time. They are very expensive here, unfortunately, but I hope we can find a way round it, the pain was like nothing I can describe! :(

  4. Awesome, thanks for that! I had some strong pain (nothing like yours, but substantial) with my first pregnancy. This time I won't go to the gym for an hour with my PT every week! Im lunges across the room didnt help! I have a foam roller already (one of my prized posessions!) and I'll be doing plenty of preggy yoga and walking.

  5. Cool information. You can also look for a chiropractor.

    Best regards,
    downtown seattle chiropractor

  6. Thank you for sharing your experience in achieving a pain free pregnancy. You have some excellent information and resources here for women experiencing severe pain during their pregnancy. I go to a Straight Chiropractor and, like you said, he is like an artist ~ amazing! Did you try a pregnancy support garment at all while pregnant? It's You Babe provides safe and effective pregnancy support garments that are not a compression garment. The design helps correct your posture and support your tummy. I wore the Best Cradle 24x7 except to wash it. It provided 'surround support' and prevented bouncing and waddling.