Symphysis pubis dysfunction/Disorder (SPD)
The main symptom is usually pain or discomfort in the pelvic region. This will probably be centred on the joint at the front of the pelvis (the pubic symphysis). Some sufferers report being able to hear the lower back and hip joints, the sacroiliac, clicking or popping in and out as they walk or change position. Sufferers frequently also experience pain in the lower back, hips, groin, lower abdomen, and legs. The severity of the pain can range from mild discomfort to extreme and prolonged suffering. There have been links between SPD and depression on account of the associated physical discomfort. Sufferers may walk with a characteristic waddling gait and have difficulty climbing stairs, problems with leg abduction and adduction, pain when carrying out weight bearing activities, difficulties carrying out everyday activities, and difficulties standing.
Pelvic Girdle Pain (PGP)
A combination of postural changes, the growing baby, unstable pelvic joints under the influence of pregnancy hormones and changes in the centre of gravity can all add to the varying degrees of pain or discomfort. In some cases it can occur suddenly or following a fall, sudden abduction of the thighs (opening too wide too quickly)or an action that has strained the joint.
During pregnancy and postpartum, the symphyseal gap can be felt moving and/or straining when walking, climbing stairs and turning over in bed. These activities can be difficult or even impossible. Pain may remain static, i.e. in one place such as the front of the pelvis producing the feeling of having been kicked, in other cases it may start in one area and move to other areas, you may even experience a combination of symptoms. Any weight bearing activity has the potential to aggravate an already unstable pelvis, producing symptoms that may limit the ability for the woman to carry out many daily activities. She will experience pain involving movements such as dressing, getting in and out of the bath, rolling in bed, climbing the stairs and sexual activity. Pain will also be present when lifting, carrying, pushing or pulling.
- Serious PGP is present in 7% of women postpartum.
*Note Please remember that Relaxin is still in your body postpartum which means you can still get PGP
Association of Chartered Physiotherapists in Women’s Health. Pregnancy-related pelvic girdle pain formerly known as Symphysis Pubis Dysfunction (SPD). Guidance for Health Professionals. 2011
In women, physical changes resulting from pregnancy, childbirth, and menopause often contribute to stress incontinence. Stress incontinence can worsen during the week before the menstrual period. At that time, lowered estrogen levels may lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause, similarly because of lowered estrogen levels. In female high-level athletes, effort incontinence occurs in all sports involving abrupt repeated increases in intra-abdominal pressure that may exceed perineal floor resistance.
Most women develop diastasis recti during pregnancy. A diastasis will have an impact on your overall core strength including your pelvic floor, on the effectiveness of your pushing, on how fast your abdominals recover from a caesarean, on how your tummy looks after baby is born and on how much back pain you experience during your pregnancy.
The two halves of your recti muscle are joined together at the linea alba, a string of connective tissue. During pregnancy, as the uterus grows, that muscle lengthens and causes the two halves to separate. As the muscle separates, the connective tissue stretches sideways making it thinner and weaker. Now, instead of muscle, you have weak connective tissue supporting your lower back and your organs. No support for the lower back translates into more back pain and no support for your organs means more difficult pushing during labor.
With diastasis recti your growing uterus is held in place by a separated recti muscle and stretched out connective tissue. Pushing the baby out is very difficult to do with a separated muscle. The uterus will tilt forward as the connective tissue cannot hold it in place properly. When it tilts forward the cervix moves out of alignment with the vaginal canal creating a detour in the baby‘s passage through the birth canal.
A sure sign of a diastasis during pregnancy is:
*belly button becomes an outie;
*belly cones when you crunch up or strain your belly in any other way
Carpal tunnel syndrome (CTS)
Carpal tunnel syndrome (CTS) is a relatively common condition that causes pain, numbness and a tingling sensation in the hand and fingers.
Usually, these sensations develop gradually and start off being worse during the night. They tend to affect the thumb, index finger, middle finger and half of the ring finger.
Other symptoms of carpal tunnel syndrome include:
•Pins and needles (paraesthesia)
•A dull ache in the hand or arm
Certain health conditions appear to increase your risk of developing CTS. These include:
•Type 1 diabetes and type 2 diabetes – a chronic (long-term) condition caused by having too much sugar (glucose) in the blood
•Rheumatoid arthritis – a condition where the joints become painful and inflamed as a result of the immune system attacking the body
•Gout – a common type of arthritis that causes pain and swelling in one or more joints
•Hypothyroidism – an underactive thyroid gland
•Obesity – particularly in young people
•Oedema – an excess build-up of fluid in the body’s tissue
Postpartum Depression (PPD) and Exercise
Postnatal depression can affect women in different ways. They can begin to have symptoms soon after the birth which can last for months, or in severe cases for more than a year.
What are symptoms of depression?
Any of these symptoms during and after pregnancy that last longer than two weeks are signs of depression*:
1.Feeling restless or irritable
2.Feeling sad, hopeless, and overwhelmed
3.Crying a lot
4.Having no energy or motivation
5.Eating too little or too much
6.Sleeping too little or too much
7.Trouble focusing, remembering, or making decisions
8.Feeling worthless and guilty
9.Loss of interest or pleasure in activities
10.Withdrawal from friends and family
11.Having headaches, chest pains, heart palpitations (the heart beating fast and feeling like it is skipping beats), or hyperventilation (fast and shallow breathing)
Other symptoms can include:
•Disturbed sleep, such as not being able to fall asleep during the night (insomnia) and then being sleepy during the day
•Difficulties with concentration and making decisions
•Poor appetite or an increase in appetite (“comfort eating”)
•Feeling very agitated or alternatively very apathetic (can’t be bothered)
•Feelings of guilt and self-blame
•Thinking about suicide and self-harming
*Note- if you are experiencing more than 4 of these systems please go to your GP or ask for help.
Postnatal depression can interfere with your day-to-day life. Some women feel unable to look after their baby, or feel too anxious to leave the house or keep in touch with friends.
According to the American College of Obstetricians and Gynecologists (ACOG), returning to physical activity after pregnancy can decrease the incidence of Postpartum Depression (PPD). But it will only decrease if the exercise is stress relieving and not stress provoking. So make sure you schedule exercise into your routine!
Factors that contribute to PPD:
1.Feeling tired after delivery, broken sleep patterns, and not enough rest often keeps a new mother from regaining her full strength for weeks.
2.Low thyroid levels can cause symptoms of depression including depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain. A simple blood test can tell if this condition is causing a woman’s depression. If so, thyroid medicine can be prescribed by a doctor.
3.Feeling overwhelmed with a new, or another, baby to take care of and doubting your ability to be a good mother.
4.Feeling stress from changes in work and home routines. Sometimes, women think they have to be “super mom” or perfect, which is not realistic and can add stress.
5.Having feelings of loss — loss of identity of who you are, or were, before having the baby, loss of control, loss of your pre-pregnancy figure, and feeling less attractive.
6.Having less free time and less control over time. Having to stay at home for longer periods of time and having less time to spend with your partner and loved ones.
After pregnancy, signs of depression may also include being afraid of hurting the baby or oneself and not having any interest in the baby.
PLEASE seek medical attention immediately if you have any symptoms of depression.