by Dr. Alison Gault
Pregnancy related pelvic instability can occur at either of the sacroiliac joints or the pubic symphysis. When this condition occurs at the pubic symphysis, it is also known as diastasis symphysis pubis. Due to a number of factors primarily being hormonal ligamentous relaxation associated with pregnancy, the ligaments are not able to support the joint. This results in shearing, joint inflammation, clunking, the sensation of giving way, secondary muscular pain and tension and in severe cases a period of disability.
One of the main aggravating factors for pelvic instability is unilateral weight bearing such as standing on one leg. This position results in a shearing force within the effected joint that would usually be prevented by the ligamentous support to the joint. This shearing causes joint displacement especially within the pubic symphysis, reactive joint inflammation, pain and secondary muscular pain and tension. I have had patients with such a severe case of instability during their pregnancy that they required the use of a wheel chair or crutches as the unilateral weight bearing that occurs during normal walking was too much for their pelvis.
Examples within normal activities of daily living that involve unilateral weight bearing are such things as walking, using stairs, getting in and out of the car and getting dressed. It is best where possible to minimise these activities as much as possible to minimise the irritation to the effected joints. Such things as:
- Gathering all you need for the day in a basket to bring down stairs to avoid needing to do several trips per day.
- Getting your bed moved to a room downstairs so you have no need to use the stairs.
- Take small steps when walking
- hiring a wheelchair when in situations requiring lots of walking such as shopping or a large social event.
- Swinging both legs out of the car before standing.
- Getting dressed seated.
Follow the link for other tips for the management of pelvic instability.
How the couple it underwear release system can help
The couple it underwear release system means that you can lie your underwear out flat on a bed or seat, sit on it then do up the clasps. This removes the need to stand on one leg and bend forward to get dressed. For those women that need a carer to help them get dressed to prevent the pain, this device can give you back your privacy.