Treatment of diastasis sympthysis pubis

This is a condition that tends to worsen as the pregnancy progresses.  It is vital to decrease pressure on the pelvis as much as possible even if you are not feeling pain at the time.

Avoid

  • Avoid standing on one leg, get dressed sitting down.
  • Avoid standing for long periods. Sit down wherever possible for tasks that require you to stand such as food preparation or ironing.
  • Avoid squatting where possible.
  • Avoid repetitive tasks.
  • Avoid high intensity exercise.
  •  Avoid separating your thighs where possible, especially turning over in bed.
  • Avoid the extreme ranges of movement of your hips, pelvis and low back.

Health Practitioners

  • Hands on treatment with practitioners such an osteopath, physiotherapist, myotherapist, chiropractor, acupuncturist can assist in improving and managing your symptoms by decreasing muscle tension and improving joint mechanics.
  • Discuss your symptoms with your GP, midwife, Obstetrician.
  • Exercise program to strengthen pelvic musculature with a specialised Physiotherapist, Osteopath or Pilates instructor.
  • Pelvic floor and core strengthening can assist greatly especially learning to brace these muscles when you need to lift or bend. Speak to your health practitioner about these.
  •  Some women experience feelings of depression, guilt, grief or anger associated with the condition. Speaking to a psychologist, councilor or a support group may assist. As can treatment from a Chinese medicine, homeopathic or flower essence practitioner.

Everyday tasks

  • If you have a severe case and have trouble walking, consider hiring a wheel chair or electric scooter if you need to go to a shopping centre or supermarket for a long period, many centres hire these out for free.
  • Listen to your body, pain is there for a reason. If it hurts, you are best to stop and avoid that activity. Ie- shopping, vacuuming, sweeping.
  • Ask for help with everything, the less you strain your pelvis, the better you will be ie-… shopping, cleaning, childcare, work, lifting.
  • Consider a nanny or babysitter to give yourself a break and help get you through.
  • Avoid heavy lifting. Get a toddler to climb onto a stool or chair before lifting them up.
  • Reduce straining everyday activities as much as possible. Ie- buy groceries online, get your groceries delivered, get a clothes and nappy washing service, get a cleaner, get meals delivered.
  • Set yourself up for what you will need for the day ie- big bottle of water, thermos of coffee, snacks, phone, remote etc so that you don’t need to get up or go up stairs all the time.
  • Get a stool to sit on when doing tasks such as ironing, washing dishes and cooking.
  • Play with children when seated where possible.
  • A claw can be of great assistance to help you pick things up off the floor.

Sleeping

  • Sleep with something in between your knees such as a body pillow or knee and Ankle pillow
  • Try sleeping with silk or satin PJ’s as you can slide rather than have to pick yourself up to turn over.
  • You may find it easier to turn over in bed by going up on all 4s.
  • Consider hiring an electric recliner if your sleep is severely affected.
  • A mattress topper can take some of the pressure off your pelvis when lying.
  • When turning over, keep your knees together; contract your pelvic floor and core abdominal muscles to increase stability.

Movement

  • Reduce the strain on the pelvic
  • Don’t put asymmetrical strain through your pelvis .
  • avoid stairs where possible. You may find it less painful to walk up the stairs sidewards. If one side is less painful than the other, always step up with that leg first.
  • swing both of your legs onto the ground before getting out of the car.
  • You need to rest and avoid irritating the joints however you still need to remain active to avoid losing muscular strength. This is a delicate balancing act.
  • Towards the end of the pregnancy or earlier on if you have a severe case, you may need crutches or a walking stick to get around. This is vital if you are starting to experience pain with all movement, especially if you feel like your pelvis or legs are going to give way.
  • Always keep your legs together! Abducting your thighs puts a great deal of pressure on the symphysis. Ie- keep your legs together when getting out of bed or your car and turning over in bed.

Sitting

  • with your knees under the height of your hips.
  • without crossing your legs.
  • With your knees together.
  • With your weight evenly over both of your sitting bones.
  • Change your position frequently from sitting, standing to lying. Unfortunately, even sitting puts strain on the pelvis.

Tips

  • Ice packs over the symphysis can be beneficial in reducing the pain.
  • Learning relaxation techniques such as meditation may assist by decreasing sensitivity to pain, decrease muscle tension and improve sleep.
  • The majority of women have no pain 3 months post partum and have a very significant decrease in the pain in the days following the delivery.
  • Sitting or lying on tennis balls may help decrease tension and pain in your gluteal muscles.
  • Getting your partner to gently put pressure on the gluteal muscles when you are lying on your side may also give you some relief.  Be careful not to slip, your pelvis is very vulnerable.
  • Your obstetrician may recommend that you don’t breastfeed if you have a severe case in order to decrease the hormone levels that cause ligament laxity. They may also prescribe you with medications that decrease the hormone levels.

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