How to cope with hip pain after childbirth?

Pregnancy is a huge stress for the entire female body, and childbirth can often result in a whole “bouquet” of pathological conditions for a woman that she had never even thought about before. Thus, a huge percentage of young mothers complain that their tailbone hurts after childbirth. For some, this condition is temporary and goes away a couple of weeks after the birth of the child, while others cannot boast of such a quick relief from the unpleasant sensations that have haunted them for many months.

How long does it take for the pelvic bones to converge after childbirth?

The birth of a baby is one of the most beautiful moments in a woman’s life.
But staying in the birthing room is not always pleasant. The woman experiences enormous pain, which she endures until the last moment, but after childbirth, pain and discomfort may remain due to changes that appeared during childbirth. Many women say they have pelvic problems after childbirth.

To understand the mechanism of childbirth, you need to know a little about the anatomy of the pelvis.

In order for a baby to be born, it must pass through the birth canal, which is formed by the bony pelvis and soft tissues. The baby's sides are surrounded by the ilium, ischium and pubis. These bones are connected at the back by the sacrum with its ligaments, and at the front by the pubic symphysis.

The pubic symphysis itself is a fusion of the right and left pubic bones using a cartilaginous disc. Therefore, in its center there is a small joint space in which articular fluid is present. The entire symphysis is surrounded by ligaments that hold it tightly.

This joint is similar to a joint, but it has a very small angle of motion. Normally, the joint space reaches only one centimeter, but the pelvic bones diverge before childbirth, and this distance becomes larger.

In front of the symphysis pubis there is the pubis, which is represented by adipose tissue and the ligament that lifts the clitoris. Nerves and blood vessels pass behind the pubic bones, and the bladder and its excretory canals are located.

So, do the pelvic bones really move apart after childbirth? Yes. But to be more precise, the pubic symphysis is stretched.

What reasons lead to divergence of the pelvic bones?

There is a physiological explanation for this phenomenon. During pregnancy, a woman's pelvis undergoes changes to ensure that childbirth is as easy as possible.

Any woman can argue that there is nothing easy in the process of giving birth to a baby. But if there were no changes in the pelvic bones during pregnancy, childbirth would be like a horror movie.

Both baby and mother should remain healthy and alive, so there are normal changes in the joint.

During pregnancy, the ovaries and placenta produce a substance called relaxin. As the name suggests, it has a relaxing effect.

Relaxin, mixing with female sex hormones, causes swelling of the ligaments and cartilage of the semi-joint, they become loose. In addition, small gaps are formed in the joint, filled with fluid.

The looseness of the ligamentous apparatus and joint fluid give the pelvis greater mobility. There is a divergence between all the bones of the pelvis.

But most of all, these changes affect the pubic symphysis; blood supply to it increases. As a result, the ligaments and soft tissues swell, which increases the size of the joint, and the gap moves apart by millimeters. In addition, the symphysis can move up and down, like the keys of an instrument.

But other factors can also cause discrepancies in the pelvic bones.

Excessive divergence of the pubic symphysis leads to changes in the osteoarticular system of the body. This takes on the appearance of a pathology; the pelvis after childbirth brings discomfort and pain. This phenomenon is called symphysiopathy, and toxicosis plays a major role in its occurrence.

The following factors also affect the skeletal system:

• Disturbances in phosphorus-calcium metabolism. The main structural component of teeth and bones is calcium. The hormone, calcitonin, and vitamin D regulate the metabolism of calcium and phosphorus in the body.

Calcitonin is produced by the parathyroid glands, and vitamin D is synthesized with the participation of the thyroid gland

Therefore, during pregnancy, a woman’s nutrition is very important; the diet should have enough phosphorus and calcium

If there is a shortage of these elements, they will come out of their depots - bones and teeth. As a result, the bones will be subject to pathological influences.

• With vitamin D deficiency, a disturbance occurs in the metabolic processes of the intestines, where calcium and phosphorus are absorbed. Micronutrient reserves are drawn from bones, which leads to demineralization. In the absence of calcium in the blood, other problems may appear, such as kidney failure, gastrointestinal pathologies.

Dysfunction of the symphysis pubis

One of the reasons causing pathological divergence of the symphysis is DLS. There are three stages in the pathogenesis of this phenomenon: 1. The period before childbirth.

Leading links: heredity, lumbar pain during early pregnancies, hypo- or hyperactivity, use of oral contraceptives, traumatic injuries to the pelvis or back.

It is possible to develop DLS in multiparous women. 2. The birth itself. Obstetric operations, large or post-term fetus.

3. The period after childbirth. Lactation.

When do the pelvic bones diverge during pregnancy?

In the interval between 17 and 20 weeks of pregnancy, the body increases the rate of production of the hormone relaxin in order to soften and relax the naturally inelastic cartilages of the pubic and sacral joints. These changes in themselves cause particular discomfort for the expectant mother.

In this case, the pelvic bones normally hardly diverge, but if the distance between them increases by more than 0.5 cm, the painful sensations will increase significantly. In addition, excessive mobility of the pelvic bones limits the freedom of movement of the expectant mother - the woman’s gait resembles that of a duck, and it seems to her that her legs are about to move apart in different directions. Adapting to such changes, the pregnant woman has to involuntarily stick her stomach forward.

In fact, it is not possible to say exactly at what stage of pregnancy the pelvic bones diverge. Physiological changes in the skeleton can occur both in the early stages of pregnancy and shortly before childbirth - the timing and degree of softening of cartilage is individual. In order not to miss the development of complications, the expectant mother should tell the doctor about all her worries and ailments.

Timing of convergence of pelvic bones after childbirth

The postpartum period is no less important time than pregnancy. Doctors often call the first weeks after the birth of a baby the “tenth month.” For many months, the female body was actively preparing for the birth of a baby. It is not surprising that it will not take much less time to return to normal.

The majority of changes in a woman's body during pregnancy occur due to the action of hormones. It’s not for nothing that when carrying a baby, they are actively produced. This is necessary both for the proper development of the fetus and for preparing bones and ligaments for the upcoming birth. Only after the birth of the baby does such an active production of “pregnant” hormones stop, after which the reverse process called involution begins. So, when do the pelvic bones come together after childbirth?

Experts note that the so-called divergence of the woman’s pelvic bones occurs immediately before childbirth. That is, the cartilage tissue softens in the area of ​​the pubic symphysis. True, this same discrepancy does not go beyond 1.5 - 2 cm. Do not forget that after childbirth, the pelvic bones cannot return to their original state with lightning speed. It's not surprising that many women begin to wonder when the pelvic bones come together after childbirth. This often takes the entire postpartum period.

It is advisable that the new mother begin performing postpartum gymnastics exercises as soon as possible, as soon as she is able and her health allows. After all, the main goal of such gymnastics is to prevent negative consequences after childbirth, such as pain in the pelvic area, incontinence or symphysitis.

One way or another, gradually the pelvic bones will return to their place after childbirth. Many women who have given birth think that the volume of their hips has increased precisely because of this divergence of the pelvic bones during childbirth. But this opinion is erroneous and originates from ignorance of the features of female anatomy.

Benefits of training

Exercises for the pelvic floor after childbirth are aimed at increasing elasticity and muscle tone. Through regular training, it is possible to narrow the vagina and restore its ribbing, return vivid emotions from intimate relationships and achieve orgasm. Considering that the vaginal muscles are involved in supporting the pelvic organs, strengthening them will prevent uterine prolapse - a common problem that appears after difficult childbirth and with age.

Trained muscles reduce the risk of inflammation of the genitourinary organs, the development of thrush, cystitis and other pathologies. Strengthening your pelvic floor muscles reduces your chances of being diagnosed with incontinence.

In addition to the above, strengthening the pelvic floor muscles after childbirth preserves youth and health due to improved blood circulation and delay of menopause. If you start exercising before birth, the process of bringing a child into the world will be easier and faster, with virtually no interruptions.

Consequences of symphysitis

If pain in the pubic area does not stop or intensifies after childbirth, you should definitely consult a doctor. Even if the pain is tolerable, without adequate treatment, serious complications are possible. These include lameness, chronic pain and problems with subsequent pregnancies and births. In the most severe cases, for example, when the ligaments of the symphysis pubis are torn, the woman will not even be able to stand on her feet, let alone move independently.

In addition, be prepared for the fact that even with successful treatment in subsequent pregnancies, there is a high probability of re-development of symphysitis. Therefore, when undergoing an ultrasound, ask your doctor to also examine the symphysis. If the discrepancy of the symphysis pubis in a subsequent pregnancy is higher than normal, you will most likely be recommended a cesarean section.

Although symphysitis is a rather unpleasant disease with a long recovery period, its severe forms develop quite rarely. With strict adherence to all the recommendations of the attending physician, most women are successfully cured of this disease.

Prevention

You can avoid the occurrence of painful sensations and all the physical and psychological problems associated with them if you are attentive to your own health after childbirth and catch the slightest “alarm bells” from your body. Do not neglect the advice of doctors, this way you will reduce pain and recover faster. To do this you should:

• reduce activity and physical activity, get more rest;
• consume more calcium during and after pregnancy;
• normalize your diet, paying attention to healthy foods, foods high in calcium and sufficient amounts of clean drinking water.

Within a week after giving birth, and then every six months, visit your gynecologist. Move more - this will not only help you return to your “pre-pregnancy” weight, but will also get rid of many problems with the pelvic bones and internal organs.

Treatment of symphysitis

If the discrepancy is small, the doctor will most likely recommend that you wear a special bandage that supports the pelvis and hips and limits movement, reducing physical activity, a set of exercises to strengthen the muscles and ligaments of the pelvis, and courses of calcium and magnesium supplements.

If possible, visit a qualified osteopath who will help restore muscle tone and balance to the pelvic bones.

Avoid any movements that may cause pain and further injure the ligaments:

• keep your feet together when getting in or out of the car;
• sit on the bed to put on underwear or trousers;
• do not sit on hard surfaces and generally avoid sitting for long periods of time;
• use a pillow to support your lower back when sitting;
• if you have to sit, distribute your weight evenly: do not sit with your legs crossed, do not lean on one side, do not do exercises with crossed legs, etc.;
• the same applies to the standing position: do not put your weight on one leg, do not lean one shoulder on vertical surfaces, etc.;
• try not to climb the stairs, use the elevator;
• Even if you feel better, for the next six months, stop cycling, running, jumping, and wearing high-heeled shoes.

For more complex conditions, hospitalization is recommended. The duration and complexity of treatment depends on the severity of the condition. In the second degree of symphysitis, bed rest is indicated for 4–6 weeks. With the third degree of symphysitis, surgery is required to apply fastening staples and subsequent strict bed rest for a long time (up to two months).

Using bandages

These devices help realign the pelvic bones, thereby reducing the severity of symptoms. They are sewn from dense elastic fabrics and equipped with belts for tightening and reliable fasteners. Adapted for 24/7 wear. It is ideal if an experienced physiotherapist selects a bandage for you.

In the first degree of symphysitis, a high-quality maternity bandage can be used to fix the pelvis.

Video: pelvic and abdominal bandages, personal experience

Physical exercise

Before you start doing the exercises, consult with an experienced specialist: depending on the severity of your condition, you may need correction of the complex.

The exercises are aimed at stabilizing the pelvis and strengthening the muscles and ligaments of the pelvic floor. The complex is performed 2-3 times daily at a slow pace, without jerks or sudden movements.

Kegel exercises

The easiest way to perform this exercise is to lie on your back and squeeze the muscles that form the anus and urethra (as if you want to stop urinating). Keep your muscles contracted for at least 5 seconds, while trying not to hold your breath or tense your hips and buttocks. Gradually increase the contraction time. Repeat 5 times.

Wall stand

Stand with your back to the wall, pressing the back of your head, shoulder blades and feet against it. Try to press your lower back to your back and stay in this position for 3-5 seconds. Repeat 5 times.

Try to press the entire back of your body against the wall

Thigh squeeze

Sit comfortably, thighs parallel to each other, thighs and shins forming a right angle. Place your fist between your knees, squeeze your knees and hold this position for 5-10 seconds. Repeat 5 times.

Make a fist with your knees for 5 seconds

If you are uncomfortable doing this exercise while sitting, you can do it lying on your back with your knees bent. Instead of a fist, you can use a small ball.

Cat

Get on all fours so that your palms are located under your shoulder joints and your knees are under your pelvic joints. As you inhale, bend your back and lift your head up. Stay in this position for 5 seconds. As you exhale, arch your back, lower your head and neck, and tighten your abdominal muscles. Stay in this position for 5 seconds. Repeat 5 times.

When performing the “Cat” exercise, stay in each position for 5 seconds.

Half bridge

Lie on your back, bend your knees and place them a short distance apart. Hands along the body. As you exhale, lift your hips up and hold in this position for 3-4 seconds. The shoulder blades should remain on the ground. As you inhale, lower your pelvis to the floor. Repeat 10 times.

The “Half Bridge” exercise will help strengthen the pelvic muscles

Drug therapy for symphysitis is rather auxiliary in nature. Calcium and magnesium supplements are intended to strengthen bones that are weakened after pregnancy. Analgesics and other painkillers reduce discomfort and make everyday life easier. Unfortunately, many painkillers are incompatible with breastfeeding, so you should consult your doctor before taking them.

Treatment of symphysitis after childbirth

Modern methods of therapeutic treatment for symphysitis can prevent surgical intervention and normalize anatomical structures. Drug treatment of symphysitis after childbirth involves the use of medications that contain magnesium, calcium, and B vitamins.

In some cases, the use of antibacterial drugs is necessary, regardless of the degree of discrepancy. In addition, it is possible to use physiotherapeutic methods, for example, ultraviolet irradiation, which will speed up the recovery process.

Treatment of symphysitis after childbirth includes some recommendations. They concern restrictions on any type of physical activity, mandatory wearing of a bandage and the use of an (orthopedic) mattress for rest. In case of severe pain, painkillers should be used.

As for physical activity, it is recommended to perform certain exercises under the supervision of a specialist to strengthen the pelvic, gluteal and lumbar muscles.

Symptoms

Conduct an initial diagnosis of your problems:

1. With inflammation, the pain is burning. It is not clearly localized and can spread to nearby tissues. The joint may turn red and if you touch it, you will feel a rise in temperature.
2. Nagging pain occurs when the joint has not yet recovered from the injury. Or if the fabric is subject to constant minor damage.
3. Constant fatigue also causes pain in the muscles. Mainly in the lumbar and femoral region. Your knee may ache if, say, you were lifting a stroller up the stairs.
4. When a nerve is pinched, the pain is stabbing. They begin in the lower back and radiate to the pelvis and legs. A concomitant manifestation of radicular syndrome is muscle spasm.
5. With inflammation of the female organs, it may seem that the joints hurt. Gynecological problems can be understood by painful urination, discomfort of the genital organs, and pain in the lower abdomen.

Consequences

Symphysiopathy, as well as divergence of the pelvic bones, are conditions that have an extremely favorable course. This pathology is not an indication for a cesarean section. During childbirth, different techniques are used depending on the degree of separation of the bones. Only in cases of severe discrepancy and danger to the pelvic bones is it recommended to perform a caesarean section.

The most unpleasant thing that symphysiopathy brings to a woman is bed rest and limitation of physical activity. It is extremely rare that exercises to align the pelvic bones after childbirth can aggravate the situation and lead to rupture of the symphysis if the distance between the edges of the bones exceeds grade 2. But this happens more often during childbirth itself, if the pelvis is initially narrow and labor activity is strong.

When a rupture occurs, the bladder may be injured and hematomas may form in the pelvic cavity. They may be accompanied by an inflammatory process. If the symphysis is severely damaged during the birth of a baby, urgent surgical intervention is required. After which it will be possible to start physical activity after 4 or more months.

Prevention of discrepancy of the pelvic bones will include a correct lifestyle, nutrition enriched with microelements, and physical activity. Every woman should know and understand that the health of her unborn baby depends only on her.

The birth of a baby is one of the happiest events in a woman’s life. It is also the most painful. After all, the process of childbirth is not always calm and quick. It involves complex mechanisms of the reproductive system, the components of which include the divergence of the pelvic bones. The woman’s body prepares for this process in advance, which is accompanied by significant discomfort and pain. When do the pelvic bones return to their natural position after childbirth? What are the features of this process?

Contraindications for performing exercises

Kegel exercises for the pelvic floor muscles after childbirth are considered practically harmless, but there are temporary contraindications, such as the presence of tears and sutures. Until the wounds heal, you should not strain the perineum. You can focus on painful sensations, and if they appear, classes should be postponed. Therefore, it is worth consulting with a gynecologist before starting training.

In some cases, gymnastics of the intimate muscles is strongly discouraged. These are health problems such as:

• exacerbation of heart and vascular diseases;
• bleeding;
• colds;
• perineal injuries;
• tumor processes;
• infections, inflammation in the pelvic organs.

Training aimed at restoring the pelvic floor requires time and effort. As with other sports activities, you should refrain from any activity while feeling unwell. The body needs strength to fight diseases, so it is not worth forcing it to spend resources on strengthening intimate muscles.

Relaxation of ligaments and thinning of the symphysis pubis

As the date of birth approaches, the hormone relaxin, the presence of which is characteristic of mammals, begins to enter the blood.

It provides relaxation of the pelvic ligaments and thinning of the pubic symphysis.

In the medical literature you can find the word “lysis”, that is, “destruction”, but in this situation, of course, it does not reach the process of destruction. It’s just that nature is doing everything possible to help the emergence of new life. Most often, these processes do not occur immediately and do not cause significant discomfort in a pregnant woman.

But sometimes there is excessive relaxation of the pelvic joints, associated with too high an intensity of natural processes. Unfortunately, scientists cannot yet explain what causes such cases.

It is excessive relaxation of the pelvic joints that can lead to pain during pregnancy. Moreover, because of this, stretching or even rupture of the ligaments may occur during childbirth, especially during surgical intervention. Additional risk factors include poor obstetric practices, including precipitating labor.

Symptoms and types of pain

For a doctor to make a correct diagnosis, it is important to know not only why the tailbone hurts after childbirth, but also what sensations this pain is characterized by. And it can be of the most unexpected nature, from aching to acute, and be periodic or constant. Additional symptoms in some cases include fever, vomiting or diarrhea, and cystitis. In addition to direct pain in the tailbone, pain can radiate to the perineum, anus, lower leg, thighs, and also radiate to the gluteal muscles.

Nature of pain

If a woman characterizes pain as very intense or sharp, and there is fever, then most likely there is an inflammatory process progressing in the uterine cavity. In this case, you need to make an appointment with a gynecologist

, who will conduct a visual examination and perform an ultrasound to check for the presence of clots that were not rejected during uterine contractions after childbirth. When, after childbirth, the tailbone hurts when sitting or walking for a long time, and the sensation is rather pulling or aching, we are talking about pathologies of the musculoskeletal system, even a fracture of the tailbone is possible. This problem is already solved by the surgeon.

Consequences

To avoid an unfavorable outcome, women after childbirth should consult a doctor even if they have the slightest concern in the pubic bone area. The most dangerous consequence of the complication is ligament rupture, as a result of which the woman completely loses the ability to move and becomes disabled.

Patients who have experienced symphysitis have a high probability of repeating the situation in subsequent pregnancies.

Therefore, it is important to tell your doctor about this problem if it occurs.

During an ultrasound examination, the specialist will pay attention not only to the condition of the fetus and uterus, but also to the pelvic bones. If there is a high probability of relapse, a caesarean section is recommended.

Women should give birth using a similar method after surgery performed on the pelvic bone tissue.

Ways to restore pelvic floor muscle tone

You can eliminate weakness of the pelvic floor muscles after childbirth in one of three ways:

1. Drug therapy that is prescribed to treat diseases that cause muscle weakening.
2. Surgical. Surgery is prescribed only in severe cases. Disadvantages: long rehabilitation period, high risk of complications.
3. Kegel exercises are effective exercises after childbirth to strengthen the pelvic floor. Can be performed at any age. With regular and correct exercises, the effect will not take long to appear.