The pelvis is a strong bony ring structure designed to protect the abdominal organs and connects the lower limbs to the spine, allowing for attachments of muscles of the hip, groin and thigh.

The pelvis is formed by three innominate bones: the pubis, ischium and ilium. At the front, it connects via the pubic symphysis (cartilage disc) and at the back, by the sacroiliac joint.

Due to the high amount of load going through the pelvis, it is a common area to get sore.

Pelvic girdle pain

Pelvic girdle pain (PGP) is an umbrella term for a group of musculoskeletal conditions of the pelvis and it is believed that around 72–84% of women develop pain in this area during pregnancy (Beales & O’Sullivan 2011).

It has long been thought that PGP is caused by changes in the stability of your pelvis, weakness of your core and poor posture. These are common misconceptions, as the pelvis (ligament and joints) is an extremely robust structure.

Hormonal changes during pregnancy change the areas’ sensitivity to pain, not ligamentous integrity. Weakness of the core is not associated with PGP, whereas excessive muscle tension is.

A thorough assessment is important to identify the aggravating factors linked to your PGP and to develop a management plan to not only relieve your pain, but to work towards rehabilitation and prevention.

Pelvic floor muscles

The pelvic floor muscles sit underneath your pelvis and run from your pubic bone at the front, to your tailbone at the back, forming a sling or hammock that supports your pelvic organs (bladder, bowel and uterus). The pelvic floor muscles also wrap around your bladder passage, vagina and back passage. Strong, correctly functioning pelvic floor muscles help to prevent leakage of urine by squeezing the bladder passage shut during exertion.

Prenatal and postnatal

Most people could benefit from pelvic floor exercises; however, due to the changes the body goes under during pregnancy and post pregnancy, it is extremely important to make sure they are functioning properly.

Problems can arise due to weakness or excessive overactivity, so it is important that you have a thorough assessment by a postgraduate physiotherapist trained in continence and women’s health. The physiotherapist will thoroughly assess your pelvic floor muscles and develop a tailored pelvic floor muscle exercise program for you that addresses specific goals you may have. Have a read of Pelvic floor explained for further information.

Pelvic organ prolapse

Pelvic organ prolapse (POP) occurs when the connective tissues and muscles in the pelvic area are weakened. This can be a natural process as women age, especially as menopause approaches when oestrogen levels begin to decrease. However, other factors such as pregnancy and childbirth, obesity, smoking, or a previous pelvic injury can cause the symptoms to be more severe. Read our guest blog on Keeping your pelvic floor strong for more information.

Groin pain

Groin pain is one of the most common problems amongst the sporting population, particularly those who partake in kicking-related sport. The most common cause for groin post is irritation and overloading of the adductor muscles, which are located on the inside of your leg and are used in a stabilisation role for the pelvis.

Common causes for groin pain include:

• A weakness of the adductor muscles
• A weakness along the leg — both left and right. It is not uncommon for a previous injury to the opposite side to result in increased work for the adductor muscle
• A change in training load, for example a sudden increase in kicking, running or weight training

Management of groin pain

• Identifying the underlying cause
• Reduce and modify aggravating activity
• Settle symptoms
• Develop a rehabilitation program to target underlying weakness to prevent reoccurrence

Pelvis pain treatment with Life Ready Physio

With professional treatment such as joint mobilisation, massage and therapeutic exercises for improved functionality, Life Ready Physio will not only alleviate pelvic pain — we’ll provide you with the tools to prevent future injuries too.

For an in-depth assessment by one of our skilled physiotherapists, book a consultation here.

We look forward to joining you on this journey to pain-free living!

References
Beales. D & O’Sullivan. P (2011) A Biopsychosocial Model for pelvic girdle pain: A contemporary evidence based perspective. Physioscience. 7: pp. 1-9.

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