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Jerusalem physiotherapy by Tamara May

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SIJ

Do SPD Belts Really Work?

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In one word yes, but I will elaborate a bit further as it does need to be in conjunction with preventative measures.
I will start by quickly describing what SPD is. It is the symphysis pubic bone, the bone at the front, which is commonly a very stable joint and closed without a gap on a normal day. During pregnancy the hormone relaxin is released to relax your ligaments and soft tissue in order to make room for your growing baby and for giving birth. Due to this, in some cases the gap between the symphysis pubic joint can open causing instability and pain. Once this pain has started – if it is truly just SPD and no other joints are involved – will continue until after the baby is born. Physiotherapy in this case can only stop it getting worse and cannot stick the joint back together and get rid of the pain. In most cases the pain will go away as soon as the baby is born.
For some unlucky women the pain will linger after the baby is born, due to the hormone relaxin being mimicked in breastfeeding mums which will not exit your body until 3 months after you finish breastfeeding. Fortunately for many though SPD is coupled with a condition called sacroilliic joint dysfunction. This is anther joint that has been moved out of place due to your ligaments relaxing. This joint though can be manipulated back into place often creating an instant relief, and this can be done by your physiotherapist.
So where does the belt come into all of this. The belt will lie over the symphysis pubic joint holding it firmly in place. Now this will not stick it back together but every time you walk quickly or stretch your leg too far this causes more pain. The belt will hold the joint that little bit more in place and also acts as a reminder to keep your legs closer together at all times.
The belt will firmly hold the joint and every time you are regularly walking this will prevent the gap getting larger, causing a small relief taking the sting out of the pain. Again this will not ease the pain as the gap will still be there but it prevents it from getting worse and aggravating it.
I am a great advocate for the SPD belt, but, very importantly, it needs to be coupled with exercise and being aware of what aggravates the pain . For instance not running, doing the stairs one at a time and rolling over in bed with knees together are all important things to remember to not cause the joint any further opening and further pain.
If you want to purchase a belt or suffer from SPD and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.

SIJ Dysfunction: Not to be Confused with SPD

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Sacroiliac joint dysfunction (SIJ) is a condition that one can suffer from during pregnancy which completely resolves itself after birth or shortly after.  Although it can be very painful during pregnancy, fortunately there is a lot a physiotherapist can do. 
Personally, I had never heard of SIJ until I started my training to become a women’s health physiotherapist. One of the reasons I and many others had not heard of it is because quite often if you suffers from SIJ, you also suffer from SPD.  Because patients often have the same symptoms from the two conditions, such as pain when using the stairs, the diagnosis of SIJ is missed.
What is SIJ? 
The sacroiliac joint is the joint at the back of your pelvis. When you have SIJ, pain is felt over the buttock and/or back of the thigh. Occasionally the pain is also felt over the groin and the entire back of the leg. SIJ is the misalignment of the sacroiliac joint.  The misalignment can take place in a few ways: it can be rotational in one of two different directions or the joint can slip upwards.  
The cause of this misalignment and the resulting pain is the hormone relaxin, which has come up a few times on this blog. Yes, the one that relaxes your ligaments and soft tissue. Relaxin has been the cause of most of the problems I have written about on this blog. But I promise you it is a useful hormone overall, as it prepares your body for birth and helps make room for the growing uterus. 
Can it be treated?
The job of the physiotherapist is this case is to diagnose the problem and then simply put the joint back in place. It sounds like it would be painful, but it is not.  This procedure will leave some patients completely cured and free of any more problems, while with others the misalignment can keep occurring and the physiotherapist will simply have to keep realigning the pelvis.  
In addition to this treatment, your physiotherapist will also advise you on stability exercises. This is because it is really important to strengthen the muscles around your pelvis and those that help with core stability. This helps to share the responsibility for your stability between your muscles and joints together, and not leaving it all to your joints. 
If you are suffering from groin and buttock pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.