BAD LIGAMENT PAIN
Q:During my first pregnancy I suffered from round ligament pain. I’m now eight weeks pregnant. How can I avoid it this time?
A:Megan answers: Round ligament pain during pregnancy is a common complaint – it’s no wonder though as this ligament (which is about 5mm in diameter and 12cm long in non-pregnant woman) undergoes considerable growth and increases appreciably in both length and diameter during pregnancy. Understanding the biomechanics of the pelvis during pregnancy will help you grasp the function of the round ligament. The uterus is suspended in the pelvic cavity by numerous strong ligaments that attach to the wall and floor of the pelvis. The round ligaments attach from the outer parts of the uterus on both sides and insert onto the pubic bone, and this prevents the uterus from moving backwards. The round ligament comprises of smooth muscle fibres, which give it the ability to contract. During pregnancy these fibres are really put to work, growing in size as a result of the additional strain of the baby in the uterus. Due to this strain and increased workload they often hold tension, as a normal muscle would if it was made to work harder than it normally does, which may pull on the uterus. Think of a balloon where one side is being pulled: this is called intrauterine constraint. A compounding reason why these ligaments may hold tension is that your pelvis is out of alignment or is not moving correctly. When your pelvic joints are restricted, it causes a “pull” on certain ligaments, which include the round ligament, that attach to the pelvis. This in turn creates torsion on the uterus. This may inhibit your baby from moving into the correct position for birth, as well as limiting the amount of space allowed for them to develop and grow. It is important that you find a chiropractor with a special interest in perinatal care that is Webster-certified and registered with the International Chiropractic Paediatric Association, to ensure that you create an optimal condition for your baby to grow and develop, and that you are free from discomfort and pain. Creating a balance in the joints, muscles and ligaments in the mother’s pelvic cavity will not only allow for an easier delivery, but it will also allow the baby room to develop without restrictions to its forming cranium, spine and other skeletal structures. I often advise my pregnant moms to release the ligaments from tension themselves by working them on both sides while they are in the shower. To find the ligament is quite easy – use your one hand to draw an imaginary line from your belly button downward and outward at a 45 degree angle from the horizontal. Using your other hand, draw an imaginary line from your hip bone (the bony prominence you feel on the front of your hip) downwards and inwards at a 45 degree angle from the horizontal. Where these two lines intersect is where you will find the round ligament. Use your fingers to work the ligament while applying a gentle pressure in an upward and inward direction towards your opposite shoulder. Keep in mind the positioning of the ligament, and that it attaches to the pubic bone, work the round ligament all the way along feeling for any difference between the two sides with regards to pain, tightness and discomfort for about two to three minutes daily. Round ligament pain with associated nausea, diarrhoea, fever, bleeding, cramping or contractions requires the attention of your healthcare provider.