One of the most common complaints that I hear in my prenatal yoga classes is a sharp, shooting pain in the pelvis~ otherwise known as lightening crotch. Unfortunately this can happen at any time during a pregnancy and it is extremely uncomfortable!
Pregnant people might experience anything from a quick flash of pain once or twice during their pregnancy while moving funny, an ache and pain any time they move positions in bed, or some people experience pain every time they move. Ouch!
If you are experiencing a pain in the front of your pelvis, what you are feeling is the pubis symphysis. The pubis symphysis is located in the front of the pelvis, and is thick fibrous cartilage, about 1 cm, that joins the two pubic bones. It is technically a joint in the pelvis, and during pregnancy we are flooded with a flow of hormones that facilitate greater movement and stretching in our joints to allow for more space for the growing uterus and an easy passage for the baby when giving birth. Pain comes when that mobility and stretching goes too far. Normally your joints, especially the ones in the pelvis, have very limited mobility. (Keep in mind that these hormones linger in the body for months after giving birth- so giving yourself time to heal and moving with intention is very important to not aggravate any problems that have come up during pregnancy or create new ones.)
Having mobility in the pelvis during delivery is something we can be grateful for! While typically the distance from the coccyx (your "tailbone") to the pubis is somewhere around 9 cm, during delivery it will expand to reach 11 to 12 cm!
While we can thank nature's design during delivery, lightening crotch feels a lot more intense than it's silly name implies. This can be an inconvenient, distracting, and downright tear-inducing experience, but unfortunately once it has begun, there's little you can do to reverse it.
What we want is prevention.
Lightening crotch, or a stretching of the joint between the pubic bones is caused by too much mobility in the pelvis. The fix is pelvic stability.
Stabilizing your pelvis can also be practiced after symptoms of lightening crotch have begun, to lessen the frequency and pain moving forward, but it should be practiced by all pregnant people- especially those with a yoga practice!
Gasp! Is this an example of a yoga practice doing harm rather than good? Unfortunately, yes. Pregnancy is a time of hyper-mobility and for the majority of the pregnant population, there is more tension and tightness in the muscles (thanks modern-day lifestyle!) but more movement in the joints. Sound like a recipe for disaster? For some of us, it is.
But fear not! Let's look at how to stabilize the pelvis and prevent this issue from happening or getting worse.
First of all, give some love to your muscles. Your pelvis is a big, heavy set of bones, and it is supported by some of the bigger muscles surrounding it. The core (no, not your six pack abs- the muscles that surround the trunk of your body, including the low back and sides of the waist), your glutes, your deep hip muscles, and the muscles on the insides of your thighs (also known as the adductor muscles).
Imagine for a moment that your inner thigh muscles are very tight, tugging and pulling on your pelvis. Your glute muscles are "turned off", meaning they are not doing much work, because they typically don't have to. These weaker muscles are not supporting the pelvis while sitting and standing, leaving the pelvis to the mercy of the tighter muscles surrounding it. Your hamstrings become shortened and tight thanks to the sitting you do much of the day, and this adds to the tension in the back of the body, pulling your pelvis further out of alignment. Your heavy belly pulls on you, with no help or support from a weak core. Does this sound extreme, or maybe even a little mean? Don't feel bad, if this is you, you aren't alone! (And to be honest, it's probably most of you.) While yoga can help to counter some of these alignment and muscular issues, during pregnancy, if proper attention isn't paid to really supporting the pelvis, you can see how things can get pulled and pushed into unintentionally painful places. We can start finding more stability by gently finding more flexibility in the hamstrings, and building strength in the core and glutes. (Bonus, this also greatly benefits pushing during labor! Win-win!)
To take our pelvic stability further, and onto the yoga mat, you can imagine that everything must always "come back to center". What does this mean? I want you to imagine the bowl of your pelvis. It has 4 bony points on the bottom, the two "sit bones" as I call them in class, and your pubic and tail bone. On the top are the two bony hip points that you can feel, and the crests of the pelvis, that make up the top of the pelvis. Now imagine for a moment, that your goal during your yoga practice, is to keep your pelvis from tipping too far in any direction. Perhaps it is filled with water, and you want to end class with about the same amount of water you started with. When folding forward or lying on the ground in a pose such a pigeon, our pelvis isn't spilling any water if the spine is in line with the pelvis the same way it would be while standing. In other words, your low back isn't rounding and the tailbone isn't over-tucking. How do we make sure this happens? We use our thighs and glutes to actively bring our pelvis back to center. We activate our core muscles in the lower belly, the sides of the waist, and the back to help level out the pelvis. For example, maybe you can try this right now.
Stand up tall with your toes pointing forward, your knees right over your toes, and your hands on your hips. Feel for your bony hip points, and find your own body's neutral space. Ask yourself, are you tucking your tailbone? Or lifting your tailbone too high? Would water be spilling out of the top of your "bowl" in any direction? Okay, now step back into a high lunge with the right foot forward and your left foot back, or Cresent Pose. Your back heel is lifted and your chest is facing forward. Keep your shoulders right over the hips, and keep your hands on your hips. Did your pelvis move? Now can you actively engage your right thigh and draw it back slightly. Imagine the large bone in your thigh, and plug it into it's socket in the pelvis. Now engage the left thigh muscles, and do the same with the left leg, but this time you will be pulling it forward. Notice if the back left hamstring is so tight with the leg straight that your pelvis tips forward. Try bending that back knee slightly until you feel the pelvis level out and come back to an upright position. Is this hard? Good! That means you are working! Hold this for 3-5 breathes and then move to the other side.
You want to apply these same actions in many of your yoga postures during class, especially anything with the legs separated wide. Think your warrior poses, straddle folds, seated stretches with open legs, etc. And the most painful thing of all- don't push into your flexibility. I know, I know.. most of my students hate this. Yoga is about being flexible and bendy, right? But for the next year or so (9 months for pregnancy, and several months after), your goal is to be strong and create a sustainable practice. That means giving 80%, and sometimes coming out of the poses a little instead of being all in. And this is a very personal thing~ yoga is all about self-discovery after all! There will be times when you can melt deeply into a juicy pose, and that's perfectly fine. But always be listening, and paying attention to what the body is telling you. If you find yourself hanging into your joints, never engaging your muscles and experiencing any pain in your knees, ankles, pelvis, etc. then it is time to check yourself and what you really want to get out of your yoga practice.
I hope this helps you, and if you have more questions about this- some of the specifics or how-to's, don't hesitate to ask! Put your questions in the comments below, or email firstname.lastname@example.org. And for those of you that are local, I will see you on the mat! I'm at Inner Evolution Yoga every Sunday at 11am.
Be Well Yogis and Yoginis!