Posted by Madeleine Speed, the Pelvic Partnership, May 2017
Although some women overcome the symptoms of Pelvic Girdle Pain (PGP) in a matter of weeks, there is a small minority who experience the symptoms of pain and reduced mobility for months or even years. This be because diagnosis or correct treatment was not offered promptly or at all. This month's blog outline's Ellen's story because it may give hope and encouragement to other women who have experienced PGP for a good many years before finding a way forward that really manages the condition effectively or overcomes the symptoms completely.
My Story by Ellen
Like many women, I first became aware of PGP when I was pregnant with my second child during my late twenties. I had three children and during the last two pregnancies, the familiar pain and difficulty walking or moving about would return and never really left. On and off, I had PGP symptoms for 15 years. I had given up ever getting back to feeling the way I did before I had PGP and it was only when I found out about the Pelvic Partnership that I started down the path to a full recovery. I am hoping that recounting my story of finding good physiotherapy and building fitness and core strength will encourage other women to find a way towards complete recovery or at least to make significant progress.
Ellen with her son, Martin
Experiencing PGP in two of my three pregnancies
Before I had my three children, I would consider myself a fit and energetic person who liked walking, swimming, taking exercise and enjoyed a good level of fitness. PGP can soon introduce a new set of expectations and my symptoms became very severe so that I needed to use crutches and a wheelchair to get around. I also experienced a great deal of pain and when I wasn't pregnant, I used medication to reduce the level of pain I experienced and which regularly stopped me sleeping or getting out and about.
It was tough and although I loved being a mum, the strain of coping with PGP meant that I couldn't do as much as I would have liked with the children when they were small and it also took a toll on my marriage.
When I was pregnant, back in the1990s, I was also trying to work and run the house. It was impossible for me to cook, clean, pick up the children or to drive when I had a flare up of PGP symptoms. I did go and see my GP and after several attempts got a referral to physiotherapy but I don't remember getting any 'hands on' manual therapy or more than access to crutches and a maternity belt.
I think I had accepted that I would never truly get better that I wouldn't be able to run, wear high heels again, or turn over in bed without pain and difficulty. What changed was coming across the Pelvic Partnership after 15 years and demonstrates that the right treatment can make a difference with PGP even if the time between the onset of symptoms and receiving treatment is well over 10 years! By chance, I found some information about the Pelvic Partnership and got in touch with Sarah Fishburn at the charity who talked to me about going and seeing a physiotherapist for manual therapy. She explained about how the pelvic joints work and how these can become stiff and sore in PGP. As a result the pelvic joints and surrounding muscles can fail to work together or to function properly, causing pain and mobility problems.
Sarah suggested that I go and see a physiotherapist she knew understood PGP and had a great deal of experience in treating the symptoms effectively. I went to see this physiotherapist (Lucy Walmsley) although I was initially sceptical about the results, particularly as I had experienced the debilitating symptoms for so long. These are the symptoms of PGP that were still problematic for me:
- Walking any further than a short distance.
- Standing for any length of time; I used to stand like a stork on one leg to try and alleviate pain.
- Sitting for a while was extremely painful and meant I sat on a special cushion filled with pockets of air to help ease the pain. I put a shoulder strap on this cushion and carried it everywhere, including to Australia and back.
- Pain and difficulty bending.
- General inflammation and pain for much of the time.
- I had issues with my internal pelvic floor muscle which made it sore to sit and painful during sex. This wasn’t discovered until many years later when I attended a Partnership conference which pushed me to go and have it checked. I even had a gynaecology operation unnecessarily to try an alleviate pain during sex when all the time it was just my internal muscle completely locked.
- Difficulty lifting including lifting babies or baby equipment but anything heavy once the children had grown up.
- Steps or stairs were a real challenge. At its worst, I would go a long way round to avoid any stairs or go up and down them on my bottom. I had a stair lift fitted at work via a government scheme.
Lucy took time to assess me to identify which pelvic joints weren't working properly and how to best to release them. I can honestly say that I instantly felt relief when she started using manual therapy to free the stiffness in my pelvic joints, realigning my pelvis. I walked out feeling sore but much freer in my movement. I could walk much more easily.
A programme for my rehabilitation
Although Lucy's intervention had immediate results for me, she helped me to recognise that I also needed to retrain my muscles to work efficiently again and she saw that my core muscles around my stomach and back were not sufficiently strong to hold my pelvis in its new and realigned position. So she set about outlining a programme of exercises and fitness to build up my strength and to supplement the manual therapy she provided.
This programme of rehabilitation and muscle strengthening kicked off my road to recovery and took about nine months. In some respects this is a long time but it really didn't feel that long compared to the length of time I had severe PGP.
During the first eight weeks I had improved to sitting more comfortably, walking without crutches, swimming, riding a recumbent bicycle and doing core-strengthening exercises at least twice a day. At this point I was taking medication to help with the pain and inflammation.
The next seven months consolidated my progress and I seemed to go from strength to strength. I felt physically more able and stronger and I managed to gradually lower my medication until I just used a Tens machine for pain relief. Over time, I didn't need to use the Tens machine anymore as the pain reduced and finally disappeared. It seems incredible but developing core strength and working my stomach and leg muscles really helped to overcome any pain I felt. I still used the crutches but needed them much less than I had originally.
Through working on my core stability and building up my general fitness to a much higher level, I made real progress. As a result, my physio saw that I could hold my pelvis in the correct position without using a support belt. She also felt that my strength had grown to such an extent that I no longer needed crutches.
I then started walking stairs again. This is the first time I had walked up stairs in nearly three years. At first there was a limit to how many stairs I could do and they still caused me some discomfort. It was easy to overdo things. But over time, I found that I could manage the stairs withou any pain no matter how many stairs I tackled.
Although, the PGP didn't stop me going abroad on holiday, after my fitness programme, I found I had really turned a corner when I returned to Venice. For the first time during numerous trips, I was able to walk up all the steps and across all the bridges. This was a far cry from my husband having to carry me up all the steps two years before when we got married in Venice. It didn't take long for me to get so confident in taking the stairs that I was able to run up them and I continue to do so.
As I didn't live that close to where Lucy provided Physiotherapy, we discussed the advantages of having an extensive period of treatment. So I went to Lucy for two weeks solid and stayed in B & B to do rehab work every day and get things really moving. She would then set me exercises to keep practising by myself. I continued with these exercises long after the two weeks to rebuild strength in the right muscles and get the most out of the treatment.
Maintaining a good amount of exercise
Once I was strong enough to walk for long distances and climb stairs, it would have been all too easy to reduce the amount of exercise I was doing or, worse still, to stop altogether. On the one hand, I was pretty much back to managing a range of physical activities at home and resuming a normal life but on the other, I could see that if I didn't stay fit, my ability to stave off PGP symptoms might be impossible. This was my fear so I felt I had to do everything to keep up a high level of physical activity. So after a discussion with my physio, I joined a gym, which was not really my sort of thing. The gym was a struggle at first because it made me realise that I was not as strong as I could be. This initial struggle just made me all the more determined to get fitter and stronger.
I gradually increased the amount of time I spent in the gym and the length of time I spent on each machine. I was pleasantly surprised to find it was getting a lot easier after the first month. Within three months I had built up my exercise to one hour three times a week. As well as working on my fitness in the gym, I continued to do core strengthening exercise at home most days. I use a wobble board and gym ball to help with these.
It's a good few years, now, since I started this level of fitness and try to keep exercising. My trips to the physio for checks and more advice are much less frequent, now. My new-found mobility has allowed me to fill my time with lots of other things but I keep reminding myself how important it is to keep up the exercise.
I would like to thank my physio Lucy Walmsley. Without her skill, help and support none of this would be possible. And thank you also to Sarah Fishburn for taking my call on the Pelvic Partnership helpline, helping me to get help and literally changing my life and mobility forever. It is incredible how much your life can change when you finally find the right path. So keep looking and trying, never give up: you just never know what’s around the next corner.
My son, Martin's, 'Fight back' at a legacy boxing event
My son, Martin was very much aware of my struggles with PGP symptoms as he was growing up. He knew that I didn't really make any progress until I found out about the Pelvic Partnership Charity, which guided my path to rehabilitation.
Earlier this year, Martin said:
"I would like to give something back to the Pelvic Partnership, so the charity can continue helping other women and their families who find themselves in a similar situation to my mum."
Martin took part in a charity boxing event called Legacy Boxing at Highcrest School in High Wycombe on 25th March this year. He used this as an opportunity to raise sponsorship for the Pelvic Partnership. The event proved a resounding success and Martin raised £1,003.98, including Gift Aid.
I am a very proud and grateful mum!
Thank you very much to Martin for wanting to help the Pelvic Partnership in return for helping his mum, Ellen, to literally get back on her feet. If you have similarly benefited from information and support through this website, please consider taking part in an event to raise money for us so we can continue to help other women with PGP. For more information about fundraising please visit our 'Get involved' section. Thank you.