Pelvic Girdle Pain, an instability in the Pelvis, Sacroiliac Joint and Symphysis Pubis, is one of the more common problems during pregnancy. It is something that as prenatal yoga teachers we need to understand fully, so that we can best support our students.
If you’ve studied our Bliss Baby Yoga Prenatal Teacher Training, you’ll already have a good understanding of the types of Pelvic Girdle Pain, namely Sacroiliac Pain and Symphysis Pubis Dysfunction (SPD). But how do we take this knowledge into the yoga class and integrate the needs of these students in a group prenatal class?
Firstly, it’s not always obvious that students might be suffering from these ailments – sometimes they might complain of simply a sore lower back, or perhaps an occasional twinge between the legs. It’s really important to try and catch these symptoms as early as possible so that the condition isn’t exacerbated. Asking more questions is important here – when do they get the pain, do they get it worse first thing in the morning, and do they notice what makes it more painful?
For someone with sacroiliac pain they might find that it hurts more after bending forward or taking a step into the bath where the weight is in one leg and the legs taken wide. If they are finding it painful to turn over in bed or the pain is between their legs when they are getting out of bed in the morning, the chances are it’s SPD.
For some, the pain can be felt some time after the movement that exacerbated it, making it hard to tell what makes symptoms worse. By spotting the warning signs you can help these students to modify their practice straight away, which will also prevent the conditions from worsening.
Of course, it’s important to refer them to a pelvic floor physiotherapist or a chiropractor / osteopath that specialises in prenatal health. Many women may not realise the issue is likely to worsen if not taken care of, so you can be key in helping them to prevent this.
It is also important to gauge their level of discomfort. There are some poses that are permissible if the condition is mild, however they should be avoided if there is great pain. A good example of this are asymmetric poses, such as a rocking lunge, are to be avoided if there is significant SI joint pain. As physiotherapist Lisa Fitzpatrick reminds us in the Bliss Baby Yoga Prenatal Yoga Teacher Training, it is important to “encourage students not to push through pain and ease off from any postures that may be exacerbating discomfort”.
As we also know from the Prenatal Yoga Teacher Training, wide legged forward bends are to be avoided for both conditions, as are balancing on one leg. This is because we are trying to ensure pelvic stability. Keeping feet parallel and avoiding poses such as Warrior II is also key.
If your students are attending a group prenatal class then it can be helpful to explain the general adjustments that they will need for their practice before the class begins. Suggest to them they keep extra props to hand, especially a chair (even if you weren’t planning to use one for the group that day).
Many poses won’t require big adjustments, just bringing the legs closer together, in the case of SPD, or avoiding forward bends in seated poses (for example Upavista Konasana – Wide Legged Seated Forward Fold) for sacroiliac pain. Also consider crossed legs versus knees wide apart for Baddha Konasana. Some of the standing poses will benefit from a chair, and balancing poses require both feet to remain on the floor for stability.
If these conditions are supported in class from the first symptoms, along with help from a physiotherapist or similar, they will hopefully be able to continue their pregnancy in comfort. Practicing yoga with specific adjustments will contribute to this.
Sometimes there are situations when the symptoms become so painful that even doing yoga is not possible. Don’t take it personally if this becomes the case, but make sure they are seeing their physiotherapist for support. Swimming (not breaststroke) can also be a great option.
As yoga teachers we have a responsibility to understand our students’ needs, especially during pregnancy where conditions can change quickly. Connecting personally with students before class and understanding where they are each week is such an important part of understanding and meeting their needs, especially when it comes to Symphysis Pubis Dysfunction and Sacroiliac Pain.
If you are passionate about nurturing women during pregnancy and postnatally, and offering holistic yoga classes with safe, appropriate and nourishing practices designed specifically for pregnant women and new mothers, you may be interested in our Bliss Baby Yoga Online Prenatal & Postnatal Yoga Teacher Training course. We also offer Online Extension Modules to enhance and further your learning in this area, covering topics including Perinatal Nutrition & Ayurveda, Prenatal & Postnatal Anatomy and Physiology and Pelvic Floor Anatomy and Physiology for Women’s Health.
Nadine O’Mara is an experienced prenatal and postnatal yoga teacher, doula, and our Bliss Baby Yoga Co-Director and Online Course Content Manager, who also runs her own business, Conscious Birth. Nadine shares her wealth of knowledge through contributing and editing content for our Bliss Baby Yoga online courses and social media, including being a co-facilitator of our Online Level 2 Fertility Yoga Teacher Training course. Nadine provides doula support, birth education and yoga for women and their partners in and around Bellingen on the NSW mid north coast, as well as offering self care and restorative yoga workshops.
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