SPD: more than just a pedal system

So this pregnancy lark. I learn something every day. One of my most recent discoveries is that SPD is not only the name of a clipless pedal system. It also happens to stand for symphysis pubis dysfunction – or what is now more commonly called PGP, or pelvic girdle pain. The latter name is a more descriptive but still really doesn’t do it justice as it can, in some cases, be enormously debilitating, rendering the sufferer virtually immobile. It happens thanks to everyone’s favourite pregnancy hormone, relaxin, causing your pelvic muscle to relax so much that your pelvis becomes unstable, leading to all manner of postural imbalances and, in most cases, extraordinary levels of pain. As if lugging an enormous baby bump all over the place, with your stomach muscles separating, your back aching, your hormones all over the place isn’t enough? I’d not heard of it before but it’s actually pretty common, with estimates ranging from 1 in 300 (diagnosed) and 1 in 50 (2% suffering symptoms but undiagnosed) women experiencing it during their pregnancy. And it’s the gift that keeps on giving, because if you experience it during one pregnancy you’re more likely to experience it again during any future pregnancies. Having read a bit about it on various forums and discussion boards, it seems that not only are you more likely to get it again but you’re also likely to experience symptoms earlier in your next pregnancy and, consequently, be more severely impaired. Lol, not.

And what, you might ask, are these lovely symptoms we get to experience? Well, the personal impact on me was that I could barely walk, which is the worst kind of nightmare for someone who has to move to stay sane. Stairs become problematic, as does standing up generally, or attempting to stand from a sitting position. Oh, and getting in and out of a car, rolling over in bed, and so on. There’s more info on this website for anyone searching out a more detailed description of the symptoms. Or just Google it.

Lucky for me I’ve had only three episodes – one most likely caused by an overenthusiastic prenatal hip opening yoga session, another a 3-hour car journey, and, more recently, a walk in the snow carrying shopping at 37 weeks pregnant (yeah, duh, what was I thinking?) – and all of them seem to have settled down within a few days or a week or two. Whether that’s been down to luck or good management on my part, who knows. I don’t care. I’m just grateful that each time symptoms have appeared they’ve subsided rather than sticking around and getting worse. I do wonder about my “treatment” of it though, which was basically to go against NHS advice (take painkillers, starting with paracetamol and working up to codeine, if it’s really bad) and instead focus on gentle exercise (basically 10-minute sessions of cat-cow and short, mindful walks), rest when I felt the need, and moving ridiculously slowly, being mindful to keep my pelvis as aligned as possible at all times. I think not having any painkillers meant it was pretty darned obvious if a particular movement was overextending me or causing any unpleasant postural imbalances, which enabled me to adjust, recheck my alignment and back away from the discomfort.

Whether my approach would work for someone else, well, you’d just have to try it and see. There is lots of info out there on the Internet for anyone suffering so you can either go down the self-care route, as I did, or hit the pills – as the NHS would have you do. Worst case you can end up on crutches or in a wheelchair, so I would definitely advise anyone who is experiencing any symptoms (which for me started as something akin to groin strain and then got much worse rather than easing off) to take them seriously and – particularly if you’re not familiar with any posture-related practice like yoga or pilates – seeking out a physio or chiropractor (check with your midwife) who can help. Some places do list PGP (or SPD) as a specialism, so they’d be my first port of call. If you are experiencing anything as rubbish as this, you have my sympathy! On the upside, you can come out of pregnancy knowing your pain threshold has most likely reached new limits (and that’s just the 9 months running up to the actual birth), which can only mean a tougher mental attitude to all those mentalist hill climbs once you actually get back on the bike, if that’s your thing. Silver linings.


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