Frequently Asked Questions about SPD and PGP
What do you say to people who are skeptical?
Of course, everybody's skeptical. Why wouldn't you be? When you tell your doctor you're coming here to learn this bizarre treatment he's going to laugh in your face. He'll say, 'don't be silly, there's no treatment for SPD'. Then he'll say, 'By the way, here's some crutches and a prescription. Go away and manage it on your own.' Think I'm joking? Try it! And nowadays, you can't even reason with your GP. As more and more people are actively looking for answers outside of the mainstream, if he doesn't like what you are doing he can strike you off his list for something as petty as not liking the colour of the waiting room!
Your midwife will tell you how many other women have SPD and that it's normal and nothing to worry about. "Here, I have these lovely crutches you can borrow". Other than that you need to visit your doctor who will send you for physio. But don't worry because it will go by itself when your baby is born. Here why not join this group, or that forum and discuss your pain? That way, you can all go round in circles, discussing something for which nobody seems to have an answer. If this all sounds a bit insane, then I'm afraid, it really is....
Your physio will give you a few exercises to do, usually one's that are wholely ineffective, and when they don't work, they'll tell you you must have been doing them wrong, so stop doing the exercises that make it worse and send you back to your doctor, who says, "oh dear, here's a prescription, and by the way, where are your crutches?" You must have been doing your exercises wrong. You'll just have to lump it until your baby is born and it will miraculously go away by itself.
3 months, 6 months, 1 year after your baby is born and you've heard it'll get better by itself for the umpteenth time, you feel like you've been round and round in circles, getting nowhere. And, you're right, of course. Very frustrating indeed!
I tell you what! If it was MY wife in pain all the time and somebody could demonstrate a logical treatment routine that might help her - skeptical or not, I'd be asking questions and want to know more. The buck, as they say, stops here!
I know this sounds like doctor bashing, and I don't mean it too. I admire anyone who spends 7 years of sleepless nights studying to be a GP, who then gets into massive debt sometimes to start a practice, just so he/she can help people in pain. No, I honour them. I don't even blame them for the situation as it stands. Doctors, midwives, nurses, are all too busy trying to plaster over the gaping holes in the NHS, that anything not quite fitting into their preconceived medical model, even if it has a place, is off limits. Through lack of time, pressure from above, lack of evidence, and even a lack of common sense sometimes, anything new is treated with scepticism.
Why doesn't my doctor know about this?
It is a sad fact that GPs in training can get as far as the consulting room without ever, for example, being shown how to examine a shoulder or a knee. What chance is there that they even know what a symphysis pubis is, except from a text book? Being aware of how to physically treat a person in pain, is not part of the requirements of practice. So if dealing with SPD and PGP physically is not part of their experience, how are they supposed to advise you on the best course of action? Best practice currently is, stop moving, pain medication, physio and crutches, all of which ARE very much in the GP's experience, so naturally these are the preferred tools to advise you about.
Why doesn't my midwife know about this?
Same answer. You know, I have midwives visit the practice for a similar treatment themselves due to their own back issues, or posture and balance issues. They would dearly love to help promote this treatment to pregnant mums, because they have even experienced it for themselves, and know first hand how good it is at solving back pain and pelvic pain. But can they tell anyone? No, of course not. Their hands are tied. The old 'jobs wurf' problem. They are not allowed to recommend something they even know first hand that works, as this is seen as overstepping the mark.
Why doesn't my physiotherapist know about this?
Essentially, the same answer, but the protocols they follow through to reach a solution will miss this possibility every time. That's a problem with the establishment rather than an individual physio. Once I show your average physio what to do, their first reaction is, "We're not allowed to touch anybody", and secondly they question "Why didn't my people show me how to do this?" But, even so, you still detect a reluctance to deviate from the 'established routines'.
Why doesn't physiotherapy work for this?
Sometimes it does. Usually in milder cases. It comes unstuck following long term or severe SPD/PGP, at which point, the physio will wring their hands and proclaim there's nothing anybody can do. I find this lumping of their own limitations on the rest of us a little tedious, because what they really mean is, there's nothing I can do.
Partly, the dissatisfaction comes when addressing the problem as a battle. It's not lack of exercise that is the issue, so doing exercises is an antagonistic approach that is working against what the body is trying to do. You have muscle contraction, even spasms, and this soon becomes a permanent condition. Afterall, if the body is in constant pain, then the logical reaction is to lock down the area and prevent further movement. In particular in the pelvic core muscles, and the spinal stabilization muscles. The fundamental flaw comes with exercises designed to stretch the muscles, when that's the last thing they are going to let you do.
Instead, you realign the pelvis, spine, legs and abdomen, that are all in this tug-o-war, by softening the muscles and reducing their tendency to spasm. This allows the posture to return to normal and you should then be able to return to normal exercises. In this instance we are talking about getting in and out of a car, walking upstairs, downstairs, shopping, walking normally, sleeping painfree and generally doing whatever you want (within reason!).
What does Symphysis Pubis Dysfunction mean?
Symphysis is Neo-latin, from Greek (origin 1570-80). In anatomy, or botany, it is a growing together of parts or structures (originally seperate), such as two bony surfaces joined by an intermediate layer of fibrous cartilage. This creates joints with only very slight movement.
Pubis is also Neo-latin (origin 1590-1600) and means of the groin or pubic region. The forward portion of either of the hip bones at the front of the pelvis.
Dysfunction, is an abnormality, impairment or malfunction in the function of a specific bodily organ or system.
Don't go getting all excited now you know that. The powers that be have renamed it to Pelvic Girdle Pain. Which is fine except that it doesn't specifically mean the area of pain in the pubic region, where most of this type of pain is coming from.
I have noticed that SPD is now called Pelvic Girdle Pain (PGP), will this make a difference to how I'm treated?
It's almost laughable isn't it, because nothing's changed. The pain is still the same, the immobility is still the same, but somehow now we've got something else to call it and so that will give us another 20 years to come up with a better description and treatment plan. "The pressure's off guys, you can relax now". Either that or it's to do with insurance billing. The fact is, the treatment's here already!! It just needs enough people to take a look at it and assess it, people who don't have this incurable tunnel vision, to realize there is another way.
What should I do if I have a setback?
Everybody has setbacks. This does not mean you are doing it wrong, the treatment didn't work, or you are back to square one. Setbacks are the nature of success. Jonny Wilkinson only succeeds because he misses every now and then. This is what keeps him sharp. This keeps him practicing. The more he practices, the less setbacks he suffers, and the more drop goals and conversions he makes long term. Only a lucky few ever go from constant or frequent episodes of PGP or SPD to no pain ever again. Most people will have setbacks.
The secret is, don't become discouraged. The longer you practice the healing procedure you have learned, the less frequently those setbacks will occur, the less severe they will be, and the less time you are in pain. So the minute you feel the SPD coming back or flaring up, you can be ready to treat it as before. Take the pain and the reason for the flare up out of the equation.
It's no good at all to go down the path of, "Well that was no good", or, "Here we go again", or "That didn't work", or "I'm back to square one". This simply isn't true! If you have followed your procedures and training with diligence, what feels like the same old problem, actually isn't the same old pattern at all. First of all, you have a much greater understanding of what turns your condition on and off. The SPD you feel now is absolutely nothing compared to the pain and agony you suffered at the start of your treatment.
The reality is, you still have the same pelvis, spine, hips and legs you had before. Your bump may be a little bigger, so you're body is having to constantly adapt to a shifting pattern. But because your general pelvic health is in much better shape, because of all the effort you have put in to realign your posture and ease the joint laxity, the typical weeks and months of quite severe pain you were suffering before, will most likely, be limited to not much more than a day, an hour or even only a few minutes. And even then, the severity should be a mere shadow of its former intensity.
Once you have gotten over the odd setback and flare up, you will come to realize they are not something to fear, rather just something to deal with and treat. As the number of flare-ups diminishes, you notice their intensity fades, and you can just go on to enjoy your pregnancy more and more.
Would you be interested in introducing this into the NHS?
Is this a question for me, or you? As the person who put this together, anyone with any clout in the NHS will just see me pushing my own product, and they will fail to see the benefits over established practice. You, on the other hand, hold ALL the cards. Once you've tried this, you can quite rightly tell your physio, your nurse, your birthing partner, your Doula partner, your midwife, your doctor all about the benefits of this very simple technique. If enough of you do it, it will be impossible to ignore.
Why should I listen to you?
Why indeed? If you've found this website then you're on a search for answers because your usual source of information (GP/hospital/midwife/physiotherapist) is failing to deliver. This seems almost impossible, doesn't it? But you tell me! I am hearing the same story over and over again. Has the advice you've received helped your poor wife get up or down the stairs, in and out of bed, in and out of the car? Has the advice you've received helped with the pain? Have you been offered anything other than prescription drugs and crutches? NO to all of that!
It's unfortunate, but your doctor normally has none, or very little, experience of physical therapy, which means they are pretty loathe to recommend anything they haven't tried for themselves. But why would they? Their own Pulse magazine has articles on a weekly basis that set out to trash anything that is in the complementary camp. I don't know if there are any financial reasons for that, or whether it's just ignorance, but there is very little incentive for your doctor to explore useful possibilities other than the usual things on offer, because that takes effort to research and information that is unbiased. If your only source of current thinking is dubiously funded, why would you expect anything different?
Hope this FAQ page has helped. Any questions to clear up before you make your booking, please contact me by: