Understanding Round Ligament Pain

Round ligament pain is a sharp pain or jabbing feeling often felt in the lower tummy or groin area on either or both sides. This believe it or not is one of the most common complaints during pregnancy and is most common during the 2nd trimester.

There are several thick ligaments (ligaments are what joins two bones together) that surround and support your uterus. One of these ligaments is called the round ligament. This connects the front part of the uterus to the groin (hence that is where the pain is felt).

As your baby grows and your uterus and tummy therefore also grow the round ligament is therefore forced to stretch. If it becomes too stretched it starts to strain. If this happens then sudden movements can cause the ligament to tighten quickly (a bit like an elastic band snapping quickly). This is what causes a sudden and quick jabbing feeling. Ligaments are suppose to tighten and relax slowly when bones bend and straighten.

The symptoms of round ligament pain include a sharp sudden spasm in the belly. More often affecting the right side more than the left. The pain also only lasts a few seconds. Some exercises may cause the pain as well as rapid movements such as sneezing, coughing, laughing, rolling over in bed and standing up too quickly.

How can the pain be relieved?

If you feel it is necessary then you can take over the counter painkillers like paracetamol or acamol. Make sure you are not taking Nurofen (Ibuprofen).

Specific exercise is very good for this. Some exercises are counterproductive to round ligament pain but exercises that keep your stomach and core muscles strong are good. Stretching is also helpful. Often one of the more helpful exercises is putting your hands and knees on the floor, lowering your head and pushing your backside into the air.

Try to avoid sudden movements. Change positions slowly, especially standing up.

Bend and flex your hips before you cough, sneeze or laugh to avoid pulling on the painful ligaments. Heat can also help relieve the pain, but make sure not to put the heat directly over the baby.

Round ligament pain is often quick and not long lasting but you should be aware if anything changes and when to go to the doctor immediately; for instance, severe pain, pain that lasts more than a few minutes, fever, chills and pain on urination and if you are having difficulty while walking.

Stomach pain during pregnancy could have one of many different possible causes and it is important for your doctor to rule out serious conditions such as inguinal hernia, appendicitis, and stomach, liver and kidney problems. Pre-term labour pains can sometimes also be mistaken for round ligament pain.

Physiotherapy is not your first port of call on this one. The diagnosis should be made by the doctor first so that everything else can also be checked. Upon diagnosis and only after that is physiotherapy then appropriate to advise on correct exercises.

If you are suffering from round ligament pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women's Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.

Taking your Pelvic Floor to the Next Level

As mentioned on previous blogs the pelvic floor muscles help support your bladder bowel and uterus, which is why they are the muscles we strengthen and exercise when having incontinence problems. The pelvic floor muscle also help to make up the core muscles of one's body. They are the foundations that help stabilise the pelvis, along with the deep muscles of the back and abdomen. This is why with prolapse one can experience back pain or abdomen pain. This is also the reason to integrate core stability exercises into your daily work out routine as well as your specific pelvic floor contraction exercises.

A good exercise to start with is lying down on your back with your knees bent in a sit up position (do not do sit- ups) and raise your bottom off the floor and hold for 2-3 seconds before lowering (not flopping) back to the ground.

When you have mastered that exercise it is time to start progressing your exercises. Only start progressing your exercises when you are ready. It is much better to do fewer exercises correctly and exercise the muscles you intend than to exercise lots and wobble all over the place because you are incorporating all other muscle groups that are not suppose to be working in order to perform the activity.

The next good exercise to do is still in the the sit up position, one leg at a time move forward 10 cm and bring back to starting position.

When you can do this easily raise one leg in the air so the hip is at 90 degrees and straighten the leg in the air and lower to the floor slowly, then switch legs and do the same.

Then move onto both hips at 90 degrees, lowering 1 leg to the floor and then switching.

The both hips at 90 degrees again and 1 at a time straightening the knee while lowering to the ground.

When you can do all these exercises without wobbling around while lying on your back still keeping both your legs straight raise and lower in a controlled manner.

If you are suffering from pelvic floor problems and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women's Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.