If Your Back Constantly Aches, Your Hips Feel Rotated And You’re Embarrassed To Run
You Need To Check For Separation
If after having children you struggle to control your bladder when you run, worry about sneezing and refuse to skip because it’s just embarrassing then you need to have your separation assessed.
Even if your kids are nearly 10 years old!
This is what I found with one of my recent patients in Bondi. But it’s not why she came in…
She wanted help figuring out why her back pain just wouldn’t go away. There was nothing severe about it, just a constant tightness.
She brought the recent xrays her normal chiro made her get…the spine was in great condition. Way better than mine. There was
no scoliosis
no obvious degeneration
no glaring bone deformity
It was fairly straight and uncomplicated. So why the constant back pain?
At 43 years old, she was just sick of waking up in the morning her feeling like an old woman.
Before coming to Balance she was seeing her every month, sometimes more. They believed the pain was a result of her ‘twisted pelvis’. Getting it adjusted helped but it always seems to come back.
To me…the twist seemed more like a compensation pattern than the root of the problem.
As we were discussing how her body moves and feels in general I discovered she still pees a little when running or sneezing unexpectedly. To me this is a massive hint she has a core issue. Immediately my focus went to assessing it.
She had what we call a diastasis rectus abdominus. Abdominal separation. It was around about 2cm and has probably been there since giving birth 9 years ago.
In her case the separation was actually 3/4 more on the right side compared to the left. This same side also tested weaker through the internal oblique (one of your inner core stabilisers). No surprise she also feels the back pain more on the right!
Her body has been forced to work around this issue for 9 years. Walking, running, in the gym and with everyday activities her body has found a way to compensate for this core issue.
You know how she compensates – rotating the pelvis!
Until she addresses the core imbalance treating the hip will only ever be a temporary solution. You may be thinking…
Why did the Obstetrician and the midwife nurses not say anything about the separation in the abdomen?
She was definitely surprised they didn’t!
Whilst I could argue they should have mentioned it, honestly it is not life threatening and not that bad.
However… If these things aren’t addressed soon after giving birth, then they carry on. They become a problem years later. At the end of the first appointment we had our diagnosis, she understood what the actual problem was. Not a twisted pelvis but asymmetrical abdominal separation.
We also had a specific plan of attack…
Treat the back pain and hip rotation for some temporary relief
Specific corrective exercises to
address the separation and
strengthen the weak internal oblique
We followed this approach for two weeks. Each time reassessing and making sure we were following the right path. It was improving steadily which is always a good sign.
A month later she booked in for a review. She was so excited to tell me it hadn’t felt this good in such a long time. I reassessed everything, the back and pelvis, the separation, the core. The difference was significant.
The best news… There was no reason I needed to see her again.
This is just one of the cases I’ve seen recently where problems have developed in women who haven’t addressed common post natal issues. Whether it’s pelvic floor dysfunction, abdominal separation or asymmetries in the core…you really need to get it checked.
A few simple but targeted exercises with a little specific treatment can prevent niggles like ongoing back pain from ever becoming a problem.
If you have kids and know you don’t have full control your bladder let one of our physios assess your separation and core control. The longer you wait the harder it can be to reverse the compensation. Just call the clinic on 9899 5512 and ask for one of the physio’s who specialise in post natal care.