Pelvic instability often occurs after pregnancy, but also due to trauma or long-term overload. The ligaments around the sacroiliac joint become too weak, causing the pelvis to no longer stay in place properly. This causes pain when walking, getting up and standing for a long time.
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Our approach
We start with gentle chiropractic to release any blockages. With real instability (slack ligaments), prolotherapy is an option: small injections with an irritant solution intended to make the ligaments stronger. The evidence is moderate; how well it works varies from person to person. Usually 3 to 5 sessions, 4-6 weeks apart. You are not tied to that number: after each session we decide together whether continuing makes sense.
Your recovery journey
Every course of treatment is tailored, but this is what a typical course looks like — from the first intake to recovery; how quickly that goes differs from person to person. You are not tied to anything and always know where you stand.
SI research
With a few movement tests we check whether the joint between the sacrum and pelvis is causing the pain. A pelvic belt may be used temporarily for the pain. This is followed by a gentle correction of the pelvis.
Stabilization exercises
Pelvic floor exercises, if needed together with a pelvic physiotherapist, and simple exercises for the abdomen and back, such as gently tilting the pelvis. Usually twice a week.
Functional structure
Gradually increasing the load: climbing stairs and exercises on one leg. If the ligaments remain too slack, prolotherapy can be an option (Dordrecht, on Thursdays also Rotterdam).
Complete stability
A pelvic belt is no longer needed and you can play sport again. At home you keep it up with exercises, about three times a week.
How the investigation is going
We look at the position of your pelvis while standing. While lying down, we examine whether there is a difference in leg length and how mobile your hips, pelvis and spine are. You will always hear what we are researching and why.
Where you are treated
Examination and chiropractic care take place at our practice in Rotterdam. Injections are given by the doctors of our practice: prolotherapy in Dordrecht and on Thursdays also in Rotterdam. If a treatment in Dordrecht suits your condition better, we will discuss this with you.
Frequently asked questions
How long do pelvic complaints last after childbirth?
Often 3 to 6 months, sometimes up to a year. Treatment and exercises can ease the pain during that time.
Can I exercise with pelvic pain?
Light activity such as walking is; avoid asymmetrical sports (tennis, football) until stability is restored.
Does a pelvic band help?
For acute pain, yes, for a short time. Long-term use weakens its own stability.
When to go to pelvic physio?
In case of bladder complaints, urine loss or pain during sex - pelvic physiotherapist is the specialist.
Will it return during the next pregnancy?
Risk is increased, but with good prevention and training it can be controlled.
Sources
Independent information from Thuisarts.nl, the patient website of the Dutch College of General Practitioners (in Dutch).
