In-Reply-To: <61960D3918C7D2119C930008C70D818F5A51AA@YTREMAIL>
Is there an Obs/ Gyn physio on your team? they would be best.
With particular attention to Levator Ani and the Pelvic floor adding
lower Trans Abdom. and checking that Multifidus plays a part. Ice is
good directly onto the symphysis 5 mins on, back to normal, then 5-10
mins on. It can be used at home 2-4 times daily.
Sticks/crutches/walking frame/bed rest can be required if in more severe
condition. The mum should be able to part her legs equally in comfort
otherwise a caesarian should be considered.
I prefer not to train the gluts, as the pelvic floor is not [in my
opinion] in the same recruitment pattern as pelvic/lumbar stabilisation.
[The mums _should_ be able to walk and hold the pelvic floor firm]
Use an elastic pelvic belt, [tubigrip is not too comfortable as it rides
into an elastic band and cuts in, unless put up over the abdomen and
folded into a strap from the lower end round the pelvis "K" or "L"
size].
Remember to teach correct sitting with cushion supports and Log rolling
for turning and getting into and out of bed. In lying waist roll,
abdomenal cushion to take the weight of the baby and pillow between
legs.
-----------------------------------------------------
Precis - just found
Deborah Fry: DIASTASIS SYMPHASIS PUBIS [Symphysiolytis]--Journal of the
Association of Chartered Physiotherapist's in Obstetrics and Gynaecology
(Now A.C.P.Women's Health) Aug 92 No.71 P10-13
DSP - Onset second trimester onwards /or/ during or immediately after
delivery
Rx--MAY TAKE 3 WEEKS or MORE
Log roll [nose, knees, navel in line],
When Acute Pain subsides--toilet in wheel-chair.
When some resolution of pain
Pelvic belt, Ice, U/S, Pelvic Floor ex's - Levator Ani [coccygeii]
Transversus Abdominis, pelvic tilt, lift nothing more than the baby.
May need - Elbow crutches OR walking frame with small steps
Shower, (not bath,) Bidet [not astride]
An aside - if Ante-natally - Trochanteric belt (pelvic belt), deliver in
prone kneel or left lat with leg supported, knees no further apart than
the measurement before the delivery /
GREAT CARE with lithotomy and epidural position.
They will possibly need an elective section if the knees cannot go far
apart without discomfort.
TRAINABILITY OF THE PELVIC FLOOR--Nielsen, C A .(1988)
A prospective study during pregnancy and after delivery
Acta obstet. gynecol. Scaninavia 67: P437-440,
-------------------------
Myra Michie
|