Altered musculoskeletal mechanics as risk factors for postpartum pelvic girdle pain: a literature review.
Asuka Sakamoto, Kazuyoshi Gamada
PMID 31645815WHAT IT FOUND
Pregnant women with more pelvic pain and disability, several positive pelvic provocation tests, asymmetric sacroiliac laxity, or low trunk endurance were more likely to have pelvic girdle pain persisting after childbirth.
Breastfeeding, age alone, and prior back pain were inconsistent.
Key findings
01Pain locations and clinical test responses in late pregnancy were associated with postpartum physical functioning and bodily pain.
02Positive symphysis pressure, FABER, modified Trendelenburg, and bilateral pain provocation tests were reported as predictors of long-term persistent pelvic girdle pain.
03Asymmetric sacroiliac joint laxity during pregnancy was associated with a three-fold higher risk of moderate to severe postpartum pelvic girdle pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review did not include level 1 studies, so it could not combine the evidence statistically. Many studies may have relied on recalled pain history, which can bias estimates. The active straight leg raising test did not predict long-term disability at 15 months in one study, so it should not be used alone. Breastfeeding, age alone, history of low back pain, and mode of delivery were inconsistent or not predictive in several studies. The included studies varied in design and follow-up, from 3 months to 12 years after delivery.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these risk-factor associations as proof that pelvic mechanics cause persistent postpartum pelvic girdle pain or that correcting them will prevent it. The review included no level 1 studies, several factors were inconsistent, and the active straight leg raising test did not predict long-term disability in one included study.