Round Ligament Pain - What’s Really Going On?
Round Ligament Pain - usually described (technically) as a sharp or pinching pain at the front part of the abdomen during pregnancy - or more informally described as “whattheheckisthis” or “whydoesithurtwhenisneeze” by those experiencing it - is a common experience during pregnancy. What is it and what do we do about it?
To answer this we need a crash course in pelvic anatomy. Don’t worry, nothing too in-depth or scary. Just some basics. -What it is- First, picture the bones of your pelvis as a nice, symmetric oval. (With some variations being more circular and less oval, depending on your particular anatomy). Now, imagine your uterus nestled in the center of that oval, with strong cords attaching it from all angles to the oval. Those are the uteropelvic ligaments - there are 4 pairs of them - and they anchor the uterus to the bones of the pelvis. Now imagine your baby happily growing inside that uterus which is slowly but surely expanding, putting increasing strain on those ligaments. This is all part of a normal pregnancy and can come with some minor uncomfortable stretching sensations. However, now consider what would happen if one of the bones that forms the oval shifted ever so slightly, causing the symmetry of the entire system to be disrupted. Can you see in your mind’s eye how some of the cords or ligaments would become shortened and others would become over stretched? Imagine how this uneven tension might affect the uterus. How would the growing baby react to this asymmetry? Might it become more difficult for them to move as freely as they could if this tension and asymmetry were eliminated? This is essentially the process that occurs that leads to round ligament pain. When the bones of the pelvis (often the sacrum) shift from their normal orientation to the other bones around them, tension is placed unevenly on the ligaments of the uterus. This abnormal tension on the ligaments often results in the pinching pain that is felt at the front or side of the abdomen - often worsening as baby continues to grow, placing more weight and therefore more tension on the ligaments. -What we do about it- Correcting the shifts that are disrupting the symmetry of the pelvis is of utmost importance in correcting this issue and reducing the discomfort felt in the ligaments. We accomplish this by conducting a thorough health history and examination to determine exactly how, where, and why these shifts are occurring. Once we know this, we perform gentle adjustments to precisely restore that normal alignment to the area. We also recommend certain neurologically based exercises to help your body learn how to maintain that normal alignment so that over time your body can maintain this alignment on its own. It’s important to note that round ligament pain that is severe and comes on suddenly can be a medical emergency, especially if accompanied by a fever or by a general feeling of being ill. If you experience this, contact your birth care provider immediately, or seek care in an urgent care or emergency care center. However, most cases of round ligament pain come on gradually or intermittently and are not accompanied by fevers or a general sense of being ill. In these cases, your first step toward identifying and eliminating the source of this discomfort should be to call our office for a complimentary consultation.