AMA: SI pain, how to not get screwed over by carrying a toddler, and more
You ask, I step on a box of soap.
Welcome to my first AMA in a minute! I’m super hyped to get these up and running, so please never be shy about shooting me a question. Nothing is ever too weird.
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Let’s get into it! Here are the questions we are tackling today:
What is the relationship between hip/SI hypermobility and pelvic pain from hypertonic muscles?
How in the good fuck does one carry their 25 lb toddler about the house and not completely screw over their pelvic floor?
Will sex ever feel the same, or as good as before, after a prolapse?
How does one build a meaningful self-care routine and stick to it?
How does a prolapse affect performance in mountain bike riding (and cycling in general)?
What is the relationship between hip/SI hypermobility and pelvic pain from hypertonic muscles?
Such a good question! The first thought I had when I read this was, “Wow, this should be a whole newsletter topic,” so maybe we will cover this in more depth next week! (Thanks, reader!)
So let’s start with the assumption that when this reader says hypermobility, they are implying general laxity in one or two joints, and not a connective tissue disorder like Ehler’s Danlos Syndrome. (If you do have EDS, most of what I am about to say will hold true, but there will be more information to layer in.)
A hypermobile joint is one that has an extraordinary range of motion, generally due to a laxity in the ligaments surrounding the joint. If you’re like, “what’s a ligament?!” — here’s a picture of the hip and sacroiliac (SI) joints and the ligaments around them:
As you can imagine, the ligaments provide an enormous amount of structural support to the joint, particularly during movement. But the problem is that bodies love stability because they love not breaking and also standing up and achieving other functional positions without dislocating joints when at all possible. Another option to achieve stability is the muscles, which try to run to the rescue when a joint is less than ideally stable.
This is where the pelvic floor comes in — let’s take a look at its proximity to the hip and SI joints:
It’s, erm… literally right there. See how some of the pelvic floor muscles and ligaments attach to the same bones? They’re buds! So of course, the pelvic floor tries to be a hero in the case of hip and SI hypermobility by tightening the fuck up.
The great irony is that this results in a weak and tight pelvic floor, contributing to things like pain AND incontinence (fun combo!). It generally responds well to stabilizing strength work, which can sometimes feel counter-intuitive.