For over 15 years, I've been teaching suspension based PT to physical therapists across the country. I have seen all different types of clinics incorporate the Redcord suspension system into their daily practice. During these classes, many pelvic floor physical therapists have exclaimed how great suspension exercise is for postpartum moms. I would hear this over and over again. But I didn't know exactly why.
So I started looking more into the research and found a published study called The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy (SPINE, 2004). Before I get into this research study, let me describe a client case I had at the time.
A new mom came to see me with chronic lower back pain. I found that she lacked core strength, so I began having her do myofascial chain exercises such as bridges, side planks and prone planks. Even though I applied bungee assistance, these exercises still required some level of "global" muscle activity. This means she had to use her outer muscles versus solely engaging her inner core muscles. I noticed that she always felt better after each session but still had some degree of lower back pain. This went on for a few weeks. So one day I decided to try a very gentle pelvic exercise called "prone lumbar setting" where she was fully suspended from the table and asked to hold her pelvis in a neutral position with the least amount of effort possible. To my surprise, when she got up from the table, she exclaimed that she had no pain. She tried all the movements that would normally trigger her pain and still nothing. That's when I knew I was on to something.
This was a perfect example of "less is more" when dealing with chronic pain. By fully suspending her in the air, it allowed the larger muscles to relax, so that we could target the smaller stabilizer muscles (pelvic floor, transverse abdominis, multifidus, etc.). These are the muscles that tend to shut down when pain is present, especially after being pregnant.
So now let's get back to the research study...
The researchers took 81 postpartum women with pelvic girdle pain and divided them in two groups. Everyone got individualized physical therapy treatment based on a physical examination. But the control group received more traditional PT consisting of massage, relaxation, joint mobilization, manipulation, electrotherapy, hot packs, and basic strengthening exercises. Meanwhile the other group received PT consisting of specific stabilization exercises performed on the Redcord suspension system. It involved progressive bridging, from two-leg bridges to one-leg bridges to side-lying hip abduction and adduction. It also consisted of upper body shoulder stability exercises, and mobility exercises for the thoracic spine. Furthermore, they taught them how to engage their transverse abdominis muscle.
Across both groups, they studied pain, functional status, and quality of life immediately after the 20-week intervention. They also did follow-up questionnaires one year and two years later.
The results showed a statistically significant drop in evening pain among those who did stabilizing exercises. Lower back disability improved by 50%. Hip strength, back endurance, and leg flexibility all significantly improved as compared to the traditional PT group. What's really impressive is that these positive changes remained or got even better in the follow up studies.
The findings from this research study were consistent with my client case. She got about 50% better from doing the myofascial stability exercises. By adding in full-body suspension to target her deep core stabilizers, I was able to knock out the remaining pain.
So why isn’t everyone given this type of physical therapy intervention after having a baby? This one research study actually changed the European guidelines regarding how to treat pelvic girdle pain. Yet postpartum women in the United States are often ignored and forced to figure it out on their own. With the data right in front of us for nearly 20 years, it's frustrating to know this isn't mandatory or standard practice.
Activcore is here to change things up. If you're struggling with pelvic pain postpartum, please take matters into your own hands by finding one of our pelvic health physical therapists. Contact us to get started now!
Sakamoto, A, Gamada, K. Are Pelvic Stabilizing Exercises Effective for Postpartum Pelvic Girdle Pain? A Literature Review. Journal of Clinical Gynecology & Obstetrics 2019;8(2):33-38
Stuge B. Pelvic girdle pain: examination, treatment, and the development and implementation of the European guidelines. Journal of the Association of Chartered Physiotherapists in Women's health. 2012;111:5-12
Stuge B et al. The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy. SPINE 2004;29(4):351-9
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.