A major consideration during pregnancy are the three of the joints of the pelvis, and their associated ligaments; two sacroiliac joints and one symphysis pubis.
The hormone relaxin normally occurs in both males and females but increases considerably (up to 10 times) during pregnancy. It is responsible for relaxation of the ligaments. As the ligaments relax, they stretch and allow the joints to widen in preparation for the baby; this movement is called nutation. This normal, physiological stretching activates nerve endings in the ligaments, which cause the counternutation muscles to tighten to support the baby’s weight and keep the pelvis stable. There is an important balance between the loosening of the ligaments, loosening of the nutation muscles, and tightening of the counternutation muscles. The more the pelvic spreads, the more muscles respond.
One problem is that the tight counternutation muscles may become painful due to lack of circulation and being “on the job” almost constantly. The nutation muscles may also become painful because they become lax and don’t pump efficiently. Decreased circulation reduces oxygen to the tissues and causes a build-up of waste products that cause pain.
A muscular imbalance develops that may cause structural modifications such as splayed and pronated feet, anterior pelvic tilt, and flattening of the upper lumbar and thoracic spine.
Additional stress on the joints from falls, accidents, poor posture, sitting too long, or activities that include bending, lifting, and twisting can increase the muscular response and pain.
The Serola SI Belt helps by acting as an external ligament support, allowing the tight counternutation muscles to relax and, just as importantly, it helps the nutation muscles maintain ideal tightness to support the baby during pregnancy. When these muscles are strengthened in pregnancy, their function will be improved in labor when she needs to push.
Another good thing: although relaxin may lead to instability of joints by reducing the integrity of ligaments, tendons and articular cartilage, it also plays a role in the repair of skeletal muscle by reducing inflammation, reducing fibrosis, and increasing tissue regeneration. By maintaining proper tone in the muscles, they break down less and heal better.
When the baby drops into the lower abdomen, the symphysis pubis becomes more involved and may become painful. Studies have shown that, at this point, it is better to lower the Serola SI Belt, from just above the trochanters, to directly on them. Because the trochanters are the widest part of the pelvis, we have made a Serola Belt Extender that increases the size of the belt to help it fit, with minimal expense. Please see the pictures above and our directions video.
As the due date approaches, it may be advisable to limit the use of the Serola SI Belt. Starting at some point that may be different for each person, due to age, muscle tone, activity, and treatment methods, it may be best to use the belt only during activity, and use rest periods to let the pelvis spread into nutation in preparation for delivery. Then, apply the belt to hold the pelvis at the newly widened place for a while, especially during activity. There is no one better qualified to know this point than the mother-to-be so, for those of you who are pregnant, listen to your body but review this principle with your chiropractor or birth provider professional.
During Labor and Delivery
There is a time, probably at the beginning of labor that the mother must switch, from activating the counternutation muscles to support the baby, to activating the nutation muscles to push the baby out. It would seem that it would be beneficial to teach the mother-to-be this principle by explaining the role of the nutation and counternutation muscles and, if reasonable, make her aware of this switch in labor. It may make labor less difficult if she is able to follow her body’s normal biomechanics.
The Serola SI Belt can help
By acting as an external ligament, the Serola SI Belt keeps the pelvic joints within normal range of motion; there are numerous benefits to this, including:
- Reduced ligament stretching
- Reduced muscle imbalance
o Tight muscles (counternutators) relax
o Lax muscles (nutators) increase tone
- Reduced muscle fibrosis
- Enhanced muscle repair
- Reduced cartilage wear and tear
- Reduced structural modifications
- Better posture
- Balanced pelvis
- Reduced pain
Although it only takes 6-8 weeks for pelvic organs to return to normal size, relaxin can stay in the body for 5 months, or more, after childbirth, so its effects on ligaments, muscles, and other tissue can remain for a long time. This is both a period of time to remain cautious and a time to align and heal your pelvic joints, ligaments, and muscles.
Many women are concerned with returning to pre-pregnancy shape; to do this, they may take up exercise and supports that claim to shrink the belly. While exercise can be great for helping to shrink the belly after pregnancy, some understanding of what we are trying to accomplish will help considerably.
First of all, do belly bands really help? I don’t think they do. There is no real way to tell because the belly will shrink anyway, simply because the baby is no longer taking up space. To say otherwise is misleading. There is no way to do an experiment with and without the belt on the same person, so we have to go with understanding the process.
Belly bands support the belly muscles; they do the work, so the muscles don’t have to. It is well known that, with these types of supports, the muscles weaken. As a result, they are less able to work during three important phases, supporting the baby during pregnancy, pushing during delivery and tightening up to shrink the belly back to pre-pregnancy shape.
Ligaments rule, muscles adapt
One important principle seems to be ignored: you can’t push a muscle into shape. The tone of the muscles must be reestablished, and they will respond by tightening. Remember, in response to pelvic ligament laxity, the nutation muscles (most of the belly muscles) loosen because, when too tight, they would put more stress on pelvic ligaments, unless the SI joint is properly stabilized.
The Best Option
So, the best treatment is stabilizing the sacroiliac and pubic ligaments, thereby removing the reason that the belly muscles have reduced tone; this can be done best by a Serola SI Belt; it just makes sense.
Exercise can be very beneficial to the belly muscles, but exercise can also put a lot of stress on the pelvic ligaments, and further the muscle imbalance; so, it can be like two steps forward, one step back. Wearing a Serola SI Belt helps hold the joints stable, especially during exercise, thereby, removing stress from the ligaments and increasing tone to the belly muscles. So, the muscles get the maximum assistance to tighten; this is the best way to shrink back to pre-pregnancy shape.
Two layers of the Serola SI Belt
The outer, elastic layer helps by pulling the pelvis together. The inner, non-elastic layer helps by limiting pelvic expansion and maintaining the gains made by the elastic layer. Together, they normalize the function of the sacroiliac joints and pubic symphysis. Remember this simple principle: ligaments rule, muscles adapt. As the pelvis tightens, the muscles tighten, and the entire belly and pelvic complex shrinks as a unit.
Dr. Rick Serola
Founder & Co-CEO
Serola Biomechanics, Inc.
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