Pelvic girdle pain and relevance of ASLR testing: A ... - Cindy Verheul

In the study of Stuge et al by means of ultrasound research it has shown that women with a
narrower PGP there is a thinner levator hiatus at rest. This indicates the tendency towards a
higher vaginal tension at rest. (Stuge et al. 2012) This again indicates that as described,
there is an increased activity of the PFM. Meaning the results O'Sullivan study seems to be
confirmed. (P. O’Sullivan et al. 2002)
A distinction between the superficial and deeper layer of the pelvic floor is made in the study
of Fitzgerald et al. Here it is shown that the tension in the deeper layer of the PFM, the m.
levator ani and m. obturatorius internus, with almost all women with pelvic pain is positive.
This in contrast with the women without pelvic pain, here there is no higher tension in this
layer of the PFM. For both groups, however, the involuntary contraction of the PFM is weak
in 50% of the cases. (Fitzgerald & Mallinson 2012)
Summarizing these studies, we could conclude that the described tension of the PFM has an
impact on the stability of the pelvis. Women with pelvic pain show a changed muscle tension
pattern, where mostly an increased tension has been observed. This increased tension is
located particular in the deeper layer of the PFM.
2.1.6 Symptomatology
Women with pelvic girdle pain have complaints due to the reduced stability of the pelvis
which affects their quality of life very seriously. (Jan Mens 2009; Röst 2011)
The pain, for these women, is always around the symphysis pubis or the left or right SI joint.
Of course these women can also have pain around more then one pelvic joint.
The pain of the SI joint is normally present in the lower back lateral of the median / centerline
at the level of the sacrum. Are both SI joints painful, then the client will experience this as a
large area around the center line. (Jan Mens 2009)
Radiation of the pain often occurs toward the side of the pelvis, sitz bone, the side of the
coccyx, groin and into the back of the leg. It is rare that the client also experience pain in the
lower abdomen. (Jan Mens 2009)
When the pubic symphysis is painful, this pain is mostly experienced exactly in the middle
front of the pelvis, however sometimes right next to the center of the pubis. This pain is
usually symmetrical. The adductor canal, pelvic and lower abdomen and groin, are the areas
where the pain can radiate to.(Jan Mens 2009)
Osteopathie Schule Deutschland
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