Pregnancy and Hyper Mobility

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By Dr. Nikki

Pregnancy is a time of exponential change for a woman’s body, especially when it comes to hormones! Some of these hormonal changes are more noticeable than others and today I want to talk about one that isn’t always so apparent. 

Relaxin is a hormone that increases flexibility in the ligaments and muscles. Each month a woman’s ovaries produce this relaxing hormone during the second half of her menstrual cycle in order to relax the uterus, prevent contractions and prepare the uterine lining for implantation of an embryo. If conception doesn’t occur then relaxin levels drop back down until her next cycle, but if conception does occur, then the placenta will begin producing relaxin also, causing levels to rise throughout the first trimester of pregnancy. This increase in relaxin is important during pregnancy because it allows the body to stretch and accommodate a growing fetus as well as prevent early contractions and relax blood vessels to accommodate for the increased blood volume that occurs during pregnancy. [1] Relaxin levels will typically peak around 12 weeks of pregnancy, with one final increase towards the end of the third trimester. 

For most women, this change in flexibility of the muscles and ligaments is not overly noticeable. But for some women, it may result in symptoms such as feeling unsteady or pelvic girdle pain. Pelvic girdle pain can look like pubic bone pain, sacroiliac (SI joint) pain, groin pain, or inner thigh pain. These symptoms will typically be most noticeable with rolling over in bed, getting out of cars or standing on one leg to perform activities such as putting pants on. If pelvic girdle pain is an issue, a prenatal chiropractor and pelvic floor therapist are two experts who are very good at helping to resolve the problem!

But then there’s another group of women which relaxin typically hits the hardest. You can probably picture someone in your life (if not yourself) as I describe it… she’s been ridiculously flexible her entire life and as a child was often performing body contortionist tricks such as hyper-extending her elbow, dislocating her shoulder or easily bringing her legs behind her head. I am referring to the hyper-mobile woman. With these women, they are much more likely to experience pelvic girdle pain as well as other joint pain during pregnancy due to the presence of relaxin on an already flexible joint. 

How can you tell if someone is hyper mobile? 

A provider may diagnose someone with hypermobiity using a Beighton score. The Beighton score looks at five different movements which include bending a knee backwards, bending an elbow backwards, bending a thumb backwards to touch your forearm, bending a little finger back more than 90 degrees, and the ability to put hands flat on the floor while standing with knees straight. If someone can do four out of five of these things, then they likely are hyper mobile. [2]

What can you do if you are hyper mobile and pregnant?

  1. Strength and stability are key with any hyper mobility, especially during pregnancy! Doing basic exercises like chair squats, glute bridges, clamshells, diaphragmatic breathing, and transverse abdominal activation can make a world of difference for pelvic girdle pain as well as low back pain during pregnancy. In addition to that it helps to strengthen and prepare for birth, which is one of the most major events a woman’s body will ever go through! 

  2. Stop stretching! Often times, we are conditioned to stretch a joint or muscle if it hurts. But with hyper mobility, we don’t want to stretch an already loose joint! It may seem counter-intuitive, but give it a try for several days and see if your joint pain improves.

What about chiropractic for the hyper mobile prenatal patient?

As a prenatal chiropractor, it is essential that we are able to identify patients who may be hyper mobile. Since we are inducing motion in joints, we need to be aware of potentially moving a joint that is already moving too much! Once this has been identified, there are specific low-force techniques that can be used to still give a pregnant woman relief with her symptoms throughout pregnancy! 

If you are in the DFW area and would like receive care with a prenatal chiropractor who will take hyper mobility into consideration, as well as provide you with guidance in strengthening and stabilizing, make an appointment here! If you live elsewhere, not to worry, you can find a list of excellent Webster Certified across the nation here. 

Resources

  1. https://my.clevelandclinic.org/health/body/24305-relaxin#:~:text=Relaxin%20production%20soars%20if%20you,pelvis%20and%20widen%20your%20cervix.

  2. https://www.nhs.uk/conditions/joint-hypermobility-syndrome/#:~:text=Joint%20hypermobility%20syndrome%20is%20when,better%20as%20you%20get%20older.