Pelvic girdle pain affects about one in two pregnancies, and most women who have it are told a story about relaxin, loose ligaments and an unstable pelvis that research disproved back in 2012. In this episode of The Hole Shebang, Kristen Parise sits down with Dr. Sinead Dufour, PT PhD, Associate Clinical Professor at McMaster University, to explain what pregnancy related pelvic girdle pain is: a sensitive, protective nervous system rather than a structural failure. They cover the real risk factors, the three step treatment model, symphysis pubis dysfunction as a harmful label and how virtual pelvic health physiotherapy is reaching women who could never get to a clinic. This episode is brought to you by kGoal. Shop kGoal smart pelvic floor trainers at blueberrytherapyshop.ca and use the code kGoal15 for 15% off. In This Episode [01:01] Twin mama first: how twins during a PhD pulled Sinead into pelvic health [03:46] One foot in the clinic, one in research, and why both get better [07:14] One in two: how common pelvic girdle pain is in pregnancy and the first postpartum year [08:50] Normal pregnancy aches versus pain that persists [11:23] The relaxin story, and why twins with 3.6 times the relaxin disprove it [14:29] Not a stability problem, a sensitivity problem: nociplastic pain explained [17:08] Beliefs beat biomechanics: the harm in the label symphysis pubis dysfunction [19:42] The eight or nine established risk factors, and none of them are structural [21:48] Guarding, the threat response and what good treatment looks like [23:52] Three steps: making sense of pain, exposure with control, lifestyle [34:18] Virtual pelvic health care, and when you still need hands and eyes in person [40:09] The Ontario fix: pelvic health in the public health nurse visit, and teaching teens their bodies [44:47] Theme song: Bitter Sweet Symphony What You Will Learn How to tell an ordinary pregnancy ache from pelvic girdle pain that needs care, why the relaxin and instability explanations failed the evidence, which risk factors matter (previous trauma, second pregnancies, fear, depleted energy, smoking, higher BMI, a history of episodic low back pain, synthetic progestin use and lack of belief that things will improve), what modern treatment involves and how virtual care opens the door for women far from a pelvic physiotherapist. About Dr. Sinead Dufour Sinead Dufour, PT PhD, is an Associate Clinical Professor in the School of Rehabilitation Science at McMaster University, where she teaches across medicine, nursing and rehabilitation science. She practices virtually through the National Pelvic Health Collective, is a founding partner of The WOMB perinatal care centres, led the SOGC guideline on conservative care of urinary incontinence and co authored FIFA's decision aids for pregnant and postpartum footballers. Her course Reframe Pelvic Girdle Pain retrains clinicians worldwide. Theme Song: Bitter Sweet Symphony by The Verve Resources and References Mentioned Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain (British Journal of Sports Medicine, 2022) Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective (Beales, Slater, Palsson and O'Sullivan) Reframe Pelvic Girdle Pain: A 21st Century Approach (Sinead's course for clinicians on Embodia) Listen to More Episodes Like This All at podcast.blueberrytherapy.ca: Chronic Pelvic Pain: Real Even When Your Tests Are Normal with Carolyn Vandyken (Ep101), Sinead's research collaborator on the nociplastic pain side of this story The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport (Ep66), who named Sinead on air as a leader in remote pelvic care Empowering Exercise During Pregnancy with Dr. Christina Prevett (Ep6) Pregnant or postpartum and dealing with pelvic girdle pain, incontinence or prolapse, or wondering about a pessary fitting like the ones mentioned in this episode: the Blueberry Therapy team offers pelvic health physiotherapy in Hamilton and virtual consultations across Ontario at blueberrytherapy.ca. Our Sponsor: kGoal kGoal makes smart pelvic floor trainers that show you what your pelvic floor is actually doing. Doing Kegels in the dark is the most common reason they do not work, and real time biofeedback replaces the guessing with something you can see. Blueberry Therapy carries the full kGoal range. The Classic is the insertable trainer most people start with. The Boost is a sit-on-top trainer you use fully clothed, which makes it the one Kristen recommends for pelvic pain, early postpartum and anyone who finds insertion uncomfortable. Both train the pelvic floor to release as well as contract. Shop kGoal at blueberrytherapyshop.ca and use the code kGoal15 for 15% off. Not sure which trainer fits, call the clinic at 289-238-8383 and a member of the pelvic health team will help you choose. Connect with Dr. Sinead Dufour McMaster experts page National Pelvic Health Collective (virtual care) Instagram @dr.sinead Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, leave a review if this episode helped you and connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.