The Effect of Asymmetry on Pregnancy-Related Pain in the Postpartum Period

Abstract

Nearly 50% of women experience back pain and other lower extremity pain during pregnancy, with many reporting lasting pain postpartum. Pregnant women experience changes to their pelvis and lower extremities that do not always return to pre-pregnancy baseline. Not much is known of the lingering effects of pregnancy related asymmetry and its relationship to pain. Therefore, the purpose of this study was to assess asymmetries of the pelvis and lower extremities to determine whether malalignment is related to areas of pain at the low back, hip, thigh, knee, leg, and foot/ankle. Methods: Seventeen postpartum women and seven nulliparous controls were recruited to participate. Postpartum women were placed in a 'no pain' and 'pain" group based on a Visual Analog Scale pain questionnaire. Biomechanical measurements were taken bilaterally for: leg length, foot width, foot length, arch drop, arch index, arch height index, arch rigidity index, rearfoot angle, dynamic knee valgus, and hip muscular strength. Measurements of hypermobility and flexibility were taken using Beighton's scale and Sit and Reach test. Results/Conclusion: Several relationships exist between pelvic and lower extremity asymmetry and pain in postpartum women. We identified multiple areas of asymmetry at the hip, knee, and foot that were correlated to pain. This information may be helpful to clinicians and the treatment of asymmetries during pregnancy to prevent pain postpartum. With the high prevalence of pain that still remains postpartum, further research is necessary. A larger sample size is needed to validate the trends found in this study regarding asymmetry and pain. iii ACKNOWLEDGMENTS I would like to thank my thesis advisor Dr. Jean McCrory. Her unwavering support and understanding have allowed me to succeed and accomplish more than I thought possible here at West Virginia University. Dr. McCrory truly inspires me daily with her dedication to her work, students, and family. Her extensive knowledge of her field has helped me obtain the skills necessary to move further in my education and career. I was sincerely blessed to have her as my mentor. I would also like to thank Dr. Corrie Mancinelli and Dr. Kristin Phillips for their expertise and valuable input with my thesis. I am grateful for their willingness to help, and their insightful ideas. Lastly, I would like to thank my family and friends for their endless support and encouragement over the past several years.