Hidden Birth Injuries: The Pelvis–Hip Link Behind Chronic Pain

In this episode, Lynn explores an intriguing postpartum case that reveals how birth mechanics can influence hip pain decades later. A clinician shares the story of a colleague whose leg was tractioned off the bed during an epidural birth – creating long-term pelvic alignment changes that eventually led her to consider a total hip replacement. The discussion highlights how unresolved pelvic positioning from birth can alter hip mechanics, including internal rotation and load through the acetabulum. This episode encourages pelvic floor and orthopedic practitioners to look beyond symptoms and evaluate how birth and postpartum pelvic alignment may be driving chronic hip dysfunction.

✨ Key Takeaways for Practitioners

• Birth mechanics can have lifelong effects: Traction on the leg during epidural births may contribute to sacral flexion, ischial splay, and ilial outflare that affect hip function years later.
• Pelvic alignment influences hip mobility: Ischial splay and ilial outflare can change acetabular orientation, limiting internal rotation and contributing to chronic hip pain.
• Assess more than the pelvic floor: TFL tension, pelvic bone position, and sacral mechanics can all play a role in postpartum hip symptoms.
• Address both tissue and experience: Combining pelvic mobilization with trauma-informed approaches to unresolved birth experiences may unlock lasting changes for clients.

This episode offers clinical insights that may change how you assess chronic hip pain in postpartum clients – and why evaluating pelvic alignment after birth can be essential for long-term outcomes.

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Transcript

Hello, everybody, and welcome to this episode. Today, I want to talk to you about a postpartum case, and this is actually from a colleague of mine and good friend that I wanted to share, and it has a really good point about it.

So I look forward to sharing that with you about the pelvis and what actually happened during her birth that really impacted her functioning today with her hip.

So we'll be diving into that, but before we do, I would like to just let everybody know that the registration is open for the Birth Healing Summit happening May 2nd.

It's a live online, and our focus is you this year. We really want to help all therapists, all body workers, to be able to show up really get you.

powerfully in your fully embodied, fully healed so that you're not getting triggered, you're aware of your shadows and your projections that you might have.

We're going to dive into the illusion of control, womb imprints, birth healing. We got it all covered. So it's going to be a deep dive weekend and it will be recorded, but it's going to be really, really powerful when you join in live.

And so I hope that you will plan on joining us that weekend. We're going to make it as fun as possible and definitely impactful.

All right. So please check that. You can find the link to register in the show notes. All right. So let's dive into this case study.

This is a really good friend of mine who had her babies are probably 30 and 28, 29, you know, somewhere.

And they might even be 32, 33. She did not hit the floor, but her leg was tractioned down and out to the side as this was happening, okay?

So I hope everybody can kind of envision that. And now I want you to think about what did that right leg and that right side pelvis experience with sliding off the bed and almost going down onto the floor, okay?

In a very heavy state, the muscles aren't able to contract. So all the weight of the leg is distracting the femur from the acetabulum, but what pressure is that putting on the ilium and the ischial tuberosity as that's happening with an epidural?

Remind you, she has no muscle strength, okay? So now she gives birth and then she, you know, gives birth two more times or one more time.

anti-american, And then now this is 30 plus years later, and I was just with her for the weekend and she is complaining of hip pain, right?

Hip pain that is so bad that she's had injections. She's seen so many practitioners. She actually is really close to getting a total hip replacement.

She's thinking she needs a total hip replacement. She thinks she has a labral tear and all this is going on.

Well, I evaluated her and she was stuck in sacral flexion. Her right issue was very splayed. I think both were splayed from all the bursts, but right was more so.

And the other thing, though, which was so important for this, is actually when I started this session, I actually got drawn to her chest.

And her chest was carrying a heaviness. chest. inside that's what her really to And I'll see And when I asked her to get curious with what that heaviness really was, she actually recognized that she was holding a lot of anger towards her husband at the time, or now since divorce, thank goodness.

But he actually said, as she's like screaming, yelling, like, help, Rich, help, help. He was like, call the nurse.

He wanted to just sleep. He's a doctor. He was on call. He was tired. And he blew her off.

And she was holding this anger that she had towards him because he didn't get up and help her right away.

And the nurse literally, she tells this story that the nurse came in and whacked him on the head, like, get up and help your wife.

And he did, they, you know, saved her from getting on the floor. But that was really being held in her chest.

So we acknowledged that anger, helped that to release. And then we were able to really focus in on the pelvis.

And I did some trauma release statements. did trauma We replayed the birth and just helped to clear out the tension being held in her pelvis and her pelvic bones, and then I was able to do the mobilizations that I teach in my holistic courses in the Treating the Postpartum Pelvis course, and get things back in better alignment, get her out of sacral flexion.

But the other thing that was super, super important for her case was she has a lot of tensor fasciae latae tension in her right side.

Anybody with TFL pain, please check to see if they are in an out flare. A lot of pregnancies, a lot of births can create this out flare of the ilium, meaning that the ASIS is those bumps on the front of the pelvis.

One side can be more lateral than the other side, or they both can be really lateral. . I was planning on getting a total hip replacement and I don't need that now and that mobilization that that medial like that getting out of outflare was so critical for her along with getting the impact from birth out of her pelvis closing up that pelvic outlet getting in the ilium out of outflare really helped reestablish a different dynamic in her hip and the muscles of her And she has no more pain.

She doesn't need a total hip replacement everyone. Isn't that crazy? And I worked with another client that I just saw.

She's got a 42 year old, 33, 30 year old. She's got three kids, left hip pain, major left hip pain.

And she is really lacking internal rotation of the hip. And I like, Oh, this has happened so many times in my clinic, decreased internal rotation.

The rotation is an, I usually find an ischial splay, that the ischium is in a abducted position and that changes the acetabulum and the ability of the femur to internally rotate.

And when we can get the ischiums back into midline, the internal rotation just goes, it has normal motion and it should be even side to side.

So this gal though, 42 years of this pelvic position because it usually starts with the first one and then each birth subsequently will add to it and keep it more stuck in that position.

And then it just makes it hard for the hip to be able to rotate in the socket like it's supposed to.

When we correct that, if it's only been a couple of years and we don't have all this titch. And then take

And how that can influence things down the road for both my friend and this other client, that when we get the bones, the ischium's back in their normal alignment, we get the outflare taken care of, then the ischium, the acetabulum's in a different orientation, and the femurs are able to rotate and move in it more successfully, more normally.

So please keep that in mind, and look for this in your clients and learn how to address the pelvic bones after birth.

If you haven't already, please, please, please, it will really help you get much better results with your clients and help moms to avoid these issues down the road.

Okay, nobody's looking for this. Nobody's doing this unless they've taken a course with me, because nobody else is teaching this.

And I really want to help spread the word. So if you can do me a favor and share this.

This information with any of your colleagues, even your ortho colleagues, they need to understand this relationship and know that this isn't just all pelvic floor, it's your pelvis and orthopedic people can mobilize the pelvis to doing the intravaginal work can be super helpful too, but, you know, sharing this with orthopedic people is, um, can be helpful as well.

All right. So please take a look at those hips. Take a look at those ischiums, Ilium outflare, Ilium outflare, and let's correct all that and let's get those hips happier.

All right. Thanks everybody for listening in. We will see you on the next episode. Share this with a colleague, hit subscribe if you haven't, so you'll be notified when the next episode is available and I will see you on the next episode.

Take care, everybody. Bye-bye. Here's to smoother bursts and faster recoveries and less hip pain for moms down the road.

Take care, everybody. Bye-bye. Bye-bye. You