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Relaxin is one of the first words you learn when you find out you're pregnant. Somebody hands it to you like a fact. Your joints are loose, your pelvis is unstable, be careful, this is just what pregnancy does.
Here's the problem. Everyone has relaxin. Not everyone has pelvic girdle pain.
This Summer Rewind is with Dr. Sinead Dufour, a Canadian pelvic health physiotherapist, researcher and co-founder of The Womb, and she has spent years trying to drag the actual state of the science on pregnancy-related pelvic girdle pain out of the journals and into somebody's treatment room. The systematic review on relaxin and pain has been sitting there since 2012. The authors of the guideline that made the relaxin story famous have since gone back and said they didn't interpret the data correctly. And moms are still being told their pelvis is coming apart.
Sinead also gets into virtual pelvic health care (she was doing it well before 2020, and no, it is not the discount version), the new Canadian guidelines on obstetrical anal sphincter injuries, and the fact that cesarean birth is the number one surgery performed in Canada and was not in the physio curriculum until last year. That one still gets me going.
🔹 Where the relaxin theory came from, and why it will not die
🔹 What the 2017 antepartum guideline said we should assess first (it is not a joint)
🔹 The guideline update Sinead is leading right now
🔹 Virtual care: who it actually serves best, and where it genuinely falls short
🔹 Third and fourth degree tears, and the new Canadian recommendation to refer to pelvic health PT
🔹 Why she thinks women should understand their pelvic floor long before they're pregnant
If you've carried pelvic pain through a pregnancy and been told it's just relaxin and it'll go away when the baby comes, trust me, there is more to it than that. And if you're a physio, this one is for you too.
If you're pregnant right now and someone blamed relaxin for your pain, what did they tell you to do about it?
CHAPTERS
0:00 Summer Rewind intro
1:19 Meet Dr. Sinead Dufour
1:38 The Womb, and how a twin pregnancy changed her career
4:46 Virtual pelvic health care before the pandemic
9:28 Treating with your hands behind your back
11:39 What patients say after the first virtual visit
14:37 Pattern recognition, distance, and the licensure compact
19:46 Snow days, sick kids, and moms who stop cancelling on themselves
21:43 Pregnancy-related pelvic girdle pain
24:21 Why pain science gets dropped the second the patient is pregnant
25:37 The relaxin myth, unpacked
31:35 The antepartum guideline update Sinead is leading
32:11 We underdosed exercise in pregnancy for years
33:51 Symptoms are not damage: FIFA, athletes, and diastasis fear
37:23 Sport, sponsors, and the fear of being pregnant in public
42:17 When postpartum and perimenopause overlap
43:56 OASIS injuries: what third and fourth degree tears mean
45:57 The new Canadian guidelines and the referral recommendation
48:17 What ACOG's fourth trimester guidance left out
52:11 How access to pelvic PT actually works in Canada
56:49 Cesarean is the number one surgery. It wasn't in the curriculum.
59:49 Rapid fire: podcast pick, trail walks, one piece of advice
1:08:13 What it means to be an active mom
LINKS
Pelvic floor assessment, Arlington VA clinic: https://carriepagliano.com/
Telehealth PT and virtual consults: https://carriepagliano.com/
All free resources and courses: carriepagliano.com
Dr. Sinead Dufour on Instagram: dr.sinead
This podcast is education, not medical advice. Always consult your healthcare provider with medical questions.
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
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