Having patients working in various areas of health care has proven to been an invaluable source of “insider information”. Such was the case when I had an enlightening conversation with an OBG surgical nurse a few years ago. I was discussing with her my observation of the high incidence of post hysterectomy persistent sacroiliac pain, dysfunction, and hypermobility. I had always assumed that the issue stemmed from the ligamentous rearrangement inside the pelvis after the removal of the uterus, since there are two large ligaments attaching the uterus to the ilium and sacrum, and that may well be part of the problem. However the surgical nurse pointed out a much more logistical reason for the post surgical strain on the pelvis, which has to do with the mere surgical positioning for the procedure. You will forgive me for the somewhat graphic photo that serves to illustrate my point. There is a lot of starting lumbar extension and hip abduction. In that confined space, you need to add two people working in tandem (surgeon and assistant), which means that inevitably one of the surgical team members could be applying additional pressure on the leg, if the patient is smaller, has reduced hip mobility, or if the surgical team is comprised of larger individuals.

Some women has uneventful recoveries from the procedures, but I have treated many women who do not. They continue to deal with some mysterious pain in the sacrum and groin areas months after surgery. Examination findings and Xrays show some major new developments stemming from the positional strains, but those can be, and should be treated and there is no need to suffer needlessly