Symphysis Pubis Dysfunction: Pain During or Post Pregnancy?

Did You Know Symphysis Pubis Dysfunction Has Been Reported In Over 30% Of Pregnant Women?! Some Studies Even Suggest Up To 60%!

Symphysis Pubis Dysfunction, aka SPD, is a condition typically associated with pregnancy or diagnosed postpartum, in which the patient may experience a cluster of the following symptoms:

• Pain in the groin area

• Pain at the pubic bones

• Low back pain

• Lower abdomen pain

• Pain in the inner thighs, buttocks, or hips

• Pain going up and down stairs

• Pain while walking

• Pain sitting or standing for a while

• Pain when moving her legs apart (or widening her stance)

• Pain can vary in intensity but it is often described as “shooting, radiating, stabbing, or aching” (ouch!).

What is the Pubic Symphysis?

The pubic symphysis is a cartilaginous joint between your right and left pubic bones. The joint can become less stable and can even separate resulting in SPD.

Why might cause SPD?

• Hormones such as Relaxin increase during pregnancy which may lead to laxity of the ligaments around the symphysis pubis joint and in the pelvis

• Muscle weakness in pelvic floor muscles

• Biomechanical straining of the ligaments in region

• Fetal and pregnancy associated weight gain

• Tearing of the fibrocartilagenous disc during delivery

• Data even suggests that stress, cortisol, and lack of sleep may act as culprits!

Good News! Pelvic floor PT can help!

Pelvic Floor Physical Therapy can help with SPD in the following ways:

1. Strengthen and Stabilize! Your physical therapist will guide you through exercises to help your muscles function optimally and gain stability. This may include strengthening exercises for those weak muscles in hips, glutes, pelvic floor, and core and lengthening exercises for muscles that may be too tight as they compensate for weak muscles elsewhere

2. Safety First! Your PT can *safely* guide you into a fitness routine, tweak your old one, and enable you to walk down the street pain free

3. What to EMBRACE or AVOID! The PT will direct you to avoid certain exercises, postures, and movements which may worsen pain or even the separation such as high impact exercise, twisting, wide stance, heavy lifting, and especially moving your legs apart

4. Tools and Tips! Pelvic Floor Physical Therapists have loads of suggestions to get you more comfortable! Such as: sleeping with a pillow between your legs, proper body mechanics (how to safely pick up your baby and how to get out of bed), or a pelvic support belt and how to wear it!

5. Breathe! Your PT will teach you proper breathing habits and Meditation tips to calm your whole system to release overall muscle tension

6. Hands On! Your PT will perform Manual Soft Tissue work to release tight muscles and teach you and even a friend to perform it on you

Remember:

It is not normal to be in intense pain during or post pregnancy! I treat a lot of postpartum women who say “I was in excruciating pain when I left the hospital and they told me it was normal”. Trust your body. Repeat after me: Trust MY body, and speak to a pelvic floor PT if you are experiencing these symptoms.

Call 212-353-8693 or email schedule@zionpt.com to make an appointment with one of our skilled Pelvic Health Physical Therapists today!

1. Depledge J, McNair PJ, Keal-Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Physical Therapy. 2005;85(12):1290–1300 2. Borg-Stein J, Dugan SA. Musculoskeletal disorders of pregnancy, delivery and postpartum. Phys Med Rehabil Clin N Am. 2007;18(3):459–476. [PubMed] [Google Scholar] 3. Leadbetter RE, Mawer D, Lindow SW. The development of a scoring system for symphysis pubis dysfunction. J Obstetrics Gynecology. 2006;26(1):20–23. [PubMed] [Google Scholar] 4. Nilsson-Wikmar L, Holm K, Oijerstedt R, Harms-Ringdahl K. Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine. 2005;30(8):850–856. [PubMed] [Google Scholar]