Pubic symphysis pain and pregnancy: What you need to know
One of the most common symptoms I treat in my pregnancy pelvic pt sessions is pubic symphysis pain. You may have heard it called symphysis pubis dysfunction, SPD, or pelvic girdle pain, PGP.
SPD in pregnancy can be extremely frustrating for pregnant women: every step is painful and symptoms of SPD can range in both intensity and frequency with some women having pain constantly while some women only have pain after sitting for long periods or walking long distances.
The good news is that pelvic physical therapy can help with pubic symphysis pain and your pelvic floor health in general.
While "pregnancy" or "being pregnant" is oftentimes given as the reason for aches and pains, it's important to know that pregnancy doesn't have to mean that you're in pain all of the time. Pregnancy can actually be comfortable and pelvic therapy can help with that.
So let's talk about pubic symphysis pain and pregnancy and exactly what you need to know about it.
What is the pubic symphysis?
The pubic symphysis is the joint between the right and left sides of your pelvis. The joint itself is designed to connect the two sides while also allowing for a little bit of mobility at the region. Overall, the pubic symphysis teams up with the sacroilliac (SI) joint to give the pelvis stability during movement.
The pubic symphysis is a cartilaginous joint and the two bones of the pelvis are held together by ligaments that cross this joint. The pelvic floor muscles work together with these ligaments to provide strength, stability, and mobility within the pelvis.
Pubic symphysis pain and pregnancy: The why
During pregnancy, ligaments become more lax (increased mobility) due to the hormone relaxin, muscles are put on extra tension and stress to support the growing fetus, and oftentimes the combination of these two things can lead to more mobility in the pelvic region and at the pubic bone.
When there is more mobility in that region plus increased pressure downward into the pelvis as the fetus grows, you can assume that the pubic symphysis moves a little bit more than normal, which can cause pain, which is exactly what SPD is.
The excessive movement in that cartilaginous joint, where the two pelvic bones meet, causes increased pain and decreased stability.
Pubic symphysis pain and pregnancy: What to do
It's important that we address pubic symphysis pain early and/or start treatment before it begins because with proper preparation, we can decrease the extent of SPD as well as decrease the odds of it showing up at all.
Inside of pelvic floor therapy, we can do that.
Pelvic floor Physical Therapy during pregnancy focuses on assessing the current state of the pelvic muscles and preparing these muscles and the structures around it for the growing fetus and birth as a whole.
Physiologically, the process of the ligaments relaxing and the body accepting and tolerating more load in the pelvic region is necessary. But we can help our body accommodate to the growing fetus in a way that also allows us to have a more stable pelvic region, even if there is more mobility as a whole, which will help minimize the amount of "play" or movement there is at the pubic symphysis, therefore decreasing or mitigating pain at the pelvic joint and in the pelvic area as a whole.
What treatment for pubic symphysis pain looks like
If you are having pubic symphysis pain, you may be told that you have pubic symphysis dysfunction. This just means that the joint is not functioning as it should.
Let's talk about some of the things that we do in pelvic therapy to address this.
First and foremost, a full evaluation with a pelvic therapist is necessary. Depending on where you are at in your pregnancy, an internal exam may or may not be indicated. This exam allows us to develop a baseline and understand where we are starting from.
Inside treatment sessions, we will go over specific strategies and exercises to strengthen your pelvic floor muscles as well as teach your pelvic floor how to properly lengthen. Because while strength of the muscles is important for support of the baby, when birth comes and the baby is born, we need you to also be able to let those muscles relax so the baby can pass through the birth canal without causing distress to the pelvic muscles.
You may have heard of kegels and pelvic tilts, but I promise, pelvic therapy is much more than just those exercises and those exercises may not even be prescribed to you if they are unnecessary or unhelpful.
We really focus on developing great coordination, strengthening the muscles, teaching the muscles how to relax appropriately, and improving pelvic stability. All of this leads to optimal muscle function of the pelvic region and therefore helps decrease pubic symphysis pain and/or prevent it from occurring at all.
Treatment for pubic symphysis pain in Durham, NC
If you are located in the Durham area, I'd love to help you prepare for birth and treat any pelvic pain you're experiencing related to your pregnancy as well as any other aches and pains you may have.
Inside sessions, we can work on birth preparation, staying strong during your pregnancy, prepping you for your postpartum journey, and mitigating any of the typical "it's because you're pregnant" symptoms.
To get started, you can schedule a free discovery call with me here. I'd love to answer any questions you may have.