Symphasis Pubis Dysfunction in Pregnancy

Ever feel like your pelvis is being torn apart? If so, you might be dealing with something called Symphasis Pubis Dysfunction. What exactly is Symphasis Pubis Dysfunction? Let's start by taking a closer look at the anatomy of a female pelvis...

Do you see that joint that is circled? That is your symphasis pubis and it connects your left and right pubic bones. The flexibility of this joint increases during pregnancy when the ligaments surrounding the symphasis pubis begin to lengthen and soften (due to the increased production of the hormone relaxin). This is a necessary step that your body takes to allow mobility within the pelvis during childbirth. At times, this loosening of the ligaments may cause decreased stability within the pelvis and can lead to minor to severe pain for the mother.

What are some of the signs or symptoms or Symphasis Pubis Dysfunction?

The pain is generally localized right around the symphasis pubis joint in the midline of the body, however it can also spread down one or both legs, the buttocks, and the lower back. Most women will experience pain when walking, climbing stairs, getting in and out of bed or the car, getting dressed, or doing any weight-bearing activity. Asymmetrical motions like moving or lifting one leg can worsen the pain. For some, the pain associated with Symphasis Pubis Dysfunction can cause difficulty sleeping. At times, there may be clicking within the pelvis, especially when walking or climbing stairs.

What are some of the risk factors for Symphasis Pubis Dysfunction?

• If you experienced this condition with a previous pregnancy, you may be more likely to experience it again

• If you have a history of pelvic trauma or injury

• If you are overweight or have gained a significant amount of weight with your pregnancy

• If you are expecting multiples (as this added weight can put extra strain on your pelvic joints)

* Many women who experience this pain do not fall into any of the categories above.

I think that I may be struggling with this, what are my next steps?

First, make sure that you talk to your care provider about your pain and concerns. While there is no "cure" for this, there are many things that you can do to help alleviate the pain and protect your pelvis throughout the remainder of your pregnancy. It is important to talk to your care provider as having Symphasis Pubis Dysfunction may require some special attention with your birth plan and guidance for the remainder of your pregnancy, as well as for your labor. Keep reading for some tips and exercises that will be helpful for you, as well as a list of care providers that can offer additional care and therapy.

What should I be mindful of? What can I do to help alleviate the pain?

• Use pain as your guide. If you find that something that you are doing increases the pain, stop or limit that movement.

• Limit motions that cause your legs or knees to move apart.

• Limit asymmetrical movements (don't overdue these).

• Do not do any heavy lifting.

• Avoid pushing heavy objects (such as a shopping cart). Try to limit the load that you are pushing by shopping more frequently, or better yet, have someone else do it for you! You can buy a lot online these days and many grocery stores even offer pick-up or delivery options. Try to get help when loading/unloading bags and limit how much weight you put into each.

• When getting in and out of the car or bed, try to keep your knees together and move as one unit. This symmetrical movement will help cut down on pain.

• Sit down to get dressed.

• Take special note of your posture. Poor posture only worsens the pain and can lead to further damage.

• If you are participating in an exercise class, make sure that your instructor knows about your condition and discuss ways that you can tailor the movements/exercises to better suit you during your pregnancy.

• Try icing and/or applying heat to the pelvic area.

• Get lots of rest - you often don't notice until the end of the day that you have pushed yourself too hard.

• Use pillows as extra support when sitting or sleeping. A pillow behind your low back and/or in between your knees can really help with pain at night.

• Avoid sitting with your legs crossed (a good habit to break anyways!)

• Try wearing a support belt. A great one can be found here.

*See below for daily exercises to help with the pain, as well as a list of various care providers that can offer support for Pubis Symphasis Dysfunction

What are some exercises that I can be doing daily?

It may seem like you can't do anything at this point, huh?! You don't want a sedentary pregnancy, so the key is to find movements and exercises that you can do that do not increase the pain or worsen your condition. This will look different for every women. No matter how minimal or how serious your pain may be, there are some basic exercises that will greatly help you...

• Pelvic tilts (click here for an explanation of pelvic tilts and various ways to do this exercise from a previous post)

• Kegels

• Adductor/Abductor conditioning

• To do this exercise, sit down on the edge of a chair and place either one or two fists, a yoga block, or a small exercise ball in between your knees. Squeeze your knees together and hold this for 4-5 breaths, releasing on an exhale. Next, have a partner place their hands on the outside of your thighs. With your partner gently squeezing your thighs inward, resist by trying to push them outward. You can also do this yourself using a yoga strap or belt.

What types of care providers can I see to help alleviate the pain and improve my condition?

• Physical Therapy. Physical therapists who specialize in women's health can offer tailored exercise plans for you that help you to stabilize the pelvis.

• Chiropractic care. Many chiropractors are well versed in women's health and can offer care throughout your pregnancy to help realign your pelvis and alleviate pain. A mother's body shifts and changes a great deal during pregnancy and often times structural changes within the pelvis can feed into the pain associated with Symphasis Pubis Dysfunction.

• Acupuncture. Care from an acupuncturist who is well versed in treating pregnant women can greatly help with pain management.

• Massage. Prenatal massages can help with reducing the pain, especially when the Symphasis Pubis Dysfunction is causing referred pain in the lower back, buttocks, and upper legs.

When will the pain go away?

This can vary between women, but the pain generally goes away after childbirth when the body's production of relaxin decreases. For some women, this pain may last much longer and these women would want to seek medical attention to help condition the pelvic floor area and alleviate the pain. No matter the case, it is important for women who are dealing with this condition during their pregnancy to seek help with daily tasks for after the baby is born as their bodies may require greater recovery time.