How to Manage Pubic Symphysis Pain During Pregnancy
First! What is the pubic symphysis? The pubic symphysis is a cartilaginous joint that connects the left and right pubic bone in your pelvis! It is located in the front and center of the pelvis. We hear about pubic symphysis pain more commonly during pregnancy, however, anyone can get pubic symphysis pain or “dysfunction”.
More commonly, pubic symphysis pain occurs during pregnancy secondary to:
Hormonal Changes! During Pregnancy, the body produces RELAXIN, which helps relax the ligaments and prepare your body for childbirth. This can cause increased mobility in the pubic symphysis.
Changes in Posture! Pregnancy will alter your center of gravity possibly placing more stress on your pubic symphysis!
Muscle Imbalances! This is where we come in as Pelvic Floor Therapists! We commonly find imbalances in the strength and length of the inner thigh muscles, difficulty with lower core activation, and imbalances of strength and length of glutes & pelvic floor!
Multiple pregnancies. As a Pelvic Floor Therapist, I do find that women who have already had a child, may experience more pubic symphysis pain in subsequent pregnancies! However, it can never NOT be treated and managed!
Here are some common signs of pubic symphysis pain:
Pain rolling over in bed
Getting in and out of the car
Climbing stairs or stepping up on to a box
Prolonged walking
Pushing something with your foot
Single leg standing!
What do all of these movements have in common? They are ASYMMETRICAL!
What can we, as Pelvic Floor Therapists do to help you with your pain? We would first do a full body assessment to determine what imbalances could be leading to your pain. Most often this leads to treatment of myofascial release to inner thighs, glutes, and lower abdominals followed by strengthening to create more stability within the front of the pelvis! This is commonly done by prescribing exercises that strengthen your Anterior Oblique Sling, such as opposite abdominals muscles to opposite side adductor muscles with specific movements. We will also provide education on ways we can manage your symptoms other than exercise!
Here are some tips and tricks that you can start today that we may suggest in combination with Pelvic Floor PT!
Posture: As your belly continues to grow into your 3rd trimester, you may feel the need to want to press your hips forward and lean your shoulders back! We want to focus on more of a “tits over toes” posture! Think about shifting weight forward so the chest is over toes, knees softly bent.
Log roll to get in and out of bed. You can also try squeezing a pillow between your knees!
Modify asymmetrical movements to double limb!
Decrease step length while keeping good posture
Support garment! I recommend the Serola Belt!
Lastly, check out this video and this video on some additional exercises!
You do not need to suffer through Pubic Symphysis pain and you should never be told that pubic symphysis pain is “just something that happens” during pregnancy!
We are here to help! Want to chat with us? Click this link here!
By: Dr. Kate Smith, PT, DPT
