Pubic Symphysis Pain with Pregnancy – Four Pines Physical Therapy
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Pubic Symphysis Pain with Pregnancy

Pubis Dysfunction

Hormonal shifts help the fetus grow properly and prepare her for child birth. While this is expected and normal, there are times when hormones start functioning too early. This causes instability and pain.

Symphysis Pubis Dysfunction, also known as SPD, is a common painful condition associated with pregnancy in which the ligaments responsible for holding the pelvic bones become too relaxed and stretchy. As a result, the symphysis pubis or the pelvic joint becomes unstable, causing moderate to severe pain. Women with symphysis pubis dysfunction during pregnancy often face major functional difficulties resulting in a considerable decrease in quality of life.1 Many women report mild to severe pain in the pubic region, groin, and inner aspect of the thigh, frequently accompanied by sacroiliac, low back, and suprapubic pain (pain above the groin and in the center of the lower stomach). Generally, pain is worst during standing activities, walking and when lifting one leg. PSD can also make sleeping difficult. Occasionally you may hear or feel a clicking or grinding sensation in the joint at your lower stomach.

Some signs of this dysfunction are:

  • Severe pain that tends to get worse when you lift your legs for getting into bed or a car
  • Difficulty to move the lower part of your body
  • Pain that increases when you lie on your back
  • Pain that worsens when you try to turn over in your bed
  • Reduced motion in your hips
  • Pain shooting down your buttocks and legs
  • A clicking sound near the pelvic area when you walk or move your legs
  • In rare cases urinary incontinence

A specialty trained Pelvic FloorPhysical Therapist can help minimize these symptoms and ensure that this issue does not continue beyond childbirth. After a comprehensive evaluation, physical therapy treatment may include soft tissue mobilization/massage, strengthening and stabilization exercises to improve support of the pelvic girdle, pelvic floor strengthening exercises, postural exercises, and education on body mechanics and strategies to minimize pain with activities of daily living.

The use of pelvic support belts to manage pelvic joint pain during pregnancy if often advocated clinically. The rationale for using belts to provide an external force that stabilizes the pelvic joints. These belts will only provide relief if the pelvic joints have been balanced by different manual techniques by the physical therapist, then applied. If your pelvic joints are not aligned, then the belt may increase or not change your symptoms.

Some ways to manage at home are:

  • Lift both legs together during activities like getting in a car and rolling in bed. Squeeze the knees together instead of separating them as this helps to stabilize the pelvic joint.
  • When moving from lying down to sitting or visa versa, roll to your side first then push yourself up or lower yourself down keeping your legs together.
  • If you have a young child, avoid holding them on the side of your hip with your hip jutted out. Instead, hold them closely and keep your alignment as upright as possible.
  • Avoid shifting all of your weight onto one leg while standing still.
  • Use a pillow to support the lower back region when sitting.
  • Learn appropriate stabilization exercises that include your pelvic floor muscles
  • Limit sitting with your legs crossed
  • Avoid any exercise that involves standing on 1 foot, bouncing or jarring or that reproduces your pain

Pregnancy is the ultimate strain on the body. A Specialty Trained Pelvic Health Physical Therapist can help make the experience a positive one.

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Dr. V. Norene Christensen

Dr. V. Norene Christensen

Born and raised in New Jersey, Norene came west for skiing and outdoor activities like climbing, mountaineering and mountain biking. Since being out west she also began to enjoy fly fishing, hunting, sea kayaking and snowmobiling. She enjoys fine wine, gardening and her family.
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