Pubic Symphysis Pain
Pubic symphysis pain during pregnancy is a definite IFKYK situation.
Also known as Symphysis Pubis Dysfunction (SPD), this diagnosis is distinctly characterized as pain along the anterior part of the pelvis where the two pelvic bones connect. It is a pretty common issue amongst the pregnant population. Most people will report pain coming on in the second or third trimester, but it’s not abnormal to report as early as first trimester, especially if it is a subsequent pregnancy.
Pain is often experienced with activities like:
Walking
Stair climbing
Rolling over in bed
Standing on one leg (dressing)
Asymmetrical movements (lunges, step ups, single leg RDLs)
Exercises that require a wide stance (sumo squat, lateral lunge)
Getting up from a chair
Weight bearing positions
What causes this pain?
During pregnancy, the demand and load placed on this joint increases significantly. With postural changes, increased weight, increased ligament laxity, and weaker musculature, pain can be a sign that the joint is overloaded.
The good thing…physical therapy can help!
Here are 4 ways to relieve pubic symphysis pain during pregnancy:
Modify movements.
As mentioned above, single leg and asymmetrical movements are usually painful with SPD. Modifying workouts to remove these kind of exercises like lunges, step ups, single leg RDL’s, and replace them with bilateral stance movements like squats, deadlifts, and hip thrusters allows you to get the strength benefits with less pain.
Same thing goes for modifying movements during daily life. If lunging from the floor to get up is painful, try keeping your stance smaller. Take smaller steps on walks, etc.
Learn to recruit the deep core with transfers.
Rolling over in bed and getting up from a chair are two common painful activities with SPD. The deep abdominals and pelvic floor attach directly onto the pubic symphysis joint. In order to increase stability to this joint, it is helpful to recruit the deep core during this activities.
How to recruit the deep core:
Inhale and expand the ribs, abdomen and pelvic floor to prepare for the movement
Exhale and draw in the core and pelvic floor like you are “hugging the baby close to you”
Perform the transfer (roll in bed, stand up) while you are blowing out and drawing abs in
Release/inhale after the movement is done
You will usually notice a decrease in pain at the pubic joint when you take a moment to draw the deep core in. Again, this provides an increased underlying support so the joint feels more secure.
Strengthen the hips.
We know the there is increased ligament laxity during pregnancy (this is normal, we need this!), so the demand for improved muscular support increases. This is why keeping up with hip strengthening is so important during pregnancy. Strengthening the inner and outer hip muscles are huge for increasing pelvic stability and support.
Here are some examples of exercises I will prescribe:
Glute bridges with ball squeeze between knees
Modified side plank with ball/block squeeze between knees
Deadlifts (regular or staggered stance if tolerated)
Squats with band above knees or block between knees
Use a belly band for increased external support.
A simple belly band can actually serve as a huge relief for pelvic girdle pain. Belly Band that I typically recommend (usually only need something basic and simple!) linked HERE on Amazon. Place it below the belly and can give a slight angle upwards as you fasten it behind you. Give some decent compression. You should feel like it gives you an extra “hug” to decrease the intensity of the symptoms.
These are options that should help manage your symptoms of SPD. It is always incredibly valuable to see a pelvic floor PT to get an individualized assessment and exercises catered to you and your body. Check the instagram reel below to see a video version of the tips described above:
This is something that definitely should be seen by a PT sooner than later so that it doesn’t create a debilitating feeling during your pregnancy.
