Pubic Symphysis Dysfunction

What is Pubic Symphysis Dysfunction?

The two halves of the pelvis are connected at the front at the pubic symphysis. This joint is strengthened by a network of ligaments which means under normal conditions very little movement occurs. The pelvic girdle however will exhibit excessive mobility due to relaxation of the ligaments of the pubic symphysis and sacro-iliac joints during pregnancy. Consequently the “locking” mechanism of the pelvic girdle is less effective and increases the strain of both the pubic symphysis and sacro-iliac joints; as a result these joints move more during and just after pregnancy. If one side of the pelvis moves more than the other when you walk or move your legs, this can lead to pain and inflammation at the pubic symphysis. Pubic symphysis problems can occur towards the end of the first trimester or after delivery. Many women notice their symptoms for the first time around the middle of their pregnancy. Most women find that their symptoms improve after the birth of their baby although a small percentage still has pain when their babies are a year old.

When does it happen?

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What are the symptoms?

• Pain in the pubic area and groin are the most common symptoms.
• You may also suffer from back pain in pregnancy, Pelvic Girdle Pain or hip pain.
• It is common to feel a grinding or clicking in your pubic area and the pain may travel down the inside of the thighs or between your legs.
• The pain is usually made worse by separating your legs, walking, going up or down stairs or moving around in bed.
• It is often much worse at night and can stop you getting much sleep. Getting up to go to the toilet in the middle of the night can be especially painful.

How does Spinal Synergy Physiotherapy treat pubic symphysis problems? How is it diagnosed?

Pubic symphysis related joint problems are still not widely understood by GPs, obstetricians and midwives and pregnant women who continue to suffer with these problems after the delivery are given few options with regards to actual treatment. It is important that you see a physiotherapist who has a good understanding of the pelvic biomechanics and with comprehensive experience in treating pregnant women. At Spinal Synergy Physiotherapy we will assess the stability of your pelvis and in particular the joints of the pubic symphysis, examine your back and assess your posture, and take a detailed look at how the deep core stability muscles such as the pelvic floor are working. Treatment may encompass gentle techniques which assist in mobilizing the pubic symphysis and release tight muscles and a program of very specific pelvic floor and deep core stability exercisers. Exercise for the deep core abdominal and pelvic floor muscles form a large part of the treatment and are aimed at improving stability of your pelvis. Self-help tips

• Avoid pushing through any pain.
• If this type of pain is allowed to flare up, it can take a long time to settle back down again.
• Avoid heavy lifting or pushing (supermarket trolleys can be particularly painful).
• When dressing, sit down to put on clothing such as underwear or trousers. Pull the clothing over your feet and then stand up to pull them up. Don’t try to put your legs into trousers, skirts or underwear whilst standing up.
• Take care when separating your legs and making straddling movements such as when getting in and out of the car or bath.
• Avoid swimming breaststroke if you can and take care with other strokes.
• Performing regular pelvic floor exercise can help to reduce the strain of the pregnancy on your pelvis.