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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.
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