Pubic symphysis pain is common during pregnancy, affecting 30% of pregnant individuals. Commonly called “symphysis pubis dysfunction,” SPD can make simple daily tasks and exercise difficult to perform. The pubic symphysis is a joint in the front of our pelvis that shifts with postural changes as pregnancy progresses.
Symptoms can include:
Localized pain and tenderness in the front of the pelvis
Shooting pain into the lower abdomen, back, pelvis, perineum, and thighs
Pain that worsens with single leg stance (pulling on pants, walking)
Pain with turning in bed
Pain when getting in/out of the car
Snapping, clicking, or grinding in the pubic symphysis joint
Dyspareunia, or pain with sex
Fortunately, SPD symptoms typically resolve soon after the baby is born, but what can we do during pregnancy to alleviate the pain?
Tip: Move as a unit
The pubic symphysis joint will shift during movement of the lower extremities, particularly when the hips are abducting, or moving apart and away from midline. For example, typically when we get in or out of the car, we lead with one leg followed by the other; when experiencing SPD, try rotating on the seat to allow both legs to move together then standing with equal weight through both feet. When turning in bed, keep your knees together by gently squeezing a pillow between them and perform a log roll-type of movement. Modify exercises as needed, especially as you progress through later stages of pregnancy. Exercises that place a distraction or shear force on the joint like sumo squats and lunges may need modifications – try regular squats, bridges, wall sits, or deadlifts instead.
Tip: Don’t stop moving, keep exercising!
Studies show one of the risk factors for developing SPD is weakness in the hips and pelvis; this is called deficits in “force closure” of the joints in the pelvis. Benefits of exercise during pregnancy are numerous, particularly when it comes to pain; individuals who participate in moderate to vigorous exercise during pregnancy have lower rates of pelvic girdle pain (the category in which SPD falls into) than their counterparts who do not. For stability of the pelvic girdle, exercises that target the gluteal, hip, pelvic floor, and deep abdominal muscles should be targeted (see our examples here). Exercise is safe and should be continued throughout pregnancy, but if you find yourself questioning what is appropriate for you, check out Mend’s guide to exercise during pregnancy and schedule with one of our experts here.
Tip: Use external support
During some activity, we may simply need more support; this is called deficits in “force closure” of the joints of the pelvis. In these cases, external bracing may be warranted. Multiple types of belts exist, so do some research on what you feel would be most comfortable for you. There are simple pregnancy belts that wrap around your pelvis and adjust via velcro straps or more supportive belts that utilize a suspender-type of suspension system which wrap under your pelvis/perineum. Research “serola belt”, “belly band”, or “vulvar varicosity belt.” In our clinic, we utilize kinesiology tape which can be worn for multiple days at a time (even with a shower or two) and does not need to be removed to pee! Check out the photo below to see the “baby belt” in action and schedule here with one of our pelvic health specialists in Boulder or Lafayette to learn how to self-apply kinesiology tape.