Pubic symphysis dysfunction and pelvic girdle pain during pregnancy: Knowing the signs and what can help.
pelvic girdle pain and pubic symphysis dysfunction during pregnancy
You may be suffering with pain during pregnancy and googling all your symptoms to find out what is going on and how you can get better. This blog will help you to identify if pubic symphysis dysfunction and pelvic girdle pain are the culprit of your pain and hopefully leave you with some tangible tips for relief!
Let me start by saying I suffered with pelvic girdle pain during my pregnancy and it was difficult to find someone that could help me. When I mentioned this to my doctors, they would just tell me I have round ligament pain or just tell me that it would go away after pregnancy. Which was obviously not helpful! I knew the symptoms would improve after delivery, but it did not mean I had to suffer through pregnancy.
I have made it my mission to support women who struggle through their pregnancy with pelvic girdle pain and / or PSD, so they are not suffering during this special time.
What is PSD/SPD:
Pubic symphysis dysfunction (PSD) is when the cartilage at the very front of your pelvis, between your pubic bones, becomes irritated from the either the pressure of the pregnancy alone or a structural change, causing excessive anterior or lateral movement of the pubic symphysis.
Symptoms:
Symptoms include pain at the very front part of your pubic bone that is worse with certain movements such as:
Rolling in bed
Getting out of the car
Going up and down stairs
Putting on paints
Walking
Single leg movements
Other symptoms may include pain of your low back that is one sided and / or sciatica like symptoms.
Who can Help:
If you’re in Columbus, GA I am your girl and I GOT YOU. But if not or if you have a friend with these concerns elsewhere, I’ll give you a few things to look for when trying to find someone that can help.
Pelvic floor physical therapist with manual therapy, spine specialty, or orthopedic expertise. Not all pelvic floor therapist are alike as their schools and previous education may not be extensive in treating this condition.
I went to the University of St. Augustine, and I am currently pursing my Manual Therapy Certification through them. In this program there are several pelvis and lumbar spine mobilization assessments and techniques. I mention this because there is a registry where you can find other PTs who have gone through this additional training all around the county.
Physical Therapist with spine or orthopedic expertise. Pelvic floor PTs offer a unique skillset with really understanding the pelvis but if there isn’t one near you, find a PT who has orthopedic manual skills that can assess your pelvis and provide hands on treatment.
Chiropractors with specialty in treating pregnant women. I likely will have some PT haters that don’t want me to say this, but I am all for any profession that is going to help women suffering in pain. Just make sure the chiro is well versed in treating pregnant women. The Webster technique is a reputable approach for chiropractors to treat pregnant patients safely.
Massage therapist. This will not directly address the mechanical changes in your pelvis but this will help you feel better in the moment. Even more, if they focus on your inner thighs and glutes, it might indirectly help those “tight” muscles from promoting some of your symptoms.
What does treatment consist of:
Treatment of pelvic girdle pain and pubic symphysis dysfunction starts with an assessment. The assessment will look at bony landmarks of your pelvis, a posture assessment, and a movement analysis. We check hip mobility and spinal mobility by assessing the vertebra with movement. We will also check the tightness and weakness of supporting muscles, including thighs and glutes.
Once we identify where the restrictions and limitations are, we treat with a graded mobilization if appropriate. This will help to correct the position. Then we supplement with soft tissue mobilization (massage, tools, cupping, dry needling etc.) to the tight muscles, and give specific exercises to the weak muscles.
Typically, clients will have immediate relief with treatment. Then they will tell me how long they experienced the relief (sometimes just a couple days, sometimes longer). We then schedule sessions based on that. Some people see me more frequently and some only have to come in a few times before having lasting relief. Point is, THERE IS RELIEF. You should not have to deal with debilitating pain through your pregnancy.
What can you do on your own:
Pain with rolling in bed? Or getting out of a car?
Try to keep your knees together as you roll. I recommend using a pillow between your legs so that it gives you something to hold onto. Break down the movement into segments.
Avoid big hip opener stretches. I recognize hip opener stretches are helpful for birth prep but it is causing undue stress on the cartilage at the front center of your pelvis, furthering the irritation. Discontinue them for the time being.
Use a sacroiliac belt or pregnancy support belt. I know, they’re bulky and ugly. I am not saying to wear it all the time but wear it during times that your pain would typically be worse. For instance, if you have pain with walking, wear the belt during the walk. Then take it off when you get home and get to rest.
Exercises:
Unfortunately, it’s hard to give an exercise program to someone with these symptoms without knowing the orientation of their pelvis, because some exercises may exacerbate pelvic girdle pain. I highly recommend you get evaluated by someone who has the skills to look at your pelvis / low back before trying various exercises. I would also caution single leg exercises like lunges, that may amplify the pain. Try these to begin and then follow up with a specialist.
Foam roll or massage gun your inner thighs.
Pelvic tilts (to activate your deep core, and yes it is still there)
Bridges with a ball squeeze between knees. (to help stabilize)
Modified side plank + rotation or crunch
Muscle energy techniques- head to my instagram page for a video description @Dr.KaylaAponte
***IF ANY OF THESE EXACERBATE YOUR PAIN, STOP. DO NOT PUSH THROUGH***
Disclaimer. This blog is not intended to be medical advice and should not be considered a replacement evaluation and treatment by a licensed healthcare provider. If you are experiencing any pelvic girdle pain during pregnancy, talk with your medical providers. You would likely benefit from seeing a pelvic floor physical therapist or pelvic floor occupational therapist.
