Pubic Symphysis Dysfunction

Pubic symphysis dysfunction is another type of pelvic pain that is at or near the pubic bone. I see this often in pregnancy and early postpartum folks. It is less common in other people.

During pregnancy the hormonal levels shift causing the ligaments of our pelvis and body to relax and loosen. This is normal and necessary in order for the body to make space for a baby to come out through the pelvis.

Some not so good side effects of these hormonal shifts can be things like pubic symphysis dysfunction. Often what is happening is the ligaments are loosening and causing the two halves of the pelvis to not work together.

The pubic symphysis is where the blue circle is in this picture. It is normally a strong connection between the two halves of the pelvis.

Frequently the pain occurs with walking, running and getting out of bed. Anything where we aren't using both sides of the body symmetrically. This causes a pulling or shearing along the pubic symphysis as each side of the body is doing something different.

Some things we do to help ease this pain is to shorten the stride when walking and running. Avoid single leg activities. Try to stand more symmetrically. Roll to get out of bed instead of sitting straight up with one leg hanging over the side of the bed.

As far as exercise squats are usually better than lunges or step ups. Two footed jumping rather than single leg jumps.

Also in the clinic we work on any tight muscles that are pulling the two muscles apart and strengthen the muscles that support the pubic bone coming together and stabilizing there.

All these things together will give the body a chance to ease the pain and begin to heal. It takes some weeks but my clients always feel better when they follow this advice for awhile and then they can go back to normal life and higher level exercise once the pain calms down and the two halves of the pelvis are working together again.

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