Pregnancy & Pubic Pain

As if it wasn’t hard enough to walk with your ever growing belly, pubic pain might make this everyday activity close to impossible.

A retrospective study revealed 31% of women reported this pain during pregnancy. Luckily for most, symptoms improve after giving birth, but for some the pain can persist postnatally.

 

Cause

One theory of etiology:

During pregnancy, the surge of the hormone Relaxin helps to soften these supportive ligaments allowing more range of motion and flexibility for labor and delivery to occur.  This is a good thing for labor but for some it can lead to an unstable joint triggering inflammation and pain.

Everyday activities stress this joint by a variety of forces.  For example, sitting compresses the joint while standing pulls inferiorly and compresses superiorly. When this joint is inflamed, you can see how pain can occur with everyday movements.

 

Symptoms

Do these symptoms sound familiar?

  • Pain, burning shooting grinding or stabbing pain in the pubic area

  • Mild or prolonged radiating to back, abdomen, groin, perineum, and leg regions

  • Discomfort at front of joint

  • Difficulty with leg movements of abduction (moving away from midline) and adduction (moving towards midline)

  • Difficulty with locomotor activity like walking, stairs, rolling in bed, up/down from chair

 

The Anatomy

The pubic symphysis joint is comprised of 2 pubic bones with a cartilage disc in between. The joint is supported by 4 pubic ligaments and when working properly these structures provide stability to the joint.

Non-pregnant women have a pubic symphysis gap ranging from 4-5mm.

During pregnancy, this increases 2-3mm and for those with increased widths beyond the normal, pain and instability can occur with daily movements like walking or caring for your newborn.

 

The Good News

 
 

Hope and Healing are always possible.

Do not suffer with this pain, come in and let us help with pelvic physical therapy.  Treatment is comprehensive and tailored to the individual. Treatment will be geared toward decreasing pain, restoring stability and control of motion of the pubic symphysis during everyday tasks.  

Interventions may include:

  • Manual therapy for the release of deep and superficial musculature and fascia to decrease stress on the joint.  Gentle manual techniques to align your pelvis and pubic symphysis in a more neutral position to decrease stress at the joint.

  • Neuromuscular re-education can be used to retrain and improve coordination of pelvic and accessory muscles to regain stability of the joint.

  • Belting may be used at times to help decrease pain and provide some external stability.

  • Neutral positioning and posturing can also help with reducing symptoms.

  • Education may include birthing positions that would be less stressful on this joint.

Sarton Physical Therapy is home to the best pelvic health physical therapists in Orange County. The physical therapists at Sarton PT have an eclectic perspective in treating pregnancy and pubic pain with their successful interventions. Let our advance board certified physical therapists help, please contact us with any questions or requests for additional information. 



MacLennan A, MacLennan S. Symptom-giving pelvic girdle relaxation of pregnancy, postnatal pelvic joint syndrome and developmental dysplasia of the hip. Acta Obstet Gynecol Scand. 1997;76:760–764.

Management of Symphysis Pubis Dysfunction During Pregnancy Using Exercise and Pelvic Support Belts  Jill Depledge Peter J McNair Cheryl Keal-Smith Maynard Williams

Physical Therapy, Volume 85, Issue 12, 1 December 2005, Pages 1290–1300, https://doi.org/10.1093/ptj/85.12.1290

Becker et. al 2010

Parker and Bhattacharjee, 2009

 

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