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Understanding Pubic Symphysis Pain

Pelvic Girdle Pain

Pregnancy is chock full of unexpected physical changes to your body. There's an endless list of "things no one told me" that happen: from the more obvious expanding abdomen or swollen feet to pelvic heaviness and vulvar varicosities. The changes can seem minor on paper, but can affect your life dramatically while pregnant and after. While many of the changes are expected and the norm, there are many conditions that can develop and cause discomfort and pain. The secret is, pelvic floor PT can often help mitigate the pain. One common condition that you may experience is Symphysis Pubis Dysfunction (SPD). Let’s explore what this is and why it happens, along with ways to help you cope and find treatment!

What is SPD?

Pelvic Girdle Pain

The pelvic girdle is the ring of three bones and three joints that comprise the pelvis. The pelvis is located in the middle of the body and is an important link between the spine and lower limbs enabling you to move, walk, jump, etc. The three bones are the sacrum and coccyx and two hips bones. Pain occurs in the front of this area when there is less ligamentous stability in the joints because of the hormones of pregnancy. SPD is often felt in the pubic bone, groin, and inner thighs. Pubic symphysis pain can also occur along with posterior pelvic girdle pain or sacroiliac joint (SI) pain. The most common cause of SPD is pregnancy. It can also be caused by injuries to the pelvic area especially from sports.

Even at the outset of pregnancy, your hormones are drastically different from your non-pregnant body. In fact, the hormone relaxin peaks at 12 weeks of pregnancy. You may barely feel pregnant and still have significant pain in your pelvis. Relaxin is an important hormone allowing for your body to stretch and support the baby. However, it also causes your joints to be more "loosey goosey." During a pregnancy, your muscles have to actively support your more because your ligaments are less stiff. In the third trimester, as your body prepares for birth, relaxin peaks again. Add this to the significant changes in your center of gravity and weakness in your core from your stretching abdominals, often means an increase in pelvic pain.

Symptoms of Pubic Symphysis Pain

The symptoms you may feel from SPD are varied and can range in degree of severity. You may experience mild discomfort or significant pain.

You may experience:

  • Pain in the pubic area, groin, and inner thighs

  • Pain when turning over in bed

  • Pain while getting into or out of a car

  • Pain with walking or climbing stairs

  • Difficulty with asymmetrical movements like lunges or standing on one leg

  • Pain when moving but not when resting

Pelvic Girdle Pain

Managing SPD

Learning to manage your SPD during your pregnancy can make all the difference in continuing to walk, work, and enjoy your time before a new baby. Making a few lifestyle modifications can greatly impact your pain level.

Begin by avoiding any movements that trigger your pain. Try to avoid excessive walking or prolonged standing. Ensure that you have regular rest periods when you are walking or standing. Listen to your body and create a comfortable environment such as using pillows to support your body when sitting or lying down. Learning to engage your core prior to movement is often key. Finding exercises that will help maintain your muscle strength and endurance without adding unnecessary strain to your body can also improve your pain.

Pelvic floor physical therapy can play a vital role in helping your manage your SPD. Your therapist can perform manual techniques to to help release tight muscles that are pulling on your pubic symphysis. They can also provide guidance on proper exercises, behavior modifications, and relaxation techniques to help you feel better and allow you to place your focus on the joy of the experience of pregnancy!

Pelvic Girdle Pain


If you have pelvic health concerns and would like to see how our therapists at

Embrace can help, follow the link to schedule your free discovery call.

embrace pelvic floor physical therapy

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