By Anna Burns, Physical Therapist
The pelvis contains three joints: the two sacroiliac joints in the back (one on each side) and the pubic symphysis in the front. Today’s topic: pubic symphysis dysfunction.
I’ve seen a lot of pubic symphysis dysfunction in my pregnant and postpartum clients. In fact, pubic symphysis dysfunction has been reported in ~32% of pregnant women (1). This joint can cause what some refer to as “lightning crotch,” or sharp, shooting pain in the front of the pelvis with activities such as walking, going up/down stairs, rolling over in bed, wide squatting, getting in/out of a car, intercourse, and standing on one leg.
Typically this happens as pregnancy hormones (particularly progesterone) loosen the joints of the pelvis (and elsewhere in the body) to prepare the body for delivery. As a result, the pubic symphysis can get irritated by subtle changes (micromovements), causing anything from a soreness to a sharp stab in this region. Some people feel it over the joint itself, while others feel it radiate into the groin or lower abdomen.
The good news? Pelvic floor physical therapy can help! With a combination of manual therapy, activity modifications, external supports, and targeted exercises, you can improve, whether pregnant or postpartum. And it’s never too late. Even years after delivery, these symptoms can linger, and you can do something about it!
Do you have experience with this? Here are a few tips to help manage in the meantime before you even come in for an evaluation.
- Shorten your stride. If walking hurts, shortening the stride will decrease the one-sided pull on the joint as each leg moves forward.
- Keep you knees together. This is a great one for rolling over in bed and getting in/out of a car. Again, this minimizes asymmetrical demands on the joint.
- Consider a sacroiliac belt, which can help to support the joint. I particularly love the Serola belt.
- Sleep on your side with a pillow between your knees to keep your pelvis neutral.
- Keep moving within a comfortable level of activity. Moving is better than not!
Don’t let pain stop you from enjoying life! Schedule an evaluation today!
- Depledge J, McNair PJ, Keal-Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Physical Therapy. 2005;85(12):1290–1300.