Feeling an uncomfortable pain at the front of your pelvis, that burns and gets sharper as you walk and move around? Are you pregnant? And in your second trimester? It could be pubic symphysis dysfunction!
Your pubic symphysis is a strong ligamentous joint at the front of your pelvis. It is where the two wings of your pelvis (the ilia) meet together in the middle at the front of your body. Between the two bones there is a small cartilaginous disc to keep a small space, and strong fibrous ligaments run between the two bony edges to keep them together. The joint is normally strong as we take so much weight through the pelvis when we stand and walk around, but it can’t be a bony union due to childbirth. For childbirth the pelvis must be able to stretch and move to widen the birth canal and allow the baby to come out!
This change in pressure around the pelvis partly what leads to pubic symphysis pain. Pregnancy can alter the pelvic load and pulls on the lumbo-pelvic ligaments, reducing the ability of the local musculature (including your abdominals) to stabilise the pelvis and lumbar spine. Although we don’t yet know why some patients get pain and others don’t, we do know that the pain is usually a sharp, shooting, stabbing or grinding pain that is generally relieved with rest. It can start at a mild pain that steadily worsens with more stress, for example walking and stairs, and it can radiate into the back, hips and legs.
Early diagnosis is important, as minimising symptoms from the start can prevent long term dysfunction in the pubic symphysis joint, as well enable you to be as active throughout your pregnancy as possible.
A Physiotherapy and Pilates assessment and treatment can be helpful to reduce the pain by reducing the muscular pull and overload on the joint. We can do this with pelvic floor and deep abdominal strengthening, glute strengthening, advice and muscular release, and sometimes a pelvic belt is needed to help as well.
If you’re not sure if you have pubic symphysis dysfunction why don’t you come in and see one of our Physios at Bend + Mend in Sydney’s CBD.