Tips for Managing Pubic Symphysis Dysfunction/Pelvic Girdle Pain

About 30% of women will develop pain in their pelvic region during pregnancy. This occurs more commonly in the second and third trimester. Pain can be located over the front of the pubic bone (pubic symphysis), across one or both sides of the sacrum, between the vagina and anus (perineum area), and can sometimes radiate into the legs. The severity of the pain can vary from mild discomfort to severe pain.

Movements that can commonly cause pain in the pelvic girdle are: walking, standing on one leg, turning over in bed, weight-bearing activities, moving from sitting to standing, going up or down the stairs, and spreading legs apart.

Physiotherapy can help to improve positioning and support of the pelvic joint, which will reduce pain in the pelvic region, and improve function and mobility. Physiotherapy exercises will focus on strengthening the abdominals, back extensors, pelvic floor and gluteal muscles, as well as stretching exercises for tense muscles around the hips, pelvis and low back. A pregnancy support belt can also help to reduce pain with walking. These symptoms tend to last until the baby arrives, but Physiotherapy treatment can help to reduce/make the pain more manageable during pregnancy. Working on strengthening exercises during the pregnancy, will also help with postpartum recovery.

Self management for pubic symphysis dysfunction:

The aim is to reduce stress on the joint, to help alleviate pain. It is essential that you tighten the muscles of your lower abdomen before and during the following activities:

When getting into bed: Sit on the edge of the bed, keeping knees close together. Lie down on your side, lifting both your legs up sideways (keep knees together). Reverse this to get out of bed. Do not attempt to pull yourself up from lying on your back.

When getting out of bed: Lay on your side, with your knees together. Hook your heels on the side of the bed, and use your top hand to push yourself up to sitting, using your heels to help prop you up.

When rolling in bed: keep knees together, and roll your upper body and lower body together.

When getting up from a chair: keep knees close together, put your hands on your knees and lean nose over toes to stand up.

When sitting down: keep your knees close together, bring your bum back until you feel the chair at the back of your legs first.

When getting into a car: sit down first and then swing legs in, keeping knees together.

When walking: take smaller steps to reduce strain/pull on the pelvis.

When using the stairs: step up sideways one step at a time.

Remember to: sleep with a pillow between your legs. Take rest breaks and move within your limit of pain. It’s important not to stay completely sedentary as this causes the muscles to weaken and tense up.

Avoid: sitting on soft sofas and chairs. A firm surface will provide more support to your back, hips and pelvis. Limit prolonged walking as an exercise, and active stretching and exercising with legs apart (e.g, squatting, sitting cross legged or breaststroke kicking when swimming).

Looking for treatment for pelvic girdle pain, and to learn exercises you can perform at home to aid in pain relief? Click here to book an appointment with our Pelvic Health Physiotherapist, Jessica.