As pregnancy pain experts, we are well versed in pubic symphysis pain and dysfunction. We are here to share what this pain is, help you identify symptoms, and provide SPD solutions!

What is ‘SPD’?

SPD is the acronym used for ‘symphysis pubis dysfunction’. The pubic symphysis is a force-absorbing disc found between your two pelvic bones. During pregnancy, there is ‘dysfunction’ in this area caused by all the adaptations required to make room for your growing baby.

The pubic symphysis is similar to the discs found between your spinal segments. The ultimate role of this small structure is to help distribute force evenly throughout the pelvis and assist in its stability. The increase in pelvic mobility during pregnancy lowers the bodies ability to transmit forces and increases the amount of shear forces in the pelvic joints, which can cause pain.

Some separation of the pubic symphysis is normal during pregnancy. However, in some women, the separation happens quickly, unevenly, or excessively which further contributes pelvic instability and SPD.

When Does Pubic Symphysis Pain Start During Pregnancy?

Pubic symphysis pain can start at any time during pregnancy. Most commonly we see SPD symptoms starting in the second and third trimesters as posture changes are more dramatic. If you experienced SPD with your first pregnancy, symptoms may appear sooner!

Signs of SPD during Pregnancy:

• Pubic bone pain [this can travel to your mid-upper thighs too]
• Burning sensation in or around your crotch 
• Difficulty walking 
• Pain when using stairs [in the crotch or groin]
• Feeling like your pubic bone is ‘tearing apart’
• Clicking or grinding in the pelvis

What does Chiropractic Care do for SPD?

SPD during pregnancy can have many causes and triggers. Like we mentioned, most SPD symptoms can be attributed to mechanical pregnancy changes. The 2 big influences : increased laxity of the pelvic ligaments & the anterior shift in your center of gravity. These changes affect pelvic alignment and function… that’s where we come in!

Chiropractic adjustments during pregnancy aligns the pelvis to its optimal position. Adjustments also have muscular benefits including releasing tension and relieving pain.

The specific chiropractic technique for pregnancy is the Webster Technique. The main goal of the Webster Technique is to neutralize the pelvis by using specific adjustments and soft tissue techniques.

Stretches & Exercises for SPD during Pregnancy:

Addressing tight muscles that surround the pelvis like the iliopsoas and piriformis muscles, help improve pelvic alignment and pubic symphysis pain. The stretches below are a preview to our Pregnancy Pain Program! 

Exercises to Avoid with SPD:

1. Single Leg Movements : lunges, stairs [in excess], step ups, etc.
2. High Impact Activities: running, jumping, etc.

Adductor Stretching for SPD

The adductor muscles attach to the pelvis, near the pubic symphysis that is causing your SPD pain! They have a few important jobs: dynamic pelvis stabilization and controlling adduction [bringing the legs together] and rotating the hip inward.

Because the adductors play such a big role in stabilizing the pelvis, they can be key muscles to target with strengthening and lengthening exercises!

You can stretch your inner thighs in lot of different ways. We have 2 inner thigh stretches for pregnancy featured in the video above! One SPD stretch uses an exercise ball and one is performed from a

Adductor Strengthening for Pubic Pain Relief

Having a good mixture of both lengthening and strengthening exercises are essential for pubic symphysis pain relief. Try a simple eccentric adductor exercise by squeezing a pilates ball between your knees. If you don’t have your pilates ball handy, you can also use your fists! You can take it up a notch by incorporating your pilates ball in bear holds and glute bridges. 

Glutes and Piriformis Strengthening

Some of the most important pelvic stabilizers are the glutes.. including the piriformis. Incorporate exercises like box squats to improve strength and pelvic stability. Both will help with SPD during pregnancy.

Another glute-focused exercise to try for SPD relief is glute bridges. Glute bridges are great for overall pelvic floor and core stability. You can make the exercise more difficult by adding a pilates ball between your knees and contracting inward. Adding the pilates ball also turns on the adductors for extra benefits! [note: if you are pregnant, don’t stay on your back too long & be careful getting up!]

Exercise Ball for Pelvic Mobility

We love using exercise balls during pregnancy! They can be useful for so many different things... one being gentle pelvic mobility. Sitting on your ball provides a comfy spot to wiggle your pelvis around in all directions & work through the sticky spots. 

There are more home techniques and solutions on our YouTube Channel, including the Pregnancy Pain Program that reviews all the common pelvic pain condition that occur during pregnancy! We cover a variety of pain conditions like low back pain, SPD, sciatica, and

SPD and Your Pelvic Floor

All of your pelvic floor muscles attach to your pelvis! This is important to keep in mind as you battle any type of pelvic pain. As pregnancy chiropractors, this is something we consider as we adjust the pelvis and improve alignment. Adjustments have the ability to improve muscle function...yes even your pelvic floor muscles! In addition to the chiropractic adjustments, we recommend that women practice pelvic floor and core exercises, both strengthening and relaxing! If you are someone that has a history of pelvic floor dysfunction before pregnancy or you want more direct one-on-one feedback, we recommend adding a pelvic floor physical therapist to your health team.

SPD & Pubic Pain Postpartum 

Most women find they have relief from their SPD symptoms after birth or within the first 2 months postpartum. It takes time for your posture to adjust back to your 'normal'. The hormone relaxin still remains elevated postpartum-- during and after the nursing period. You can use a pelvic girdle or SI belt to keep up with your newborn. Be sure to focus on your pelvic floor and core function! If symptoms are not improving with time, we recommend seeing a pelvic floor physical therapist. For all our postpartum recs, check out our C-Section Recovery List & our Vaginal Birth Recovery List.

This post includes affiliate links. We make a small commission for products purchased using these links (at no additional cost to you). Thank you for supporting Chiro for Moms/Chiro for Kidz, and making the content you see on this blog possible.

           ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Interested in photos like the ones featured in this post?  We work with Megan Norman, a Minnesota-based family and newborn photographer with incredible talent.  

            ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

References:

• Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Pract. 2010;10(1):60-71. doi:10.1111/j.1533-2500.2009.00327.x