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Pelvic Girdle Pain with Symphysis Pubis Dysfunction

Your pelvis is made up of a stable ring of bones, a bit like a hula hoop, which are held in place by strong ligaments.

Common Signs & Symptoms

You may feel pain with any of the below:

  • Standing on one leg (such as when getting dressed)
  • Walking
  • Walking upstairs
  • Turning in bed
  • Moving your legs apart such as when getting out of a car

Description

Your pelvis is made up of a stable ring of bones, a bit like a hula hoop, which are held in place by strong ligaments. For your pelvis to absorb stresses and strains when you walk, it is essential that this ring remains stable. The pubic symphysis joint is found above your genitals, where your pelvis bones meet at the front. Sometimes the ligament holding your pubic joint together (your pubic symphysis) can become stretched and inflamed, causing pain when you stand and walk.

It is most common to suffer Pubic Symphysis Dysfunction in the latter stages of pregnancy. The hormone relaxin is released to prepare for the birth of a baby and this makes your ligaments more flexible. Strain on the joint such as with running, can also cause weakness of the ligaments or your joints to shift (malalignment) leading to pelvic girdle pain, although this is less common. The area surrounding the symphysis pubis may also become very tender with very sharp localised pain being accompanied by referred pain into the hips, groin, and inner thighs.

Other causes:

  • Sometimes diastatis (separation) of your pubic bones occurs during delivery, if your baby is born quickly.
  • Training on uneven or hard ground.
  • Muscle imbalance and weak core, tightness in the hips, groin and buttocks.
  • High kicks, such as during ice skating, dancing or gymnastics
  • Wearing ill-fitting shoes
  • A waddling walk
  • Leg length discrepancy
  • Gynaecological surgery

Advice & Treatment

Avoid standing and walking activities to reduce the strain on your pubic symphysis joint and ligaments. A pelvic girdle belt can be very effective in improving the stability of your pelvis to reduce your pain.

If you are close to the end of your pregnancy, you may need to rest from standing and walking activities and wait until the level of your hormone relaxin has lessened after birth for your pain to fully go, this can take up to 6 months.

Treatment by a physiotherapist specialising in back pain can help to see whether your back joints are causing further aches and pains too.

Other things you can do:

  • Assess the surface of the ground or floor you are training on - if there is no sping in the surface it may increase the strain going through your pubic symphysis
  • Improve the flexibility and balance of your muscles in your core (stomach and back), hips, groin and buttocks
  • Avoid high kicks (dancing, gymnastics) and wait for your symptoms to settle further before you gradually begin again
  • Warm up before you play sport or new activity, and begin training of any new activity slowly
  • See a podiatrist who can assess whether you need orthotics
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