Symphysis Pubis Dysfunction

  Well done! You’ve taken the first steps to understanding and relieving your Symphysis Pubis Dysfunction! Once you read this page answer the questions on the sheet given by your physiotherapist at Musculoskeletal Physiotherapy Australia and bring that to your next treatment session. Recovery from your Symphysis Pubis Dysfunction is crucial in order to achieve your goals and gain rapid and long-lasting results. Your physiotherapist at Musculoskeletal Physiotherapy Australia has requested that you read this page so that you understand your condition and know how to best manage in between physiotherapy consultations.
Pelvis

Pelvis

What is Symphysis Pubis Dysfunction?

Symphysis Pubis Dysfunction (SPD) is the clinical term for a collective group of signs and symptoms of pain in the pelvic and groin area. Other names for this common condition include pelvic insufficiency, symphysis pain syndrome, pelvic joint syndrome, pelvic girdle pain and pubic symphysis dysfunction. All these terms refer to the same condition, that being instability with the ‘pubic symphysis’ joint that connects the two pubic bones together at the front of the pelvis. This joint is pictured on the right. Similar to the sacro-iliac joint at the back of the pelvis, the pubic symphysis is vulnerable to abnormal forces that can weaken the ligaments that are intended to hold it in place.  When the surfaces of each hip bone are not lined up in the way they are intended to be, this can cause pain and inflammation. In severe cases, a full separation or displacement of the joint (>10mm) is called a Diastic Symphysis Pubis (DSP) and requires imaging for diagnosis.
Symphysis Pubis Diastasis

Symphysis Pubis Diastasis

What caused my Symphysis Pubis Dysfunction?

The exact cause of SPD is not yet known! However, what is known is that there are certain conditions that can predispose you to SPD more than others. Pregnancy is one such condition. During pregnancy, there is an altered load on the pelvis, which can lead to spino-pelvic instability, and also a change in the hormones produced. Two hormones that are produced during early pregnancy are Relaxin and Progesterone. These hormones are responsible for breaking down collagen in the ligaments within the pelvic joint to cause laxity and softening of the ligaments. As the ‘pubic symphysis’ joint relies a lot on the surrounding ligaments for support, these lax ligaments are unable to support the pelvis as usual, and will lead to joint dysfunction. Other factors that can contribute to the cause of this condition include, calcium deficiency, increased weight, lack of exercise (weak musculature) and anatomical or genetic variations.

How can you help me with my Symphysis Pubis Dysfunction?

A detailed history, taken by your Musculoskeletal Physiotherapy Australia Clinician, of the pain or injury can determine the underlying cause of your SPD, while a physical assessment of the knee, hip, back and surrounding structures, can determine the best course of action in treating the condition. Usually, treatment will involve correcting any abnormal gait (walking) biomechanics, and strengthening/stretching muscles to reduce muscle imbalances, weakness and tightness.  

What should I do to avoid aggravating my Symphysis Pubis Dysfunction?

  • AVOID activities that aggravate your pain, until you have seen a Musculoskeletal Physiotherapy Australia Clinician.
  • AVOID generic strengthening activities such as squats and lunges, until you have seen a Musculoskeletal Physiotherapy Australia Clinician, as they may be contributing to the muscle imbalances, rather than helping them.
  • REMAIN ACTIVE, while avoiding aggravating activities.
  • For RELIEF, applying ice to the area may help to reduce some pain and inflammation in the initial stages. Be sure to wrap the icepack in a towel, and only apply for 10 minutes every 2 hours. CEASE use if you have any negative reaction.
  • RECEIVE physiotherapy care to get your joints, ligaments and muscles de-loaded and moving freely with no restrictions.
Keep good care of your body and your physiotherapist will continue to monitor your condition. Once your Symphysis Pubis Dysfunction has resolved you will be able to resume your full activities without worrying about future flare-ups.
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