Treating Symphysis Pubis Dysfunction (SPD) with Pelvic Floor Physical Therapy

Overview

Symphysis Pubis Dysfunction (SPD) is a painful condition affecting the joint where your pubic bones meet at the front of your pelvis. If you're experiencing sharp pain in your pubic area, especially with movement, you're not alone in this challenging but treatable condition.

SPD creates instability and discomfort in the pelvic girdle, making everyday activities like walking, climbing stairs, or even getting dressed feel overwhelming. The condition occurs when the symphysis pubis joint becomes too mobile or misaligned, often accompanied by inflammation and muscle tension that radiates throughout the pelvic region.

This condition affects approximately 32% of pregnant individuals, though it can impact anyone regardless of pregnancy status, gender, or age. While SPD is most commonly recognized during pregnancy due to hormonal changes that increase joint flexibility, many people experience this condition following pelvic trauma, intense physical activity, or as part of broader pelvic floor dysfunction. The encouraging news is that specialized pelvic health physical therapy has proven highly effective in managing SPD symptoms and restoring functional movement.

At Mendwell Pelvic Health, we understand that SPD affects people across all demographics. Whether you're pregnant, postpartum, an athlete dealing with pelvic instability, or someone experiencing unexplained pelvic pain, our comprehensive approach to pelvic floor physical therapy addresses the root causes of your discomfort. Our treatment plans are designed to be inclusive and respectful of all individuals, recognizing that pelvic health conditions can affect anyone seeking to improve their quality of life and return to the activities they love.

Symptoms

Recognizing SPD symptoms is the first step toward finding relief through targeted pelvic health treatment. The pain and discomfort associated with this condition can significantly impact your daily routine, but understanding these symptoms helps you communicate effectively with healthcare providers about your experience.

Primary SPD Symptoms Include:

• Sharp, aching, or burning pain directly over the pubic bone area
• Audible clicking, grinding, or popping sounds when moving your legs
• Pronounced difficulty walking, often resulting in a waddling or shuffling gait
• Severe discomfort when climbing stairs, especially going up
• Pain when getting in or out of vehicles, particularly low cars
• Intense discomfort when separating your legs for activities like getting dressed

Movement-Related Symptoms:

• Significant pain when rolling over in bed or getting up from lying down
• Difficulty bearing weight on one leg, such as when putting on pants or shoes
• Increased pain during transitions from sitting to standing
• Discomfort during activities requiring hip abduction or rotation
• Pain that worsens with prolonged walking or standing

Associated Symptoms:

• Lower back pain that may extend into the hips and inner thighs
• Pelvic muscle tension and spasms
• Fatigue from compensatory movement patterns
• Sleep disruption due to position-related pain
• Anxiety about movement and activities that previously felt natural
• Impact on intimate relationships due to pelvic discomfort

Many people with SPD describe feeling like their pelvis might "fall apart" or that something is fundamentally unstable in their core. These sensations, while alarming, are common experiences that respond well to appropriate pelvic floor physical therapy interventions.

Causes

Understanding what contributes to SPD helps demystify your condition and empowers you to participate actively in your recovery. Multiple factors can lead to symphysis pubis dysfunction, and often several elements combine to create the perfect storm for this challenging condition.

Pregnancy-Related Factors:

The hormone relaxin, produced during pregnancy, intentionally softens ligaments to prepare your body for childbirth. However, this necessary process can sometimes create excessive mobility in the symphysis pubis joint. Additionally, as your center of gravity shifts and your body adapts to carrying additional weight, movement patterns change in ways that can stress the pelvic joints. The growing baby's position can also influence pelvic alignment and contribute to joint dysfunction.

Biomechanical and Structural Causes:

Muscle imbalances between your core, pelvic floor, and hip muscles create compensation patterns that stress the symphysis pubis joint. When certain muscles become tight while others weaken, your pelvis loses its stable foundation. Previous injuries to the pelvis, tailbone, or lower back can create lasting changes in how you move and distribute weight through your pelvic girdle.

Activity-Related Triggers:

High-impact activities, repetitive lifting, or sudden increases in exercise intensity can overwhelm the pelvic joints' capacity to maintain stability. Sports involving rapid direction changes, jumping, or asymmetrical movements particularly challenge the symphysis pubis joint.

Medical and Surgical History:

Previous pelvic surgeries, including cesarean sections, gynecological procedures, or abdominal surgeries, can alter tissue mobility and create scar tissue that affects pelvic mechanics. A history of pelvic fractures or significant trauma may predispose individuals to developing SPD later in life.

Postural and Lifestyle Factors:

Prolonged sitting, especially in poor ergonomic positions, can contribute to muscle imbalances and joint stiffness. Chronic stress and tension often manifest as pelvic floor muscle dysfunction, which interconnects with symphysis pubis stability. Poor sleep quality and inadequate recovery between physical activities can also impair your body's ability to maintain optimal pelvic alignment.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy offers a comprehensive, evidence-based approach to treating SPD that addresses both immediate pain relief and long-term functional improvement. Our specialized treatment recognizes that the symphysis pubis joint doesn't function in isolation but as part of an integrated pelvic system that includes your pelvic floor muscles, deep core stabilizers, and hip muscles.

Immediate Pain Management: Our pelvic health specialists employ targeted manual therapy techniques to reduce inflammation and muscle tension around the symphysis pubis joint. Through gentle mobilization and soft tissue techniques, we help restore normal joint mechanics while decreasing pain signals. These hands-on approaches provide relief that allows you to participate more fully in your rehabilitation exercises.

Comprehensive Assessment and Treatment: Every treatment plan begins with a thorough evaluation of your pelvic girdle mechanics, muscle function, and movement patterns. We assess how your entire kinetic chain contributes to your SPD symptoms, examining everything from your breathing patterns to how you walk. This comprehensive approach ensures we address all contributing factors rather than just treating symptoms.

Muscle Re-education and Strengthening: Pelvic floor physical therapy focuses heavily on retraining the coordination between your pelvic floor muscles, deep abdominal muscles, and diaphragm. These muscles work together to provide internal support for your pelvic joints. We teach you how to engage these muscles properly during daily activities, creating a natural support system that reduces stress on the symphysis pubis joint.

Functional Movement Training: We understand that your goal isn't just pain reduction but returning to the activities that matter to you. Our treatment includes specific training for daily tasks like getting dressed, household activities, exercise routines, and work-related movements. For pregnant individuals, this includes preparation for labor positions and postpartum activities.

Education and Self-Management: Knowledge empowers healing. We provide detailed education about pelvic anatomy, SPD triggers, and effective self-management strategies. You'll learn positioning techniques for sleeping, sitting, and moving that minimize joint stress. We also teach you how to modify activities during flare-ups while maintaining your progress toward full recovery.

At Mendwell Pelvic Health, our approach to treating SPD combines cutting-edge techniques with compassionate, individualized care. We recognize that each person's experience with pelvic pain is unique, requiring a treatment plan that addresses your specific symptoms, lifestyle, and goals. Recovery from SPD isn't always linear, and we provide ongoing support to help you navigate challenging days while celebrating your progress. We adjust your treatment plan as your symptoms improve and help you gradually return to higher-level activities when appropriate.

Frequently Asked Questions

Can pelvic floor physical therapy help SPD during pregnancy?

Yes, pelvic health physical therapy is considered one of the most effective treatments for pregnancy-related SPD. Our pregnancy-safe techniques help manage pain while preparing your body for labor and delivery. Many clients experience significant symptom improvement that allows them to enjoy their pregnancy more fully while building strength for postpartum recovery.

How long does SPD treatment take with pelvic floor physical therapy?

Most people begin noticing improvement within 4-6 sessions of consistent pelvic health physical therapy, though individual timelines vary based on symptom severity and contributing factors. Complete resolution typically occurs over 8-12 sessions, with many clients developing effective self-management skills that prevent future flare-ups.

Will SPD symptoms return after I finish physical therapy?

With proper treatment and self-management education, many people experience lasting relief from SPD symptoms. We teach you preventive strategies and provide exercise programs you can continue independently. Some individuals benefit from occasional follow-up sessions during times of increased activity or life changes.

Can men develop symphysis pubis dysfunction?

Absolutely. While SPD is more commonly discussed in relation to pregnancy, it can affect anyone regardless of gender. Men may develop SPD following pelvic trauma, intense athletic activities, or due to muscle imbalances and postural issues. Our treatment approach is equally effective for all individuals experiencing this condition.

Is it safe to exercise with SPD?

Exercise is generally beneficial for SPD when properly modified and supervised. Our pelvic health specialists help you identify which activities to avoid temporarily and which exercises support your healing. We provide specific guidelines for returning to your favorite activities safely and gradually.

What should I expect during my first pelvic floor physical therapy appointment for SPD?

Your initial visit focuses on understanding your symptoms, medical history, and functional limitations. We conduct a comprehensive assessment that may include observing your movement patterns and evaluating muscle function. All examinations respect your comfort level, and we explain each step of the process. You'll leave with a clear understanding of your condition and a personalized treatment plan.