Symphysis Pubis Dysfunction

What Is Symphysis Pubis Dysfunction?

The pubic symphysis is the front point where the left and right pelvic bones meet just above the genital area. Symphysis pubis dysfunction (SPD), also sometimes referred to as pelvic girdle pain, involves irritation, instability, or misalignment at this pubic symphysis junction. SPD particularly causes discomfort during weight-bearing activities such as walking and going upstairs. 

SPD is common during pregnancy due to hormonal changes and associated ligament laxity. During pregnancy, the pubic symphysis becomes more mobile due to the hormones which are released in the body including relaxin, which prepares the pelvis for childbirth. This increased laxity allows slight widening of the pelvic ring which can sometimes result in instability, leading to SPD. Pelvic girdle pain can also occur in non-pregnant individuals due to trauma, surgery, or muscular imbalances.

What Does SPD Feel Like?

People with SPD commonly report:

• A sharp or aching pain over the pubic bone
• Pain radiating into the groin, front of thigh, or hips
• Some individuals will report clicking or grinding at the front of the pelvis

Key symptoms that are associated with SPD include:

• Pain and instability walking, shifting weight and changing posture.
• Discomfort with single-leg activities (e.g. standing on one leg when getting dressed, and going up and down stairs, hopping)
• Pain with prolonged standing 
• Pain turning over in bed.
• Worsening pain during activity or at night

What Not to Do with Symphysis Pubis Dysfunction

To avoid worsening symptoms:

• Refrain from pushing through pain during exercise
• Don’t do lunges, deep squats, or single-leg exercises like step ups unless otherwise advised
• Avoid crossing your legs when sitting, as this often aggravates symptoms
• Limit heavy lifting or fast-paced walking, running, hopping or jumping

How to Help Symphysis Pubis Dysfunction?

A Women’s Health Physio plays a vital role in managing SPD. Key approaches include:

• Strengthening pelvic floor, deep abdominal, and gluteal muscles
• Using pelvic belts or compression garments for support
• Manual therapy to relieve soft tissue tension
• Postural correction and movement retraining
• Guided low-impact exercises such as bridges or pelvic tilts can help manage pain and improve trunk stability 

What’s the Difference Between SPD vs Symphysis Pubis Diastasis?

The terms sound very similar, yet describe slightly different conditions:

• Symphysis Pubis Dysfunction (SPD): Is a functional condition involving pain, irritation, or slight instability in the pubic symphysis joint. This is usually without significant separation on imaging. 
• Symphysis Pubis Diastasis: Is a more severe form of pelvic injury where the pubic symphysis separates. Typically separating more than 10 mm. It may result from childbirth, falls, or severe ligament damage.

While both cause pelvic pain, diastasis often involves visible joint widening on imaging. Will often require more intensive rehabilitation that SPD and in rare cases, surgical intervention. A Women’s Health Physiotherapist plays an essential role in treating both conditions, with diastasis generally taking longer to heal.

Is Physiotherapy Effective for Pelvic Girdle Pain?

Physiotherapy is the first line treatment for symphysis pubis dysfunction. Research confirms that a combination of exercise therapy, manual therapy, and patient education significantly improves pain and mobility in pregnancy-related pelvic pain.

A 2015 study published in the British Journal of Sports Medicine found that tailored physiotherapy during pregnancy led to better outcomes than standard advice alone.

Recovery timelines vary. In pregnancy-related SPD, symptoms usually resolve within 6–12 weeks postpartum. With early physio treatment, discomfort can be significantly reduced before delivery. For non-pregnant patients, recovery can take a few weeks to several months, depending on the cause and treatment adherence.

Self-Care Tips For Pelvic Girdle Pain

In addition to physiotherapy, the following tips can effectively help manage symptoms:

• Using pillows between your knees for sleep alignment
• Getting in and out of bed and other transition postures while keeping the knees together
• Applying ice to the pubic area can help manage pain and may reduce inflammation
• Wearing flat, stable and supportive footwear 
• Avoiding heavy lifting and asymmetrical single leg movements

Symphysis pubis dysfunction can significantly impact mobility and quality of life, especially during pregnancy. Physiotherapy provides effective, conservative care to prevent worsening of symptoms, relieve pain, and ultimately restore function.

If you’re experiencing pelvic pain or feelings of pelvic instability, whether dealing with SPD or a more severe symphysis pubis diastasis contact Sydney Physio Clinic. A tailored treatment and rehabilitation plan can help you move with comfort and confidence again.