What is Symphysis Pubis Dysfunction (SPD)?
The pelvis is comprised of four bones, strengthened by a network of strong ligaments. The ligament that connects the bones of the pelvis together is called the Symphysis Pubis (SP). During pregnancy, the SP becomes softer due to the action of the hormone relaxin. Relaxin is produced during pregnancy to soften joints and ligaments in preparation of birthing of your baby. Whilst this softening is crucial for the birth process, it also means a reduction in stability of the pelvis during pregnancy, particularly with the increasing load as your baby grows.
How does SPD affect you during pregnancy?
SPD is estimated to affect up to one in five women during pregnancy, varying in severity. Many women start to feel discomfort around the middle of their pregnancy, however, SPD can occur at any time during your pregnancy or after giving birth. Symptoms of SPD include pain in the pelvic region, with a focus in the frontal area, where the SP is located. SPD is also associated with pain in the lower back and abdomen, hips, groin and legs. A characteristic ‘clicking’ sound in the hips or lower back; (the sacroiliac) is also often reported during physical activity, especially change of stance.
Severity of the condition varies significantly, with some cases disabling and long term. It is comforting to know that the majority of cases will spontaneously resolve after the birth of your baby, however, in order to minimize the impact of SPD, in terms of both severity and length; it is important to address problems early.
What can you do? Physiotherapy.
Physiotherapy is a widely used in the management of SPD. Pelvic floor and core strengthening exercises can help increase stability of the pelvis and core muscles. Physiotherapy is also beneficial in maintenance of posture, which can be affected with the increasing load of your baby.
There are also some ‘common sense’ management techniques which should be implemented. These include avoiding strenuous activity and stretching exercises (in particular a straddle or squat position), heaving lifting and prolonged standing.
We have compiled a list of physiotherapists who have both experience and an interest in pregnancy. If you suspect you may be suffering from SPD, please inform Dr Morris. We are more than happy to help with arranging appointments, and our experienced midwifery team can help guide you if are experiencing difficulties or pain.