Picture this: You wake up from a not-so-restful sleep (waking several times to pee, discomfort, insomnia) and keep your eyes closed for a few seconds. You finally get up the energy to heave yourself out of bed and as soon as you do, a sharp TWINGE of pain hits you in the crotch. You stop for a few seconds to let it pass and get your bearings to stand up. You take your first few steps of the day (toward the bathroom, obviously). Ouch… ouch... ouch… each step causing echoes of the pain you felt getting out of bed.
Throughout the morning you can feel discomfort in the area coming and going, but you’re doing your best to ignore it.
But then… YOU HAVE THE AUDACITY TO PUT ON PANTS.
After finally deciding which bottoms you’re going to wear (the cuter/less comfy ones or falling back on the same trusty joggers you’ve been wearing since the bump showed up), you bend forward with your weight shifted to one side, ready to put your foot through the pant leg. As soon as you do, it hits you again. The dreaded crotch pain. UGH.
Ahh pregnancy... Such a beautiful journey.
If this scenario sounds familiar, you might be experiencing Symphysis Pubis Dysfunction (SPD)—a painful yet common condition during pregnancy. Many expecting parents suffer from pubic bone pain, pubic symphysis pain, crotch pain, pelvic girdle pain, or pelvic girdle dysfunction, but few realize there are ways to manage and treat it effectively. The good news? You don’t have to endure the pain alone. A board-certified pelvic floor physical therapist specializing in women’s health can help relieve your symptoms, support your body through pregnancy, and prepare you for both birth and postpartum recovery.
What is Symphysis Pubis Dysfunction (SPD)?
SPD occurs when the pubic symphysis joint, a small but crucial joint at the front of the pelvis, becomes excessively mobile or inflamed. During pregnancy, the body produces hormones like relaxin to help loosen ligaments in preparation for childbirth. However, in some cases, these hormones can cause too much relaxation, leading to instability in the pelvic girdle and resulting in pain and dysfunction.
Symptoms of SPD During Pregnancy
SPD presents in various ways, but the most common symptoms include:
Pain in the pubic bone area (front and center of the pelvis)
Discomfort in the groin, thighs, or perineum
Sharp, shooting, or burning pain when walking, climbing stairs, rolling over in bed, or standing on one leg
Clicking or grinding sensation in the pelvis
Worsening pain with movement or after prolonged standing
If left untreated, SPD can significantly impact daily life and even contribute to difficulties during labor and delivery.
Why Does SPD Happen During Pregnancy?
Several factors contribute to the development of pubic symphysis pain during pregnancy:
Hormonal Changes
Increased levels of relaxin soften ligaments, which can lead to excessive movement of the pubic symphysis joint.
Postural and Gait Changes
As the belly grows, posture and walking patterns change, placing additional stress on the pelvis.
Pelvic Floor Dysfunction
Weakness or imbalance in the pelvic floor muscles can contribute to instability and pain in the pelvic girdle.
Prior Injury or Pelvic Trauma
A history of pelvic injury or conditions such as hypermobility syndrome can increase susceptibility to SPD.
How Can a Board-Certified Pelvic Floor Physical Therapist Help?
Seeking treatment from a pelvic floor physical therapist specializing in women’s health is the most effective way to manage SPD during pregnancy. Here’s how expert care can make a difference:
1. Pain Relief & Stabilization Techniques
A pelvic floor physical therapist will use hands-on techniques, targeted exercises, and supportive strategies to reduce inflammation, improve pelvic stability, and alleviate pain.
2. Individualized Exercise Programs
Strengthening and stabilizing the core, glutes, and pelvic floor muscles can help support the pubic symphysis joint. Safe and effective exercises, such as deep core activation and hip stabilization movements, will be tailored to your needs.
3. Manual Therapy & Soft Tissue Release
Gentle manual therapy can address muscle tightness and alignment issues that contribute to pain, helping to restore balance in the pelvic region.
4. Pelvic Support Devices & Movement Modifications
Wearing a pelvic support belt can provide extra stability, and learning proper movement techniques (such as keeping knees together when rolling over in bed) can help prevent symptom aggravation.
5. Birth Preparation & Labor Strategies
A pelvic floor specialist can guide you in positioning techniques for labor that minimize stress on the pubic symphysis joint. Understanding how to activate the right muscles during childbirth can help reduce pain and potential injury during delivery.
6. Postpartum Recovery & Long-Term Pelvic Health
SPD pain may not immediately resolve after delivery, but a pelvic floor therapist can help facilitate a full recovery postpartum. Addressing any lingering pelvic instability or dysfunction can prevent long-term complications such as chronic pelvic pain or incontinence.
When to Seek Help
If you are experiencing pelvic pain, pubic bone pain, or any symptoms of SPD, do not wait for it to worsen. Seeking early intervention from a board-certified pelvic floor physical therapist can make a significant difference in your pregnancy experience, birth outcome, and postpartum recovery.
Final Thoughts
While Symphysis Pubis Dysfunction (SPD) can be a challenging aspect of pregnancy, it is treatable with the right approach. Working with a pelvic floor physical therapy specialist ensures that you receive expert guidance tailored to your unique needs. If you’re struggling with pubic symphysis pain, pelvic girdle pain, or crotch pain, reach out today to start feeling better and enjoy a more comfortable pregnancy journey.
At Bonneville Pelvic Health, we specialize in women’s health and pelvic floor physical therapy. Contact us to schedule an evaluation and take the first step toward relief and recovery!
Written by:
Dual Board-Certified Pelvic Floor Therapist and Owner of Bonneville Pelvic Health
As an expert in pelvic floor rehabilitation, Dr. Bailee Burningham brings extensive experience in treating complex pelvic floor disorders. She is dedicated to providing compassionate, patient-centered care.
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