The Pubic Symphysis (PS) is a joint formed between the pelvic bones at the front of the pelvis and along with the sacro-iliac joints, it helps to keep the pelvis steady and absorb shock during activity. Pubic Symphysis Dysfunction is a common and very painful condition which can affect both men and women. It occurs because of poor joint alignment, either through tight muscles pulling on the joint or when the joint becomes too lax, causing excessive movement and leading to pain.
This can be a result of :
- Pregnancy – softening ligaments result in increased joint mobility. Often worse in the last trimester of pregnancy and can be exacerbated by strenuous activities during pregnancy, increased maternal age, or after several pregnancies or difficult deliveries.
- Biomechanical issues – Hypermobility, excessive weight gain, poor posture, muscle weakness
- Anatomic/genetic variations.
- Excessive tightness of muscles around the joint.
- Sports injury – such as landing hard on one leg or legs sliding far apart, excessive breaststroke, or associated with a groin strain.
Signs & symptoms
The severity of symptoms may range from mild discomfort to severe debilitating pain. Symptoms include:
- Deep ache, burning, shooting or stabbing pain in the joint, located directly between the groins.
- Pain may radiate into the lower back, abdomen, groin, perineum &/or thighs.
- Increased pain when loading the joint, particularly in single leg positions.
- Pain subsides with rest.
Aggravating factors
- Excessive single leg loading.
- Lifting heavy loads, especially in a squat position, or carrying heavier loads on one side.
- Twisting/bending whilst lifting.
- Pushing heavy objects.
- Crossing your legs whilst sitting or on the floor or getting in/out car.
- Standing or sitting in one position for long periods of time.
Management
- Assessment by a Physiotherapist of the stability of the pelvic joints and strength/function of the pelvic muscles.
- Myofascial release and activity modification to reduce joint loading.
- Pelvic belt to stabilise joint if severe.
- Anti-inflammatories and pain relief medication as required.
- Exercise program to retrain stabilising muscles – occasionally water based exercises are used first to load muscles without causing joint pain.
- If pregnancy related, symptoms often settle post birth, especially if receiving Physiotherapy management.
- If related to other factors, symptoms should fully settle with a course of treatment, avoiding aggravating activities and being compliant with rehabilitation exercises.
Stop putting up with pelvic pain – book in with one of our Physiotherapists to get your body and your life back in balance today!
