Congratulations! You’re pregnant! It’s nine months of excitement; but also
involves some planning and lot of research.
The last three months can also involve physical restrictions. Symphysis Pubis Dysfunction (SPD) is a real complication
of pregnancy that arises from increasing size and weight.
The pelvis is made up of three bones – the
two iliac bones and the sacrum. The
sacrum is connected to the iliac bones through the sacro-iliac joints (found
along the posterior aspect of the pelvis).
The two iliac bones are connected to each other in the front through the
symphysis pubis. Minimal movement occurs
at these joints. Their function is to
provide a stable platform for the movements of the arms and the legs.
A hormone called relaxin is released in the
pregnant body during the second trimester.
This hormone loosens up the ligaments of the pelvis, allowing the baby
to pass through without any difficulties or complications.
As the ligament of the symphysis pubis
loosens, the body increasingly relies on the muscles of the pelvic floor, hips,
and the overlying fascia, to maintain the alignment of the pelvis. The inability to do so may result in pain and
instability in the pelvis; and is termed symphysis pubis dysfunction (SPD). Although not very common, experts believe
that more than 2% of all pregnant women will experience the symptoms of this
dysfunction. SPD often goes undiagnosed
and unmanaged, possibly because the symptoms are considered “normal” during
Signs and symptoms:
Back and/or hip pain
Pain in the pubic area,
accompanied with a grinding or clicking sensation
Pain and/or tenderness along
the inside of the thighs
Pain that increases during
weight transfer (walking/running/going up or down stairs), when stepping
side-ways, turning in bed
Pain that is worse at night and
possibly stops you from sleeping.
Getting up to go to the toilet in the middle of the night can be
Weakness in the legs; inability
to support oneself in a seated or standing position
These symptoms can be quite distressing in
the prenatal period. Symptoms persisting
into the postnatal period could affect the new mother’s ability to look after a
newborn, as well as her self-confidence.
Early diagnosis is key.
women’s health physiotherapist will be able to provide ergonomic advice
(movements to avoid), supports (trochanteric or SIJ belts) and exercises
critical for the effective management of SPD.
Make an appointment with the Physio department if you experience any of
the symptoms listed above; or if you want exercises to keep your pelvis
supported through your pregnancy.