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What is PSD & how can we help?

Symphysis Pubis Dysfunction (SPD) is a condition that affects one third of pregnant women, most commonly in the third trimester of pregnancy (between 28 and 36 weeks of pregnancy). Painful and disabling, this syndrome is nevertheless benign and does not adversely affect the fetus. This syndrome is therefore related to the physiology of pregnancy and is not pathological. Some women are more prone than others, but we do not know why . What are its causes? How to relieve it? Answers from Samantha Slatem, osteopath .

What is SPD?

Symphysis Pubis Dysfunction (SPD) is a condition that affects one third of pregnant women, most commonly in the third trimester of pregnancy. SPD is characterized by discomfort and pain in the front of the pelvis, which can extend into the back, legs, and groin. It is caused by the weight of the baby and the hormonal changes that occur during pregnancy, resulting in increased flexibility and stretching of the pelvic ligaments, thereby lessening pelvic stability. Common symptoms of Symphysis Pubis Dysfunction (SPD) may encompass, but are not restricted to:

  • Sharp, tearing, or shooting pain localized in the pubic symphysis.

  • Radiating pain that can extend into the lower abdomen, back, groin, perineum, thigh, and/or leg.

  • Pain experienced during various movements such as getting in and out of a car, rolling over in bed, and walking going up or down the stairs.

  • Pain is relieved when resting.

How can osteopathy help you to relieve it?

During pregnancy, as the abdomen expands , the abdominal muscles undergo elongation and thinning, reducing their support. This, in turn, places greater demand on the inner thigh muscles, which attach to the pubic bones. Additionally, the hips naturally rotate outward to provide a wider base for balance, accommodating the added anterior weight from the growing fetus. This outward rotation places added stress on the pubic joint, pulling it laterally. This is your body doing what it’s meant to do.

Your osteopath will not be able to stop this hyperproduction of relaxin but we can release muscular spasming, alleviate pressure on your pelvic floor. He will also act to loosen the ligaments of the uterus, relax the tensions of the muscles of the uterus and finally rebalance your pelvis. Let's be honest, there are no miracles but the improvement of the symptoms will allow you to breathe and it makes the difference.

Tips for managing symphysis pubic dysfunction

This is some of the advice I suggest to anyone struggling with symphysis pubic dysfunction;

  • Visit an osteopath specialise in pre/post natal care. Osteopathy can help immensely with taking the load of the pubic joint and preventing worsening of symptoms.

  • Wearing a pelvic belt can be really useful to give the pelvis more compression and therefore stability. The smiley belt or serola belts are the ones I often recommend.

  • Be a princess : Keep your knees together as much as possible, avoiding any abductions movements. Getting in and out of the car is often a difficult task for anyone struggling with SPD so a good tip is to sit on a plastic bag. This gives you a bit more slide and glide, allowing you to swivel on the seat with your knees together.

  • Sleep with a pillow between your knees.

  • Sit up slowly : when going from lying down to sitting up. Especially first thing in the morning when you have been lying down for a long period of time, it can be particularly painful when you try to move. A good tip is to roll onto your side first, bring your legs forward to 45 degrees and push up using your upper body rather than doing a sit up motion.

  • Exercises : Strengthening the pelvic floor, glutes and abdominal muscles. But only symmetrical exercises (no lunges but go for squats)

Frequently asked questions: 

-Will it affect my labour?

 No. Experiencing pelvic pain during pregnancy does not necessarily guarantee that you will endure the same discomfort during labour. The pelvis undergoes significant changes in preparation for labour, it can expand up to 5 cm to facilitate the baby's progression in your pelvis.

  • If I have pubic symphysis pain during pregnancy, will I have it forever?

The majority of women will have spontaneous recovery from pelvic pain within one month postpartum with a  full recovery by 6 months. While it's reassuring to know that symptoms will likely subside entirely by 6 months, osteopathic treatment can be extremely beneficial if pain continues longer than 3-4 weeks!

  • If I had SPD with one child, will I get it again with the next?

Unfortunately there’s no clear answer on this, it's basically a flip of the coin. Research indicates that women who experienced symphysis pubic dysfunction in their first pregnancy, have a 41-77% chance of experiencing it in another pregnancy.  But remember every pregnancy is different. One of the best things you can do is go back to exercises and visit your osteopath before your pregnancy to ensure the pelvis and your pelvic floor are functioning at their best to accommodate the growth of the fetus.

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