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Many of you know it all too well — that sharp, shooting pain in your groin when you take a step, roll over in bed, or attempt to do a typical daily movement. You could be experiencing symphysis pubis dysfunction, commonly known as SPD. The bad news: it’s a pain, literally. But the good news: you’re not alone, and you’re not stuck with SPD pain. Today, I’m here to help. 

What is SPD? 

Symphysis pubis dysfunction can happen to anyone, but it’s most commonly reported during pregnancy. In fact, nearly 1 in 3 pregnant women report SPD symptoms at some point during their pregnancies! SPD can show up differently for different people. Some classify it as sudden and sharp pelvic girdle pain, while others experience a more widespread, steady pain. Some people can even feel SPD in their upper thighs or perineum. Take it from my clients – none of these choices are fun!

Symphysis pubis dysfunction can flare up during a variety of normal everyday activities, including: 

• Walking

• Widening your legs as you get dressed

• Going up or down stairs

• Putting most or all of your weight on one leg

• Rolling over in bed

Why does SPD occur? 

As mentioned, pregnancy is the most common reason for SPD. However, anyone can experience symptoms, not just pregnant women. For women who do experience SPD because of pregnancy, know that symptoms don’t always resolve on their own postpartum. 

SPD occurs when your pelvic joint — aka the symphysis pubis — is unstable. This happens for two primary reasons. 

Hormonal changes

Typically, your pelvic ligaments are relatively tight. This keeps your pelvis in alignment. However, during pregnancy, hormonal shifts cause those ligaments to relax and stretch. This is a good thing! Creating extra space in your pelvis is necessary for vaginal delivery. However, sometimes those hormones do their job a little “too well” – or at least a little too early. When those ligaments can stop holding your symphysis pubis in place as usual, you’ll experience SPD symptoms. 

Muscular imbalance

Whether you’re pregnant or not, muscular imbalance can cause an imbalance in your symphysis pubis, which leads to SPD symptoms. Typically, I have found that lack of muscular strength or lack of mobility and proper pelvic floor tension are the two most common culprits of SPD symptoms. Thankfully, both of these can be treated effectively! 

How to treat SPD

Treating SPD with physical therapy 

If you’re experiencing SPD symptoms, finding a local pelvic floor physical therapist should be your first step. Pelvic floor PT is the gold standard for diagnosing and treating SPD. In your appointments, they’ll help you release any muscular tension imbalances. Your pelvic floor can be the underlying reason for SPD symptoms — if  one side of your pelvic floor is tight, it can cause asymmetry in the pelvis. Allowing your pelvic floor to relax and align can alleviate pain. 

In many cases, your pelvic floor physical therapy will also include strengthening your anterior oblique sling. This muscle group runs diagonally across the front of your body. When it’s strong and healthy, it helps you move rotationally through your core and stabilizes your pubic symphysis. Strengthening these muscles can greatly reduce SPD pain over time. 

Managing SPD symptoms at home

In addition to physical therapy, there are simple movements you can add into your daily activity at home to support your body during pregnancy (or any SPD pain flare). If you’re actively in pain from SPD symptoms, here are some daily movement modifications that can help: 

• Get in and out of your car slowly. As you do, keep your legs together as much as possible, rotating your entire body instead of stepping one foot out at a time. When you swing one leg out wide, this can cause stretching at the pubic symphysis joint, which is painful when SPD is occurring. 

• Sit down when you put on socks or shoes. Putting your full weight on one leg can irritate SPD symptoms, because it’s asking one side of the body to withstand potential loose ligaments, muscular weakness, or both. 

• If you sleep on your side, put a pillow or two in between your knees. This keeps your pelvis aligned symmetrically, which causes much less strain. 

• If you roll over in bed, go slowly. Brace your core, breathe, and even squeeze the pillow between your legs as you turn. 

• Invest in extra support tools to help your pubis symphysis joint. When I was pregnant, I loved this belly support band from Baobei for reducing pelvic girdle pain. This belly band is also a great option for lift and support. And these bloomers are perfect for pregnancy and postpartum alike! They provide fantastic pelvic floor and core support during and after pregnancy. 

Reduce pain and build strength during pregnancy

Finding safe and effective ways to train during pregnancy can be difficult. But I believe that you can stay active and build strength throughout each trimester, preparing your pelvic floor for birth while you reduce common pregnancy aches and pains. I created Movement Through Pregnancy to show you how! 

In this program, you’ll get access to 37 weeks of workouts from week 5 through 41, filmed during my own pregnancy so you follow along week by week! Every week includes a workout specifically designed to target your pelvic floor and core workouts, which can mitigate SI pain and SPD symptoms (or even stop them before they start). You’ll also get access to educational modules that address common diagnoses and bodily changes and an incredible community support system – and so much more. 
I genuinely want every woman to feel strong and empowered in her body during each trimester. SPD pain doesn’t have to ruin your pregnancy days. Try Movement Through Pregnancy and optimize your prenatal strength!