Pubic Symphysis Dysfunction

Understanding Pubic Symphysis Dysfunction

Also known as: SPD, Symphysis Pubis Dysfunction, Pelvic Girdle Pain, PGP The pubic symphysis — the cartilage joint at the front of the pelvis where the two pubic bones meet — allows only a few millimeters of movement under normal conditions. Pregnancy hormones soften the supporting ligaments, and when the SI joints or pubic symphysis load unevenly due to pelvic asymmetry, muscle imbalance, or prior injury, painful shearing develops. SPD affects roughly one in four pregnant patients and is a common cause of the pelvic girdle pain that makes ordinary activities — walking, turning over in bed, getting dressed — genuinely difficult. Sharp, grinding, or burning pain directly over the pubic bone, often with an audible click when walking or turning in bed, and severe pain when parting the legs — getting out of a car, putting on pants, climbing into bed — is the hallmark.

Standing on one leg can feel nearly impossible. Very gentle SI and pubic symphysis adjustments, pelvic blocking with padded wedges, targeted adductor and inner thigh soft-tissue work, and a pregnancy support belt worn low across the hips often provide immediate relief. "Unit movement" strategies — keeping the knees together when rolling, getting in and out of cars, or dressing — are practical and effective. When pelvic floor dysfunction is also present, we co-manage with a pelvic floor physical therapist.

We may recommend: gentle pubic symphysis and SI adjustments, pelvic blocking, pregnancy support belt, adductor soft-tissue therapy, unit-movement coaching, pelvic floor PT co-management, prenatal stabilization exercises Seek immediate care if: You cannot bear weight, the pubic gap feels dramatically widened, or you develop fever postpartum — contact your OB or seek emergency evaluation.