Understanding pubic bone pain during pregnancy.
In my practice, Empower Her Physical Therapy, I see many pregnant mamas who are experiencing pubic bone pain during pregnancy. This is very common, but also very treatable! Pubic bone pain is most often referred to as pain that occurs in the front of the pelvis, located on the bone that is approximately 6 inches below the belly bottom. If you take your hands and place them on that bone, you may find it to be very tender to touch. This is called the pubic symphysis joint. This joint is where the 2 pelvic bones meet and are connected in the front through a cartilage-like tissue. It is responsible for force transfers from the upper body to the lower body such as when we take a step during gait. This joint is typically very stable and strong but can be affected by numerous things during pregnancy. Pubic bone pain may also coincide with pain in the back of the pelvis in a joint called the SI joint or sacroiliac joint.
Cause of pubic bone pain during pregnancy.
Hormones. Relaxin is a hormone that our body releases during early pregnancy. It steadily rises in the first trimester, reaches its peak level at about 12 weeks, and remains high throughout the pregnancy. This hormone can cause the sensation of looser joints, muscles, and ligaments during pregnancy.
Weak pelvic muscles. Weaknesses in the muscles that surround the pubic bone such as the inner thigh or adductor muscles, glute muscles, pelvic floor, and core muscles can contribute to poor stability of the pelvic bones. These muscles need to be balanced in strength and flexibility from side to side to support the pubic bone during pregnancy. This can help negate the effects of the relaxin hormone and keep the pelvis strong.
Sleeping and sitting positions. Prolonged sleeping, sitting, or standing positions in poor postures or postures that allow for more stress or compression on one side. For example, sitting at a computer with one leg up for a long period without switching or sleeping only on one side with poor awareness of leg positioning. Or, performing repetitive activities that require balance on one leg or excessive rotation on one leg. Just to name a few examples.
Walking patterns. When we walk, our bodies need to be able to alternate from one side to the other side in an equal fashion. This can become altered in pregnancy as our pelvis widens. The pregnancy waddle - IYKYK! While we can’t necessarily stop our pelvis from widening, we can work on exercises that help to shift in and out of the pelvis so we don’t get too stuck in one position. You can find an example HERE and HERE.Â
Baby’s positioning. Sometimes baby’s position in the womb is low and forward in the pelvis causing them to rest directly on the pubic bone. We can often perform certain exercises to create more space for our babies, allowing them to rotate and position better in the uterus.Â
Symptoms of pubic bone pain during pregnancy.
A dull ache that is constant in the front of the pelvis
Sharp pain that occurs with rolling in bed, getting in and out of the car, or standing on one leg
Pain when pivoting on one foot
Pain that is worse with activity but improves with rest
Managing pubic bone pain.
When it comes to managing pubic bone pain during pregnancy, quick action is best! The longer we allow something to manifest, the harder it is to treat. Also, the less advanced you are in pregnancy, the greater the likelihood of resolving your symptoms quickly. Now, this doesn’t mean we can’t help manage your symptoms if you are later in your pregnancy, it just means we may have a more challenging time, so take action now! Some things we will address in your evaluation visit with us will be:
How you are walking, sitting, standing, and sleeping.
How well your deep core and pelvic floor muscles are working to support your pelvis.
How strong your glutes and hip muscles are.
How much mobility you have or may not have in your hips.
If a pelvic support band is appropriate for you and if you are wearing it correctly.
If you would benefit from modalities such as cupping, dry needling, or massage therapy.
Prevention Tips
The biggest prevention tip for avoiding pubic bone pain during pregnancy is getting an assessment of your core and pelvic floor so that you can start to work on your pelvic strength during early pregnancy. Guidance on proper postures and body mechanics may also help prevent pain.Â
ConclusionÂ
If you are reading this blog post and experiencing pubic bone pain, we’d love to chat with you to see if you would be a good candidate for treatment! There is so much that can be done to help you be comfortable and enjoy your pregnancy and we would love to help you along. You can call us a call at 941-312-1861 to book or learn more about our services HERE.
I hope to see you soon!
In health,
Dr. Emily
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