Pelvic pain can make even the simplest movements—walking, rolling in bed, or climbing stairs—feel overwhelming. One common but often misunderstood cause of pelvic pain is Symphysis Pubis Dysfunction (SPD). This condition primarily affects pregnant women but can also occur in athletes and individuals with pelvic injuries.
At TruStrength Performance and Rehab, we see patients in Denver and Centennial struggling with SPD and help them find long-term relief through physical therapy and movement retraining. If you’ve been told you have SPD, here’s what you need to know.
Understanding the Pubic Symphysis
The pubic symphysis is a joint located at the front of your pelvis, where the left and right pubic bones meet. Normally, this joint has very little motion. Strong ligaments hold it in place, and the surrounding muscles provide stability for daily activities like walking and standing.
In SPD, the ligaments become overly stretched or unstable, and the joint moves more than it should. This extra movement creates pain, inflammation, and dysfunction.
Causes of Symphysis Pubis Dysfunction
SPD can develop for several reasons:
- Pregnancy: Hormonal changes, especially the release of relaxin, loosen pelvic ligaments to prepare for childbirth. While this is normal, sometimes the joint becomes too unstable.
- Injury or Trauma: A fall, car accident, or direct pelvic injury can destabilize the pubic symphysis.
- Athletic Overuse: Sports or exercises involving repetitive hip movements or uneven loading may stress the joint.
- Postural Imbalances: Weakness or tightness in the core and hip muscles can alter pelvic alignment and place extra strain on the pubic symphysis.
While pregnancy is the most common cause, anyone can experience SPD.
Common Symptoms of SPD
The symptoms of SPD vary, but most people experience one or more of the following:
- Pain in the front of the pelvis, just above the pubic bone
- Aching or sharp pain that worsens with movement
- Clicking or grinding sensations in the pelvic area
- Pain that radiates into the hips, thighs, or lower back
- Difficulty walking, climbing stairs, or rolling over in bed
- Waddling or shuffling gait due to instability
Pregnant patients often describe SPD as feeling like “something is pulling apart” in the pelvis.
How SPD Is Diagnosed
A physical therapist or physician can diagnose SPD through a combination of:
- Patient history: Noting pain patterns, pregnancy status, or injury history.
- Physical exam: Palpating the joint and testing mobility.
- Movement assessment: Identifying difficulty with walking, standing on one leg, or stair climbing.
- Imaging: Rarely needed, but X-rays or MRIs may rule out fractures or other pelvic conditions.
Why Physical Therapy Is Essential for SPD
Although SPD can feel discouraging, the condition is highly treatable. Physical therapy addresses both the pain and the underlying instability.
At TruStrength, our approach to SPD includes:
1. Pain Relief Techniques
- Manual therapy to release tight muscles
- Gentle mobilizations for alignment
- Support belts or taping for stability
2. Strengthening the Core and Hips
- Focus on the deep core muscles (transverse abdominis)
- Activation of the glutes and hip stabilizers
- Progressive exercises tailored to your stage of pregnancy or activity level
3. Movement Training
- Education on safe ways to roll in bed, stand, and climb stairs
- Strategies to reduce strain during daily activities
- Adjustments for athletes to train safely while healing
4. Holistic Support
- Collaboration with OB/GYNs, midwives, or other providers when needed
- Guidance on posture, sleep, and activity modifications
Learn more about how physical therapy in Denver can help you manage pelvic pain.
Safe Exercises for SPD
While every program is individualized, here are some common exercises that help patients with SPD:
- Pelvic Tilts – Gentle activation of the lower abs to stabilize the pelvis.
- Glute Bridges – Strengthens the glutes without overloading the pelvis.
- Side-Lying Leg Lifts – Targets the hip stabilizers.
- Clamshells – Builds glute strength and improves pelvic control.
- Postural Training – Focuses on sitting, standing, and walking alignment.
These exercises should be done under professional guidance to avoid overstressing the joint.
Living With SPD During Pregnancy
SPD is one of the more challenging pregnancy-related conditions, but there are strategies to reduce pain and improve function:
- Use pillows between your knees when sleeping on your side.
- Take smaller steps when walking to reduce pelvic strain.
- Avoid high-impact exercise like running or jumping.
- Use a pelvic support belt when needed.
- Ask for help with tasks that require lifting or bending.
Many women find that SPD improves after delivery, but physical therapy during pregnancy can make a significant difference in comfort and mobility.
SPD in Non-Pregnant Patients
Although SPD is most often discussed in the context of pregnancy, athletes and active adults may also experience it. Runners, soccer players, and dancers are especially vulnerable due to repetitive hip movements.
In these cases, treatment focuses on strengthening the pelvic stabilizers, correcting movement patterns, and gradually reintroducing sport-specific training.
Frequently Asked Questions About SPD
1. Does SPD go away after pregnancy?
For many women, symptoms improve within weeks or months after delivery. However, some may need physical therapy to fully restore stability.
2. Can SPD cause long-term damage?
If left untreated, SPD can contribute to chronic pelvic pain, muscle imbalances, and difficulty returning to activity.
3. Is it safe to exercise with SPD?
Yes, with modifications. Low-impact, stability-focused exercises are best. A physical therapist can guide you.
4. Do pelvic belts really help?
Yes, support belts reduce strain on the pubic symphysis and make walking or standing more comfortable.
5. Can men get SPD?
Yes, although it is less common. Trauma, sports injuries, or joint instability can lead to SPD in men.
Final Thoughts
Symphysis Pubis Dysfunction is a painful but treatable condition that affects many pregnant women, athletes, and active adults. With the right combination of physical therapy, exercise, and lifestyle modifications, most patients can regain stability and return to their normal activities.
If you’re experiencing pelvic pain in Denver or Centennial, TruStrength Performance and Rehab can help. Our team specializes in treating SPD and other musculoskeletal conditions with a personalized, whole-body approach.
Schedule your appointment today and take the first step toward moving with confidence and comfort.