Loosening of the symphysis during pregnancy

Our pelvis not only protects some of our internal organs and enables us to walk upright, it is of great importance, especially during pregnancy and childbirth. It consists of a ring of bones and the pelvic floor muscles. The pelvic ring also has three joints: the two sacroiliac joints and the symphysis, also known as the pubic symphysis. 

The symphysis connects the left and right pubic bone via a cartilaginous connection.

It usually allows little mobility for the pelvic ring. During pregnancy, however, the female body produces more of the hormone relaxin to prepare for the upcoming birth. This in turn makes the tissue softer and the ligaments more elastic - especially in the area of ​​the symphysis but also in the sacroiliac joints between the ilium and sacrum. This is normal, but it can cause pain if the pubic symphysis dilatation becomes too intense. Then one speaks of symphysis loosening.

Hormonal reasons are cited as the cause of a loosening of the symphysis. In principle, the loosening can also be related to a possible overload of the expectant mother. This overload does not necessarily have to be of a physical nature.

A loosening of the symphysis can also be promoted by undetected structural injuries from previous pregnancies or insufficient regression, which leads to greater overall instability in the pelvic girdle.

Symptoms that may be related to a loosening of the symphysis

• The pubic bone area hurts, sometimes accompanied by pain that radiates from the back into the lateral thighs or inner thighs.
• Normal walking causes difficulties. The typical waddling gait of pregnant women is usually attributed to a loosening of the symphysis. The feet are automatically rotated outwards when running to make walking more bearable.
• Standing on one leg is painful and often hardly possible.
• The lumbar region is painful (because the sacroiliac joint also becomes unstable).
• Lying on your side is very uncomfortable without a pillow between your knees. Some women report that turning over while lying down is associated with pain.
• Getting up (out of bed, out of a chair, out of the car, etc.) can be challenging.

A loosening of the symphysis during pregnancy is perceived as painful to varying degrees. For some women, the pain occurs only selectively, while others report major problems and limited mobility over a longer period of time. As always, every woman and every pregnancy is different. In the event of symptoms, a doctor or midwife should always be consulted in order to relieve pain as early as possible and to take individual measures to relieve it.

Sleep - during the day

What to do to relieve the symptoms?

Irrespective of the reasons for the symptoms, the relaxation of the symphysis is always a signal from the body. A reminder, so to speak, to adjust the daily workload as much as possible and to build in more rest periods overall. Please note that the following information and tips are not medical advice and no promise of healing can be given!

1. Avoid certain movements with symphysis complaints in everyday life and during sports/yoga:

When the pain is severe, some women try to avoid it by moving as little as possible. But this is not always advisable, especially since the pain occurs even when lying down or sitting. Rather, it is crucial to specifically avoid or modify those movements that cause pain.

• lateral movements of the legs and shearing movements
• one-sided movements of the legs (e.g. lunge)
• too much stair climbing (high steps and big steps). Walk the stairs slowly and deliberately.
• Cross-legged and stretching of the adductors, e.g. butterfly in yoga
• Refrain from lifting too heavy (especially small siblings)
• turn longer walks into shorter ones

2. Supportive Abdominal Belt/Maternity Belt

A pregnancy belt fits tightly below the abdomen and ensures that the ilium is compressed and the entire abdomen is supported. This provides more support and relieves the pelvis, so that the pain is alleviated. Until the belt arrives, you can help yourself with a sling or cotton scarf. At home or when sitting, the belt is often felt to be uncomfortable. Lighter, less firm maternity support corsets are a good alternative here.

3. Tape

Kinesiotape is not only the secret recipe of competitive athletes. Kinesio taping can also alleviate many discomforts during pregnancy. The elastic cotton tapes work specifically on the affected muscle groups, relieving and supporting them. They also stimulate blood circulation and metabolic activity in the body. The positive effect on the muscles comes from the fact that the skin is gently lifted and massaged by the elastic tape with every movement. This stimulates lymph and blood flow, muscles are supplied with more blood and thereby relax. If you also work with tension during the application technique, the tape also has a stabilizing effect on the body. Kinesiotape is therefore also applied under and on the stomach in pregnant women. It supports the lateral and rectus abdominis muscles to support the baby's weight.

4. Homeopathy

Globules SYMPHYTUM C6.

The recommended potency should definitely be checked with the doctor, pharmacist, naturopath or midwife

trust are discussed. (Frequent recommendation: take three globules three to six times a day at the beginning)

5. Physiotherapeutic measures, osteopathy and acupuncture can also provide relief.

6. Everyday tips for symphysis complaints/relaxation

• Always take breaks and check which to-dos are really important!
• Put your pants on while sitting, then put weight on both legs and stand up.
• Sleep with a nursing or side sleeper pillow between your legs to help keep your legs/hips parallel. possibly additionally support the abdomen.
• Different sitting and lying positions:
  It is also recommended to find variety in the sitting and lying positions. From the sofa to the chair to a sitting ball and sometimes to the floor. Changing positions brings relief and ensures that the muscles and the musculoskeletal system are not challenged too one-sidedly.
• If you have to sit for a long time, a slightly inflated Pilates ball makes it easier to straighten your lower back.
• A plastic bag on the car seat makes it possible to turn with both legs at the same time to get out.
• The four-footed position in particular is felt to be very relieving, as the baby's weight is taken from the pelvis.
• Of course, a healthy and balanced diet always contributes to general well-being. Calcium-rich foods help strengthen bones and joints. Vitamin D intake is also repeatedly mentioned in this context.

7. Exercise and sport in moderation

This aspect seems to be the biggest challenge in the face of pain: less is more and it is important to watch how the body reacts.

A gentle, balanced yoga practice is highly recommended and helps to alleviate the symptoms in the long term. This should also include some daily strengthening exercises (e.g. with a large ball) to stabilize the pelvic girdle. Activating the deep abdominal muscles and the pelvic floor helps to stabilize the pelvis and thus indirectly the symphysis.

Pelvic and symphysis stabilization exercises

In all exercises, ensure even breathing and clear alignment! If you are new to yoga, be sure to have a teacher or midwife show you the exercises.

Symphysis loosening and childbirth

"It is important to emphasize that a loosening of the symphysis does NOT have to be a reason for a caesarean section. Exceptions confirm the rule here too and of course this should be clarified in individual cases in consultation with the doctor," explains Jessica Strickmann (@erdmutterberlin), midwife at St. Joseph Hospital in Berlin.

In her experience, many women report that the symptoms and pain caused by the loosening of the symphysis are less noticeable during childbirth or even disappear completely. On the one hand, because body and mind focus differently, on the other hand, because the baby steps deeper into the pelvis, more tension and stability is restored in the pelvic girdle for a short time.

"But regardless of whether the symphysis is loosened or not, childbirth is movement and women should always be guided by their intuition," says Jessica Strickmann. If the pressure becomes too intense, the experienced midwife advises positions that relieve the strain, such as the deep knee-elbow plank or the quadruped stand. Warmth and movement in the water, as well as lying on your side with a pillow between your legs, can also bring relief.

How long the symptoms last after the birth is very individual, says Strickmann. Rest after birth and subsequent targeted regression are always important, especially with regard to possible subsequent pregnancies.

All the best to you and your baby!

Sincerely,

sabine