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Symphysis, also known as pelvic girdle pain, is a common issue among women during pregnancy, although it's not often talked about. In fact, very few women are aware that they can take action to address the loosening of the ligaments that hold their pelvic bones in place. We often only find out about symphysis when we are confronted with the pain of a growing belly during pregnancy. It's that uncomfortable pulling sensation that happens in the pubic area which can sometimes be so painful that normal walking, putting on shoes, or climbing stairs becomes a challenge.
Where and what is Symphysis exactly?
Our pelvis has multiple important functions. It not only protects internal organs and allows us to walk upright, but it also plays a crucial role during pregnancy and childbirth. The pelvis consists of a ring of bones and the pelvic floor muscles. Within this pelvic ring, there are three joints: the two sacroiliac joints and the symphysis, also known as the pubic symphysis.
The symphysis serves as the connection between the left and right pubic bones through connective cartilage. Normally, the pelvic ring doesn't offer much flexibility. However, during pregnancy, the female body produces a hormone called relaxin, which softens the tissues and makes the ligaments more elastic. This effect is particularly noticeable in the symphysis area and the sacroiliac joints between the ilium and sacrum. It's a normal process, but if the widening of the pubic symphysis becomes too pronounced, it can lead to pain. This condition is referred to as symphysis loosening.
Hormonal changes are often attributed as the cause of symphysis loosening. Additionally, excessive strain on the expectant mother's body can also contribute to this condition, which doesn't necessarily have to be physical in 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
Pain in the pubic bone area, sometimes accompanied by pain that radiates from the back and into the outer or inner thighs.
Walking can become challenging, and the characteristic waddling gait of pregnant women is often attributed to symphysis loosening. The feet may naturally turn outward during walking or running to make it more bearable.
Standing on one leg can be painful and difficult.
Lying on the side without a pillow between the knees can be uncomfortable, and some women experience pain when changing positions while lying down.
Getting up from a bed, chair, or car may also be challenging.
The severity of pain varies for each woman experiencing symphysis loosening during pregnancy. Some women may only have selective pain, while others may face major problems and limited mobility for an extended period of time. It's important to remember that every woman and every pregnancy is different. If you experience any symptoms, it's crucial to consult with a doctor or midwife. They can provide early pain relief and recommend individual measures to alleviate discomfort.
How to relieve symptoms
Regardless of the causes for the symptoms, the relaxation of the symphysis is always a signal from the body. This is a reminder to adjust your daily workload as much as possible and to fit more rest into your daily schedule. Please keep in mind that the following information and tips are not medical advice and we cannot make any promises regarding healing.
1. Avoid certain movements while experiencing symphysis pain in everyday life and during sports/yoga:
When the pain is severe, some women try to avoid it by moving as little as possible. This is, however, not always advisable, especially since the pain occurs even when lying down or sitting. Preferably, it is crucial to specifically avoid or modify those movements that cause pain.
- lateral movements of the legs and scissoring movements
- one-sided movements of the legs (e.g. lunges)
- excessive stair climbing (steep steps and large steps). Take stairs slowly and deliberately.
- Cross-legged and stretching the adductors, e.g. butterfly in yoga
- Refrain from lifting too much weight (especially small children)
- take shorter walks instead of longer walks
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 relief the pelvis, alleviating related pain. Until the belt arrives, you can mimic the support of a belt by using a sling or a cotton scarf. At home or when sitting, the belt is often felt to be uncomfortable. In this case, a good alternative can be lighter, less firm maternity support corsets.
3. Tape
Kinesiology tape isn't only for competitive athletes. Kinesiology taping can also alleviate many discomforts during pregnancy. The elastic cotton tape works by relieving and supporting the affected muscle groups. The tape also stimulates blood circulation and metabolic activity in the body. The skin is gently lifted and massaged by the tape with every movement, stimulating lymph and blood flow. Muscles, supplied with more blood, can now relax. If you also work with tension during the application technique, the tape also has a stabilizing effect on the body. Kinesiology tape 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
SYMPHYTUM C6 Capsules. The recommended dosage should definitely be discussed with your doctor, pharmacist, alternative practitioner, or midwife. (Common recommendation: take three capsules three to six times a day)
5. Physiotherapy, osteopathy and acupuncture can also provide relief.
6. Everyday tips for symphysis complaints/relaxation
Always take breaks and decide which of your to-dos are actually important!
Put your pants on while sitting, then evenly distribute your weight on both legs while standing up.
Sleep with a nursing or side sleeper pillow between your legs to help keep your legs/hips parallel. The abdomen can additionally be supported when needed.
Different sitting and lying positions:
We also recommend incorporating a variety of sitting and lying positions. From the sofa to the chair to a yoga 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 out 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 worth mentioning repeatedly 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 your body reacts.
A gentle, balanced yoga practice is highly recommended and helps to alleviate long term symptoms. 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, keep your breathing even and try to maintain clear alignment! If you are new to yoga, be sure to have a teacher or midwife show you the exercises first.
