Symphysis Pubis Dysfunction

What is it?

Do you experience sharp, shooting, shearing pain in front of your pelvis and in between your thighs when walking up/down the stairs, moving legs apart such as turning around in bed or getting out of a car, or standing on one leg? This is known as Symphysis Pubis Dysfunction or SPD.

What causes it?

More commonly experienced during pregnancy due to increased levels of a hormone called relaxin. Relaxin is a hormone that relaxes your muscles and ligaments to become “loosey goosey’ to accommodate a growing baby and for preparation for birth. This increase in flexibility can lead to instability in the joints and can cause pain in the pelvic joint known as pubis symphysis dysfunction.

Additionally, because of this increased mobility, your muscles that attach to the pelvis may tug and pull in different directions causing more pain at the pubic symphysis. In the clinic, we typically find an imbalance of the adductors (inner thighs), piriformis (deep buttocks), and or hip flexors. Often treating these muscles (with dry needling and other manual therapy techniques) and improving the stability of your core and glutes can immensely improve your symptoms and even eliminate them while you are pregnant.

When does SPD start during pregnancy?

Symphysis Pubis Dysfunction can occur anytime during pregnancy, your body may produce the hormone relaxin as early as 10 weeks into your pregnancy. It is most common during the 2nd and 3rd trimesters. (Harris N. 2020).

“In fact, up to 60% of pregnant people experience pain in their symphysis pubis, says Sheila Hill, M.D., an OB-GYN in the hospitalist division of Texas Children’s Pavilion for Women” (Harris N. 2020).

“Up to 25% of all pregnant will experience SPD though not all will get diagnosed.” (Amy O, 2023).

Although the pain and discomfort may decrease your quality of life, it is not dangerous to you or your baby. In fact, it is very treatable in pelvic floor physical therapy! And we can help 🙂

Tips and Tricks to relieve pain and discomfort!

Minimize standing on one leg. Sit while you shave, get dressed, put on/off shoes.

Wear a Sacroiliac belt to increase stability and support during activities.

Place a pillow between your knees while you sleep.

Being mindful to keep knees close together when getting out of a car. Stay symmetrical!

Taking shorter steps. And taking one step at a time on the stairs, facing sideways.

Posture checks – keep your core (transverse abdominal muscles) activated, soft bend in knees, avoid standing with knees locked out, spine neutral by engaging glutes, think about tucking in your tail so you achieve a slight posterior pelvic tilt.

Strengthen inner thigh, glutes, and core muscles to increase stability and support.

And most importantly, see your favorite pelvic floor physical therapist at Reborn Pelvic Health & Wellness.

We will make sure to give you an individualized plan of care that is designed specifically for you and your body.

Exercises that can help with SPD.

Remember it is crucial to perform these without pain! If you experience pain doing any exercises or activity, please reach out to a pelvic floor physical therapist to make sure these exercises are a right fit for you.

Transverse abdomen activation

Bird dog

Glute bridge

Hip thrusts


How To Treat SPD During And After Pregnancy

Work with a pelvic floor physical therapist to learn how to strengthen stable muscles to reduce pain and increase strength. At Reborn, we have seen great success with dry needle + mobility (breathing and range of motion) + strengthening muscles (pelvic floor, glutes, inner thighs, core) to resolve SPD pain.

Many of our patients are able to successfully obtain pain free activity, stay active during pregnancy, and have amazing postpartum recoveries.

If you are experiencing any of these symptoms feel free to reach out to us, at Reborn Pelvic Health & Wellness, to get all your questions answered and to get an individualized treatment plan.

Amy O’Connor, C. E. (2023, June 27). Symphysis pubis dysfunction (SPD) during pregnancy. What to Expect.,not%20all%20have%20it%20diagnosed).

Harris, N. (2022) SPD in pregnancy: What is symphysis pubis dysfunction?, Parents. Available at:

Blog By: Dr. Hyerim Kim, PT, DPT