The pubis symphysis is the cartilage forming the joint between the right and left pubic bones. It generally doesn't move much, except during pregnancy. However, it can be injured due to falling, tripping or other trauma, according to Caring Medical. The joint can also be injured through excessive exercise such as swimming the breast stroke or running, kicking or sit-ups, all of which can put a slight but continual strain on the joint. Muscles that attach to or near the joint can make it unstable when they are in spasm or out of balance.
Before treating pubic pain, an accurate diagnosis is important, since there are so many different causes for pubis symphysis pain. Besides overuse and trauma, the pain can be due to infection or arthritis, as well as more serious conditions such as a tumor. If the pain is due to overuse, then exercise may be contraindicated until the inflammation dies down. Exercise could make the problem worse. Your physician may use an MRI or other imaging tools such as x-rays to determine the source of the problem.
A study in the March 2007 "American Journal of Roentgenology" suggests that adductor dysfunction is a frequent cause of pubic pain. The study reviewed soccer players with injuries to the symphysis pubis. The recommended treatment in this case includes rest, avoiding activities that aggravate the condition, over-the-counter anti-inflammatory medications and adductor muscle stretches to relieve pressure on the pubic bones and joint. A simple way to stretch the adductor muscles is to squat with your back against a wall for support and your elbows between your knees to push the knees outward.
The pubic joint relaxes during pregnancy due to hormones that soften the ligaments. This, plus pressure on the pubis from the growing baby, can cause pubic pain. "Well Mother," a website for pregnant women, recommends avoiding activities that open the hips. For instance, you should keep your knees together when you roll over in bed at night. Exercises that strengthen back and abdominal muscles, such as the yoga cat stretch, can help to support the pubic joint. To perform the yoga cat stretch, start on all fours, on your hands and knees with your spine and neck aligned. As you inhale, drop your abdomen toward the floor and look at the ceiling. As you exhale, round your back toward the ceiling and move your head downward to look at your navel. Perform the movement slowly, breathing smoothly. Repeat five or six times.
The levator ani muscle attaches to the posterior of the pubic bones and connects them to the coccyx and sacrum. Kegels, exercises that strengthen the levator ani muscle, will provide additional support for the pubic joint and counteract to some extent the strain put on the joint by the adductor muscles. You can learn to tighten the levator ani muscle by stopping and starting urine flow while you are urinating, and practice tightening the anal sphincter as if you are trying to prevent a bowel movement.
- CaringMedical.com: Sports Injuries: Pubic Symphysis Injury
- Well Mother: Symphysis Pubis Dysfunction
- "Sports Medicine"; Groin Injuries in Sport: Treatment Strategies; Lynch SA et al.; August 1999
- "American Journal of Roentgenology"; Patterns of Bone and Soft-Tissue Injury at the Symphysis Pubis in Soccer Players; Cunningham PM et al.; March 2007