Although symphysis pubis dysfunction, or SPD, affects 1-in-4 pregnant women, 7 percent continue to have pain after childbirth. A small amount of pain in the pubic area is relatively common during pregnancy, but severe pain and SPD are not. Symptoms of SPD include pain in the lower back, hips, down the legs, groin and in front of the pelvis caused by inflamed tissues of the pubic joint. Exercises that support the pelvic region and strengthen muscles in that area might reduce SPD pain.
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Kneeling Exercise for SPD
The kneeling exercise for SPD is a posture exercise that promotes proper alignment in the pelvis. You use pillows and a scarf to support your pelvis. To perform this exercise, pile three cushions on the floor and kneel over them with your shins on the floor, knees touching and your feet spread apart so the cushions fit between your calves. Use a scarf or yoga strap to tie your knees together just above the knee, then sit on the cushions. Your hips should be higher than your knees. You can use more pillows if this is not the case. Just sit and let your pelvis rest on the pillows.
Kegel exercises for the pelvic floor muscles assist women suffering from SPD, also known as pelvic girdle pain. The pelvic floor muscles support women's bladders, bowels and uterus. Pregnancy and childbirth weaken these muscles. After giving birth, Kegel exercises help the pelvic floor muscles regain their strength. To perform Kegels, tighten the muscles around your anus and vagina as if to stop the flow of urine or passing gas. If you have difficulty contracting your pelvic floor muscles, place a finger in your vagina and squeeze it. Your pelvic floor muscles move upward if you do this correctly. You can test yourself by actually stopping the flow of urine, but do not do this often, as you can weaken your pelvic floor muscles this way.
Exercises to strengthen the deep abdominal muscles that support the pelvis also help you regain core strength, such as Kegels after giving birth. The transverse abdominus, or TVA, muscle is the closest muscle in the abdomen to the spine and wraps around the waistline like a corset. To activate and strengthen the TVA, do a deep breathing exercise. Sit in a chair and put your hands on your abdomen just below the belly button. Inhale into your lungs and abdomen, which makes your belly expand. Then expel the air by squeezing the abdomen just below your hands. This exercise is possible while pregnant, but it's much harder to feel your muscles and breathing with a pregnant belly.
The pelvic tilt is another core exercise that reduces SPD by increasing core strength. This exercise involves kneeling on the floor on all fours, which is not particularly comfortable when pregnant, but is easy after giving birth. Start the pelvic tilt on your hands and knees with your back parallel to the floor. Take a deep breath, then as you exhale using your TVA, tuck your tailbone to flatten your back and tilt your pelvis forward.
REFERENCES & RESOURCES
- Tunbridge Wells Osteopaths: Symphysis Pubis Dysfunction, or Pelvic Girdle Pain
- "Active Birth Journal”; "Pubic Pain: Symphysis Pubis Dsyfunction (SPD)"; Janet Balaskas; 2004
- "Pregnancy Day by Day"; Hope Ricciotti and Carol Cooper; 2009
- MUTU; "Exercise for Symphysis Pubis Dysfunction (SPD) or Pelvic Girdle Pain (PGP) in Pregnancy"; Wendy Powell
- Mayo Clinic: Kegel exercises -- A How-to Guide for Women
- "Pregnancy Day By Day"; Hope Ricciotti et al; 2009
- Pelvic Instability Network Scotland: FAQ