My Experience with Pubic Symphysis

 

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On Saturday, I entered the 28th week of my pregnancy.  This pregnancy, while a rollercoaster of emotions, has been a wonderful one for both Bo and myself. Overall, we were blessed to conceive easily and then I was able to make it through the dreaded first trimester with just some exhaustion and nausea.  In comparsion to the stories I’ve read and heard, this pregnancy has been very easy – until last week.

Unfortunately, last week I began to think that the pain and discomfort I was feeling in my pelvic area was more serious than I once thought. Since I started feeling the pain, about three weeks ago, I assumed that since it wasn’t causing many of the emergency signals, cramping, bleeding, piercing pain or contractions, that it was just “normal pregnancy discomfort” associated with carrying extra weight.  After speaking with my OB-GYN, I adjusted workouts that immediately caused pain – jogging instead of running and avoiding any jumping movements.  But after spending an especially active few days, I woke up last week barely able to walk to the end of the street without stopping to breathe through the discomfort. Luckily, my friend Abigail Bales is a Physical Therapist who specializes in pregnancy and post-partum care.

I sent her a quick text, describing my pain and within minutes she squeezed me into her appointment schedule and let me know that nothing is “normal” during pregnancy. Some feelings may be common, but nothing should be ignored.

While I waited for Friday’s appointment to arrive, I spent much of last week listening to my body and taking note of the things that caused pain.

  • Getting out of bed
  • Anything on one leg (i.e taking off pants, trying to take off shoes quickly, barre moves on one leg, etc)
  • Getting out of cabs/cars
  • Running (I dashed for a subway and squealed in pain on Wednesday.)
  • Non pre-natal yoga

As soon as I sat down on the table Friday, I started to make excuses. “Maybe I’m a hypocondriac. Maybe being here is stupid. I’m sorry I’m wasting your time. I’m sure this is normal.”

I have no idea why these words came out of my mouth or why asking for help from an expert felt so dramatic and difficult. Luckily, Abby is far smarter than me and within minutes she calmed me down enough to make me feel at ease, assess my body and diagnose me. It felt wonderful to have someone describe the symptoms I was feeling to me. Everything she said matched the pain in my body that I had such a difficult time articulating.

Since I knew I would have a hard time describing the diagnosis to you guys, Abby did the hard work for me.

Image result for pubic symphysis dysfunction

During pregnancy, the connective tissue of the entire body is swiftness by a hormone called relaxin. And relaxin doesn’t discriminate. It affects your feet, your teeth, and in a major way, your pelvis.

The joint that connect the two sides of the pelvis in the front of the body is called the pubic symphysis. There isn’t supposed to be a log of movement at that joint, but when it’s softened by the relaxin hormone, the joint can move excessively or even separate partially, both of which are extremely painful. The weight of the baby plus the forward tip of the pelvis puts a ton of extra pressure o this joint during pregnancy. Combined with the softening of the connective tissue, it’s the perfect storm of pain during pregnancy.

Running, jumping, and straddle positions can exacerbate the symptoms or increase the possibility of developing pubic symphysis dysfunction during pregnancy as the pelvis becomes more unstable and the ability to contract core and pelvic musculature decreases. The natural tendency toward a forward tilt of the pelvis, turned out position of the hips/femurs “waddle walk”, and additional weight all contribute to the pressure on the pubic symphysis and further the risk of developing pain.

I now realize that the pain I was feeling over the past month was my body trying to tell me to stop running. It is so easy to see in 20/20 hindsight and I wish I’d listened. But, unfortunately, as a first-time pregnant woman, I thought it was just the normal trials and tribulations of pregnancy. There is both good and bad news with this diagnosis. The good news is that there are certain things I can do to control it such as limiting exercises that cause pain, foam roll, focus on strengthening my pelvic floor, and enjoy epsom salt baths. The bad news is that there are certain things which I have less control over such as hormones, natural body mechanics and weight gain.  Each week, Abby and I will work together for an hour to release pain and tightness in my lower back and inner thighs which is exacerbating the problem, strengthen my pelvic floor and work to improve the situation.

Unfortunately, this diagnosis, leaves me in a place of having to say “see you later” to my good friend running for the forseeable future. While some people’s bodies allow them to run through their entire pregnancy, my running days are over. It isn’t goodbye as I know that in time, once my doctors and body tell me that I am ready to run again after giving birth, running will once again be an outlet that allows me to spend time with my thoughts or a best friend, enjoy endorphins after the sweat and leave me feeling strong and empowered.

But, until then, I’ll be finding those endorphins through other workouts. I spent some time working with Abby to put together the best schedule possible that will allow me to still enjoy the sweat and endorphins I crave while also being gentle on my body.  Here is an example of this week’s workout plan

  • Monday – Swimming & PT exercises/foam rolling
  • Tuesday – Orangetheory & PT exercises/foam rolling
  • Wednesday – Prenatal Pilates & PT exercises/foam rolling
  • Thursday – Swimming & PT exercises/foam rolling
  • Friday – Orangetheory & PT exercises/foam rolling
  • Saturday – XtendBarre or Power Walk & PT exercises/foam rolling
  • Sunday – Pre Natal Yoga & PT exercises/foam roll

Please, friends, learn from me. Do not wait to get help or ask questions especially when you have doctors and resources whom you trust.

Your turn: If you have any questions about this, Abby and I will do our best to address them in the comments section!

brooks 3

Photo Credit – Alexis Damen photography

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15 Comments

  1. Heather's looking glass March 28, 2017 / 10:40 am

    I totally had this but was never diagnosed! I started feeling pain in the early 20’s week wise and it got to where even power walking made it so I couldn’t stand up out of a chair later that day! Glad you are listening to your body!

    • ashleyd March 28, 2017 / 1:51 pm

      I’m so sorry you didn’t get diagnosed! Glad you recovered well though!

  2. Christina @ montessoriishmom.com March 28, 2017 / 11:47 am

    I’m glad you got some answers and hope the physical therapy helps! I didn’t have this, but definitely had the same feelings about asking for help / not wanting to seem overdramatic. I got quite the lecture from a doctor about calling / coming in for any reason instead of waiting / assuming everything is “normal”. I feel like there are so many stereotypes of “crazy pregnant ladies” that it made me want to not be like that, but it really is hard to know what’s a big deal when it’s your first time being pregnant!

  3. Jesica @rUnladylike March 28, 2017 / 1:31 pm

    I, too, said see you later to running at 28 weeks. I had some weakness in the area you do but nothing as painful as what you are experiencing. There were some workouts that would really affect me for a day where standing on one leg and getting in and out of bed were really tough. Barre was actually one of them if I did too much single leg work, so you may want to do modifications for single leg work at the barre. I started walking a lot and was able to do that until the end. I was surprised how much walking 4-5 miles took out of me at the end, especially in my pelvic area. Keep listening to your body and don’t push it. You’ll probably continue to feel different and weaker once week 32 hits. Baby girl Diamond is going to be such a strong girl. Hugs and I’ll be thinking about you!!! PS Way to go getting in the pool!

    • ashleyd March 28, 2017 / 1:51 pm

      Thank you so much Jesica! Yes the pool felt SO good that I wouldn’t be surprised if the final month I do far more of that than anything else.

  4. Lindsay March 28, 2017 / 1:46 pm

    I had this too starting at about 26 weeks. Putting pants on nearly made me cry every day. The good news is, after birth it completely disappeared. I was able to start walking/jogging again 4 weeks after birth and back to Crossfit at 6 weeks. You’re in such good shape I’m sure you won’t have any trouble either if you continue to listen to your body during pregnancy. Best of luck to you!

    • ashleyd March 28, 2017 / 1:50 pm

      Thank you so much Lindsay for your kind comments and sharing your experience!

  5. Kristen March 28, 2017 / 2:48 pm

    I had to stop all exercise at 28 weeks, except for walking because I was pregnant with twins and they wanted to make sure they stayed in as long as possible. I thought that after they were born, I would be back to running as soon as my MD cleared me. And, while I did run some on maternity leave, once I went back to work (~50 hour work weeks), exercise pretty much went out the window. I was exhausted, wanted to spend awake time with the boys because they were changing so fast, and just had a lot more to do — laundry, dishes, cleaning, all exploded. Although I was quite active during this time, with lots of walks, I was not running or taking formal exercise classes. Once the boys were in a really good routine, older and not changing quite as fast, I went back to exercising. I am as fit as I have ever been, and don’t regret for one minute the time I took off from exercising when the kids were younger.

    • Colleen March 29, 2017 / 1:32 am

      I love that you said you don’t regret taking this time off – I am in the midst of it all and I think it’s so important for people to know that it’s ok to shift priorities and not be at the fitness level you were at before baby.

  6. sabine March 29, 2017 / 5:21 am

    I’m loving your posts lately. They sound so honest, raw and are informative.

    I didn’t know of all the hardships your going through pregnancy apart from the obvious. Thank you for sharing.

    I also love your energy and the fighter mentality. I have a feeling that you will be a great mom.

  7. Angie March 29, 2017 / 2:17 pm

    I didn’t have your diagnosis but with both my pregnancies I stopped running because I would get awful round ligament pain, even when wearing the support belt. I continued to walk, hike, and do pregnancy geared workout videos. There are great ones on YouTube! I also gave myself grace to have more rest days then normal. I had to have c sections both times and my recovery went well because I was in shape. I honestly didn’t even feel like running or training for races until I was 6 months post partum. The sleep deprivation is real and until my boys were better sleepers I didn’t push the workouts and just walked and hiked. Its good you’re listening to your body. This is a short time of not running in the grand scheme of things.

  8. Paul March 29, 2017 / 4:38 pm

    A friend had this condition and it wasn’t nice. All the best with the rest of your pregnancy Ashley. It’s good that you’re listening to your body and the running can wait!

  9. Jill March 30, 2017 / 9:24 pm

    You are doing so fantastic with this pregnancy! However, also give yourself the grace to have some total rest days as well. You’re body is doing so much work growing a child. Exercise is fantastic for both you and baby – but try and allow yourself some real quiet time where you just lay on couch/binge watch tv/read books etc.. You do you!

  10. Rich April 3, 2017 / 3:05 pm

    Hi Ashley – I just wanted to wish you all the best with the rest of your pregnancy. Rich 🙂

  11. Marcus DelFino April 3, 2017 / 8:22 pm

    This was so incredibly in depth, and thank you for sharing so much. My wife is pregnant, and I know she’ll love reading this. Thanks again!

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