The right exercise for symphysis pubis dysfunction (A.K.A. Pelvic Girdle Pain) addresses pain in the joints of your pelvis. Appropriate exercise and alignment shifts can help to stabilise the pelvis. This will relieve pressure and strengthen and release the muscles.
The affected joints are the symphysis pubis joint (SPJ) at the front and/or the sacroiliac joints (SIJ) at the back.
Depending upon the level of pain and range of movement, bodyweight exercises such as a supported squat (adapting the depth of the squat or how far you open your legs) will also improve strength and stability.
No.1 exercise for symphysis pubis dysfunction: find and activate your core muscles
The most important stablilization for your hips and pelvis, comes from your core. That means your deep abdominal muscles, your pelvic floor, lower back, and your glutes.
A key foundation of the MUTU program is the MUTU Breath, a mindful exercise for symphysis pubis dysfunction to connect with and gently engage your full core. Here’s a super-quick animation version to try! You can lie down, sit, kneel or use any comfortable position.
More core and kegel technique tips
Kegels or pelvic floor exercises are often described as the action of stopping yourself from urinating. But are actually more effective if you imagine you’re trying not to pass wind! As you exhale, gently pull up your sphincter muscles like you’re stopping a fart. Don’t squeeze your glutes, this is your butt *hole* not your butt. (Nope. No such thing as TMI here LOL)
Then move your focus to your vagina and imagine you are drawing a tampon high up inside you. It’s more a lift than a squeeze. Inhale and relax (don’t push away, just let it go). Then exhale and lift again. Repeat 5 times. Quality is much more important than quantity.
No.2 Supermum exercise for symphysis pubis dysfunction
Start from all fours, with your hands directly underneath your shoulders and your elbows slightly bent.
Gently engage your core as above on an exhale, as you raise your left hand. Just off the floor is fine. This is enough to make your core work.
Inhale, relax, release and lower your hand to the floor.
Repeat, lifting your right hand from the floor. Move with your breath, moving and engaging on the exhale. Back to the floor, release and relax on the inhale.
When you feel more stable, you could try stretching the raised arm right out in front.
Try not to let your pelvis load (shift) into the hip that is in contact with the ground. Your core muscles should be doing the work.
If you feel super stable, lift the opposite knee as well as your hand! The goal here is *not* to lift hand or knee high. You might not add in lower limbs at all. If you wobble or feel unstable, bring it down. The goal is stability with a low load on the core..
Try this: Squatting
Exercises for symphysis pubis dysfunction can include squatting but you will need to modify. Strengthening the muscles of the lower body will also help to stabilise the pelvis, so do squat, but with support.
Keep your shins vertical and your knees behind your toes and only go as low as is comfortable and without tucking under.
Keep your butt and tailbone untucked and sit right back into the squat. Hold onto something for support. Place a chair behind you for reassurance so you know something is there to catch you. To come back up, exhale, engage core and push up through the outside of your feet and your heels.
You want to feel the muscles in your backside and thighs working, rather than the fronts of your thighs. Shift your weight into your heels to shift ‘the work’ to the backs of your legs. Repeat 5 times.
Hold a strong and fixed stair bannister or heavy furniture in front of you, or just rest your hand on one side on the back of a chair or table.
Don’t forget to stretch
Stretching and releasing are vital to release tight muscles which will be extra tense as your body anticipates and compensates for discomfort.
Your calves, hamstrings and adductors (inner thighs) will need particular attention but work within your limits. If a stretch hurts if your muscles start to shake or your body twists and turns to enable the position… it’s not working.
Reduce the range, and stretch only where you can feel release and are able to breathe steadily and easily.
Keep as active as you can, as doing nothing at all will make the pain worse. Walk as much as you can, using smaller strides if large steps are painful. Wear minimal shoes without a heel and walk with good alignment.
Don’t hunch your shoulders or bend forward from the hips. Drop your shoulder blades down and draw them together, breathe deeply and look straight ahead.
Seek professional help for symphysis pubis dysfunction
If your pain is severe and debilitating be sure to consult with a specialist physical therapist, chiropractor or osteopath to realign your pelvis. Your muscles will be inhibited by allowing these exercises to work for you properly if they are overcompensating for misalignment or pain.
A specialist PT can assess the position and the symmetry of movement of your pelvic joints, especially the sacro-iliac joints at the back of the pelvis. Treatment may involve a combination of joint realignment or mobilisation and soft tissue or muscle treatment.
When the body is experiencing pain, muscles tighten and compensate, causing asymmetry and misalignment of joints. It is important that you receive treatment from a physical therapist, chiropractor or osteopath to correct this. Also try to carry out gentle exercises such as these, preferably daily.
Complimentary therapies such as acupuncture or cranial sacral therapy may also provide relief.