Pubic Symphysis Disorder (PSD) Sucks!

Pubic Symphysis Disorder, what the heck is it?  Pubic Symphysis Disorder occurs to some pregnant women when the hormone Relaxin in their systems does its job too well.  Normally this hormone is a hero as it is responsible for softening the ligaments of your pelvis which allows for the birth of your bundle of joy.  Sometimes however, this process of loosening is kicked into overdrive and the pubic bones start to shear against each other.  As you can imagine, this is not a good thing.  It causes pain so intense, it's like thousands of knives stabbing into your groin, over and over.  One wrong move brings tears to your eyes and steals away your breath.  Anyone who has ever experienced this is cringing at the memory.  If you are reading this, because you are going through this right now, I know how you feel.  I've been there.  Keep reading about how I dealt with this condition and maybe you'll find some hope.

I suffered with this pain two out of my three pregnancies.  During my first pregnancy I had been swimming laps (approximately three times a week) before I got pregnant and continued to do so.  For the most part, I did not have any difficulty with my pubic joints, unless I had been squatting down doing gardening or had walked a lot of stairs.  Then, the pulling on my pubic joint would cause such pain I could hardly walk for hours.  When I asked my doctor about it, he said stop doing what was aggravating it.  Well, duh!  He also said it was just something I'd have to live with.  Sigh, nice.  I stopped pulling weeds, took the elevator when possible and kept swimming.  Luckily for me, this kept it well managed and under control.  At the time, I didn't realize the pain I'd felt had a special name or diagnosis.  I believe the swimming I was engaged in, kept my core strong and kept the pubic bones from shearing as long as I didn't put them under undue stress.

With my third pregnancy, I was not swimming anymore.  About 14 weeks into my pregnancy I could not walk more than a couple hundred feet before I was in agonizing pain.  I went to my doctor and was told there was nothing to do for it except to wear a big elastic band around my hips.  He followed that gem of advice with, "don't worry, after you have your baby, everything'll go back to normal."  At week 14 of a 40 week haul and I could barely walk from my car to the damn doctor's office, this was not something I wanted to hear.  I dutifully went to the mall, bought the silly rubber band, and cinched it tight around my hips.  It didn't do a darn thing. 

I am a Physical Therapist Assistant, and was never taught anything about PSD in school, nor did my fellow therapist friends have any advice for me either, other than to wear a TENS unit (a little electrical stimulation device that helps to mask pain).  I am not one to sit by idly, and I also knew that my core muscles needed strengthening to offset the sloppy ligaments.  Since walking and exercising on land was near impossible, I decided to join my local gym and get into a water aerobics class.  The beauty of exercising in the water is that it is buoyant and supports you while at the same time giving you resistance to strengthen you.  I was cautious with my movements in the beginning, keeping them small and in a pain-free range.  But I worked out with as much gusto as I could.  After the first workout, I found I was a little sore, but no worse for the wear.  The next class, I increased the size of the movements and the intensity.  I went to the class 3-5 times per week, as it felt so good to be able to move around in the water, it was liberating.  At the end of the class we would jog around the pool.  After a few weeks, I felt so good I was lapping all my silver-haired classmates.  I know, not a crowning achievement, but going from hobbling a few feet here and there to lapping folks in a running spree was good for my morale.  Here's the amazing thing about all this.  Within a couple weeks, my symptoms went away!  Absolutely zero groin pain!  So I added walking outside the pool to my exercises as well (obviously, I didn't overdo it, and I paid attention to my body), and I kept hitting the pool, and pushing my pool workouts to the limits of my comfort.  To my knowledge, no studies have been done to prove that this is an effective cure for PSD, but in both my pregnancies when I was afflicted with this dastardly problem, my time in the swimming pool took away the symptoms after they appeared. 

My last pregnancy was about 9 years ago now, and I remember searching desperately for a solution to my situation.  As I look around the web today, there is still little to no helpful information about PSD.  It appears that the main advice still being handed to folks is to put on that useless rubber band (ridiculous), to take it easy (not always possible, especially if you have more than one child), to skip the stairs (I couldn't avoid that, I live in a two story house) and to maybe try a TENS unit for pain (just a band aid, doesn't solve the problem).  It makes good sense to me that the pubic joint needs the extra muscular support because the ligaments are not able to do their job.  Therefore you need to strengthen the core muscles, and traditional Kegels are not going to do the trick!  Water is the perfect supportive and resistive environment to challenge your core without undue stress.  Each person is unique and presents with different health issues during their pregnancy, therefore it's important to check in with your doctor before joining a program, but if he/she gives you the okay, get into the water ASAP.