Tagged: pubic symphysis instability
This topic contains 2 replies, has 2 voices, and was last updated by Karen 7 months, 2 weeks ago.
September 14, 2018 at 9:25 am #79331
3.5 months postpartum now and everything is going quite well. I’m working through the 7 day advanced program, not with quite as much consistency as I’d like, but doing it, and I started running around 10 weeks pp, ramping it up since then. Everything feels fine regarding my pelvic floor, but I do have a question about pain while running that perhaps you could help with. When I run, I often feel a dull ache in my left pubic bone. It was quite strong the first time I ran (just 1.5 miles), though didn’t really leave any lingering soreness afterwards. The second and third runs, the pain was much better – still slightly present but definitely improved. I hoped it was just something that needed to strengthen up and would go away altogether on its own. Fast forward to now and it’s definitely still there. The longest run I’ve done was 6 miles, and the pain is always a dull, background-level sort of pain, but definitely something I’d like to resolve. Do you know of what could cause this, and of any exercises to address it? I’m guessing it has something to do with the pubic symphysis, as I did have pubic pain towards the end of my pregnancy which I did not experience with my first.
The only other time I feel any similar pain down there is during certain strong plank holds, particularly if my hands are lower than my pelvis (as in the plank walkouts).
Thanks for any insight you might have as a PT and postpartum runner.
-KarenSeptember 27, 2018 at 8:23 am #80111
First of all, congrats! Love your progress. And you are right on point – it sounds like your pubic symphysis. Lay on your back with your legs straight – palpate your pubic bone, pressing down so that you feel the shelf of the pubic bone – it should feel even. If one side is higher then you may have a slight upslip or if you palpate the front surface of your pubic symphysis – you may feel one side raised more than the other, it may be anteriorly displaced. Of course this eval and treatment is best done by a PT hands on, they will be able to adjust you as needed and give home stretches/isometric contractions that can make slight adjustments as needed.
One such isometric contraction is too have your husband hold the outside of your bent knees as you lay on your back with your feet on the floor – feet shoulder width apart. From this position, simply press your knees apart against the pressure of his hands – he should not allow any movement. You effort should be significant. Follow that isomentric contraction by squeezing your knees together against a ball or two fist placed between your knees. Hold each contraction for a 3-5 count. Repeat x 3 or so. Can do as needed.
This may require time off from running as you work to give your pubic symphysis time to stabilize. My PT progression would be to get all your planks pain free, all squats pain free (including single leg squats), before returning to running.
Tough news for a runner progressing her distance, but in order to get rid of the pain, the activities causing the ache have to be stopped until we build up through the progression I have stated above.
These isometrics place traction and compression forces on the pubic bone. It will not, however, keep you there. That will occur with the deep stabilization exercises of the 7 Day. The fact that you feel an ache with some of the more advanced planks tells me that you have some pubic symphysis instabilty and that the pull of your lowest TA fibers is effecting this. I am okay with these advanced planks as long as we keep even weight on both feet – so don’t do alternate leg lifts until you can perform just the hold without discomfort. That goes for any single leg activity you do – if you feel pain, adjust exercise to allow for equal weight on both legs.October 10, 2018 at 4:59 pm #85614
Thanks, this is very helpful!