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Have you heard about deterrent cases, when women felt during pregnancy pain and couldn’t walk, and even after birth it didn’t return back to the normal? Behind it could be mentioned diagnosis called symphysiolysis.
HOW DO JOINTS OF THE PELVIS LOOK?
The pubis bones are in front connected with ligament cartilage. This connection is firm and flexible and it is called symphysis. It enables the pelvis to be flexible during impacts during walking, and by women it adapts to the dimensions of the baby during the childbirth. On the back side is sacroiliac joint. It is located between the sacrum and the pelvic bone. It is firmly connected with strong ligaments.
WHAT’S THE DEAL EXACTLY?
During pregnancy, the body of the woman undergoes many changes. Among others, hormonal changes increase the levels of estrogen, progesterone and relaxin (you can learn more about it here: Physiological changes during pregnancy). This is naturally releasing the ligaments in the sacroiliac joint (SI joint) and the symphysis. It has its purpose, it is important for the pelvis to be flexible enough during birth. With growing baby inside, there is an increasing pressure on the pelvic joints. Normal release of the symphysis is considered in range between 3-8 mm. Symptom of pathological release range to 10 mm and more. If the gap between the pelvic bones reaches 25 mm, it is considered as a rupture. Such release of the symphysis distorts statics, normal walking becomes nearly impossible because it causes significant pain.
SYMPTOMS
Determining the diagnosis is up to gynecologist and orthopedist. It is quite rare health condition. Subjective feelings during symphysiolysis can manifest in these ways:
- Inconsolable pain in the symphysis area and tailbone in any position.
- Walking becomes impossible.
- Standing on one leg becomes challenging or almost impossible.
- Waddling gait
- Tangible gap between the symphysis
WHAT CAN YOU DO ABOUT IT?
Symphysiolysis is primarily hormonal issue. It appears often in women who expect more than one baby, but also in women with sedentary jobs and hypermobility. It starts individually, usually in a higher stage of pregnancy, the condition usually gets in order after birth. The pressure on the pelvis is lowered when the baby is born and the hormonal levels drop down. But there are also cases, when the problems remain even after the birth.
Present treatment of this problem is still very insufficient. It consists mainly of not putting any pressure on the pelvis so the pelvic bones would not move. Hospitalization is important as well as diagnosing with X-ray imaging method. There are maternity belts which serve a support and hold the symphysis passively together, alternately you can use bandages. C-section can be often performed after consultation with gynecologist and orthopedist, because normal childbirth would be problematic and could even worsen the problem and prolong recovery.
Last option is surgical solution, that is when the symphysis is ruptured. The symphysis is stabilized and fixed with metal plate. Further natural childbirths are not recommended after such treatment.
Read also about the Alexander technique during pregnancy and after birth.
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
