Practicing Yoga with Pubic Symphysis Pain

Hey Mary,

I think I might have pubic symphysis dysfunction. I have sharp pain near my pubic bone when I get in and out of my car, and roll over in bed. I noticed a similar pain in class today whenever we were in wide-leg poses. Is there anything you suggest to help me feel better?

SPD pain sucks. I had it during my second pregnancy, and it lasted well into my postpartum before I discovered what is really helpful in helping it heal.

With pelvic pain, you need to focus less on stretching, and more on strengthening. But that doesn’t mean you can’t practice yoga!

Here’s how:

• Squeeze a yoga block (or a Pilates ball or rolled up blanket) between your inner thighs.

This can help “reset” your pelvis, and help your pelvis feel safe (which will result in less pain). Squeezing something between also strengthens your inner thigh and abdominal muscles, and we want to do that when pelvic pain shows up!

You can do this in Bridge pose, Tabletop positions, Reverse Clams, Mountain Pose, and Chair Pose. Avoid wide leg poses until your pain decreases, and replace wide leg poses with some of these poses.

• Strengthen your glutes

  
  

When pelvic pain shows up, it’s really important to focus on strengthening the muscles that support your pelvis (glutes, inner thighs, abdominal muscles).

In yoga, you can strengthen your glutes with Clams, reverse clams, Donkey kicks (keep them as small as you need to stay out of pain), Chair Pose Squats, Hinge Ups, and Bridge pose.

• Relax your pelvic floor

  
  

Pelvic pain is often accompanied by pelvic floor tension. All that strengthening of your inner thighs, glutes and core will help encourage your pelvic floor to relax.

You can also encourage your pelvic floor to relax with pelvic tilts, meditation, and coordinating your movements with breath. Exhale during the hardest part of the movement (like standing up from a Chair Squat), and inhale during the easier part of the movement (the lower).

Of course, I also recommend working with a pelvic PT. A pelvic PT can do manual release and reset work that is beyond the scope of practice of a yoga teacher. Besides, the more people you have on your team, the more likely it is you will find relief faster.