struggling with lightning crotch during pregnancy?
“Lightning crotch” is a type of sharp, shooting pain that occurs at the front of the pelvis with quick movements.
More commonly referred to as “symphysis pubis dysfunction (SPD)” or “pubic symphysis dysfunction (PSD),” this type of pelvic pain is incredibly common during pregnancy (around 32% of pregnant people experience SPD).
Wondering what in the heck the pubic symphysis is? It is the joint at the front of the pubic bones that connect the right and left sides of your pelvis together. The symphysis pubis widens/becomes more mobile during pregnancy to make room for baby during labor and delivery so that baby can exit through the birth canal.
Picture showing the symphysis pubis connecting the right and left sides of the pelvis together.
Common symptoms of symphysis pubis dysfunction include:
Discomfort
Sharp, sudden pain
A clicking or grinding noise in the pelvic region
Pain that is lasting in the groin, back, lower abdomen, perineum (area at the genitals), and/or thighs
It is incredibly common for pubic symphysis pain to develop during pregnancy due to the hormonal changes that occur…Ever heard of the hormone relaxin before? This hormone helps to prepare the body for your upcoming labor and delivery! These hormonal changes, in addition to our growing baby and uterus, usually result in a change in how we move and our body mechanics throughout pregnancy which can cause pain at the pubic symphysis.
All of this sounds like it sucks and is painful, right? Absolutely. The good thing is that lightning crotch or pubic symphysis dysfunction is something that you don’t have to grin and bear during your pregnancy (even though your medical care provider may tell you otherwise).
Okay so what can we do to make you more comfortable during your pregnancy and improve (or even resolve!!) the pubic symphysis pain? I am biased, but there are a TON of things we can work on together in pelvic floor physical therapy. Here are some of my go-to recommendations:
Using a pelvic support belt or brace. My personal favorite that I personally use when I have pubic symphysis pain during pregnancy and the one that I recommend to all of my clients is the Serola SI Belt. The belt is worn low over the widest part of your hips and should velcro directly over your pubic symphysis. Using the belt should give a little extra compression to the joint which can help with any potential shearing forces that are occurring at the joint during pregnancy that can happen with changes in hormones and how you are moving throughout your pregnancy. I usually recommend for clients to use this while up moving around such as with exercise, walking, or whenever they aren’t sitting or laying down to give more comfort to the area.
Strength training. With increased abdominal weight from your growing baby and uterus can magnify any existing weakness that you may have in your core, hip, glutes, or inner thigh muscles. I frequently recommend strengthening exercises using weights or resistance bands that focus on your glutes, abs, and inner thighs, which are muscle groups that attach directly onto your pelvis and can contribute to pubic symphysis pain. Strengthening the muscles in this area can help to further improve the force closure at the joints and improve pelvic pain. Some of my go-to exercises for clients struggling with pubic symphysis pain include:
Squats (including curtsy squats, reverse lunges, and split squats)
Deadlifts
Lateral hip and adductor (inner thigh) strengthening exercises (like lateral lunges, clamshells, monster walks, and sliding hip abduction)
Core strengthening (like Copenhagen planks, mountain climbers, bird/dog, and Pilates ball oblique crunches and crunches)
Positional modifications. With pubic symphysis pain and dysfunction frequently standing in asymmetrical positions (like standing more to one side and putting more weight through one of your legs or standing on one leg at a time while you put your pants and shoes on) and moving into different positions where the legs come apart (like getting into and out of a car and getting in and out of bed) can cause shearing at the pubic symphysis which can be a trigger for lightning crotch. Doing simple modifications like keeping your legs together while getting into and out of the car, squeezing a pillow between your knees and legs as you get into and out of bed, and sitting down to put pants and shoes on can help to keep equal weight placed through the legs and reduce the risk of shearing forces which can be a trigger for pain at the pubic symphysis.
Addressing tension in the hips, abdomen, and pelvic floor muscles. Doing stretches for any tight muscles attaching to the pelvis as well as hands-on techniques through pelvic floor physical therapy treatment to improve tension and discomfort in these muscles can also be incredibly helpful for clients experiencing pubic symphysis pain.
Have questions or feeling on the fence about whether or not pelvic floor physical therapy is for you? If you’re looking for treatment for lightning crotch or pubic symphysis pain or are struggling with pelvic floor issues and you’re located in Durham, North Carolina I would love to work with you! Reach out to me here to tell me a little more about what is going on so we can chat more and get the process started. Live outside of the state of North Carolina? I also offer virtual appointment options to provide more accessible care to those seeking out pelvic floor treatment for IC.
Dr. Brook Orvis is a Board-Certified Women’s Health and Pelvic Floor Physical Therapist, Duke Residency-Trained in Women’s Health, and the owner of Flora Physical Therapy. As a momma to a spirited toddler, she understands the difficulty of being a parent while prioritizing self-care, including caring for your body and pelvic floor. She believes that pelvic floor therapy is for everyone and is passionate about providing accessible treatment options for birthing people, men, women, kids, and the LGBTQIA+ community so that they can take better care of themselves and receive equitable care. She loves educating and empowering clients to take charge of their body and health and to not accept leaking of urine, prolapse, pelvic pain, pain during sex, and core weakness as a normal part of being a human.
Thinking that you may benefit from pelvic floor physical therapy treatment? Or know someone else struggling with pubic symphysis pain or lightning crotch that you think may need care? Reach out here to schedule a pelvic floor physical therapy appointment with me today. At Flora Physical Therapy I am passionate about providing 1:1 accessible treatment options including in-home, in-clinic, and virtual appointment options to help meet you where you are.
