Womens Health

Symphysis Pubis Dysfunction (S.P.D.)

(With or without low back pain and sciatica).

S.P.D. is a manifestation of Pelvic Girdle Asymmetry as the result of a pre-existing pelvis and low back pain condition (sometimes undetected).

The woman may have had low back pain with sciatica sometime in the past, which may have settled by itsself or following treatment. However, pelvic and lumbar spine position and mechanics may not have been addressed, leaving the pelvis vulnerable during pregnancy.

During pregnancy the hormone Relaxin is produced in order to allow increased movement within the pelvic joints (sacro-iliac joints at the back of the pelvis and symphsis pubis joint at the front). Relaxin makes the ligaments more pliable to allow the pelvis to expand during 2nd stage labour in order to facilitate delivery of the baby.

Physiotherapy - Spine & Pelvis Physiotherapy - Force Plate Example - Spine & Pelvis Twist
Pictures of Torsioned Pelvis and Force Plate Reading

Force plate analysis of pelvic structural loading giving accurate data on pelvis position and load prior to and after treatment.

This allows the clinician to determine the effectiveness of the given treatment structurally as well as symptomatically.

Physiotherapy - Womens Health Physiotherapy - Womens Health
Pictures Before and After Treatment

Regaining normal pelvic position and mechanics is a straight-forward exercise and can usually be achieved in one or two treatment sessions, irrespective of stage of pregnancy. i.e. it is safe to treat during the whole 40 weeks of pregnancy right up to the day of delivery - the day after and anytime thereafter.


Initially, a Serola belt may be needed to support the pelvis in the correct position along with postural and muscle correction with advice on daily activities.


Incontinence - Bladder Symptoms

There are four main types of bladder incontinence:

  1. Stress Incontinence
  2. Urge Incontinence
  3. Irritable Bladder
  4. Frequency Incontinence

All of the incontinence types have a structural and mechanical element to them as well as a muscular and nerve component. This is due to the muscles and bladder ligaments attaching to the pelvic bones. If the pelvis is twisted the ligaments which support the bladder attach to the inner aspect of the pelvis, also twist the bladder leading to Urge, Irritability and Frequency types of Incontinence.

Normalising the pelvic position reduces the tension and twist within the ligaments and the bladder. this also offloads the nerve supply leading to an immediate reduction of these symptoms.

Stress Incontinence will be helped in a similar way. However, coccyx (tailbone) position also needs to be addressed with stress incontinence as the pelvic floor muscles attach to it at the back of the pelvic floor. If the cocccyx is jammed or bent forwards, backwards or sideways, this will alter pelvic floor position, tension, strength and function.

Mixed Incontinence:

Treatment is still aimed at structural and mechanical mobilisation along with addressing the nerve component, i.e. position and tensions.

Possibly the most common type. There is Stress, accompanied by a combination of Urge, Frequency and Irritability.
May be all of these!


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