PT on the Net Research

Reduced Pubic Symphysis Gap


Question:

I do not know what is my condition is exactly. My X-ray shows a reduction in the pubic symphysis gap. I go to the gym three days a week and work out with free weights and doing cardio. I have been experiencing groin pain for last two months over the pubic area while running, sharp pains while shifting directions, pinching sensations, discomfort while raising my right leg to get into vehicles. My doctor has increased my calcium dose and asked me to go very slow with my work outs, so I have really cut down on my weight training, reduced the weights drastically and even quit any kind of running and jogging. My concern is that I am no longer able to give my body the intensity it requires for further weight reduction. What is the cause and effect of a reduced pubic symphysis space (instead of widened, which seems to be widely written about)? How should I adjust my work out routine? 

Answer:

Thank you for your question. Although this answer is not meant to be black and white, I hope to help you in your personal pursuit of finding a solution. Our first step would to assess all the global movement patterns that exacerbate the discomfort you mention. Once identified, we would attempt to “tweak” your position and motion to assess what structures (part) is affecting the pattern of movement (the whole). This whole-part-whole approach will allow us to hopefully uncover the CAUSE as opposed to only looking at the symptom (which is often the diagnosis). In other words, if you show a reduced pubic symphysis space, the question is WHY. You mentioned the area hurts during movement and not in stillness. Therefore, our thoughts are it is a movement abnormality that is potentially causing and/or exacerbating your proposed structural deformity. Another question I have is, how do you know the reduced pubic symphysis isn’t normal for YOUR structure and what you're feeling may be a result of another cause? This is hard to comprehend because of objective X-rays, yet it is too often the case. My point is, just because someone has discomfort in a region and structural abnormality is shown, it doesn’t mean that’s WHY the pain exists. Yes, it may be a PART, but most often, it is not the cause. You need to find a qualified movement therapist that can analyze your walking, running and all daily functional movement patterns BUT from a functional perspective and not an isolated perspective. I would strongly recommend purchasing Gary Gray's DVD on the Pelvic Floor. Gary does a wonderful job explaining the functionality of this region from a functional perspective. The great news is its a natural approach!

The bottom line is, your therapist or trainer must assess your body functionally and design a program that follows YOUR functional threshold. Stimulate your body so the discomfort improves – don’t just do to do.