SPD: Keep Your Legs Together

“I’m pretty uninhibited with my husband,” Sally tells me. “But that doesn’t mean I’m comfortable with him putting my knickers [panties] on.”

Sally’s recalling the humiliation she felt during pregnancy eighteen months ago. She developed symphysis pubis dysfunction (SPD), which means her pelvic joints became inflamed and unstable. The illness made simple tasks—like putting on underwear—too painful to contemplate without her hubby’s helpful hands.

“Any movement when I had to separate my legs was agony—take that to mean just about everything,” she explains.

“Every day, Mark lays my knickers on the bedroom carpet. I stepped in to them, and then he pulled them up. The next challenge was walking downstairs, one slow, sore step at time. SPD made the rest of my pregnancy an absolute nightmare.”

The pain went off the charts at the end of her second trimester. “Until then, the pregnancy had been text book,” Sally says. “I barely even had any morning sickness. Then I got out of bed one morning, and screamed in pain. It was like my groin was on fire.”

SPD is named after the pubic symphysis, the joint at the front of the pelvis where the two hips bones meet. Normally the pelvis is a tight, closed system of bone (comprising the two hip bones plus the tail end of the spine, called the sacrum). These bones are reinforced by lots of ligaments, making the pelvis stable.

Sometimes however, this stability is compromised during pregnancy when the hormone relaxin kicks in. Its job is to loosen those pelvic ligaments to prepare for birth.

Although the exact mechanics of SPD are unknown, it seems SPD causes an over-loosening of the ligaments, leading to misalignment and in some women, excruciating pain. And of course, the problem is exacerbated by the weight of a growing baby.

“A physiotherapist diagnosed SPD immediately,” Sally explains. “She presented me with a pelvic girdle—essentially a big nylon band which strapped under my bump and held my hips together. I hated the way my bum [butt] squidged over and under, but it made walking less painful.”