SPD Treatment Ideas
Last week’s blog talked about what SPD is (for a refresher, follow this link). This week I want to talk a bit more about some treatment ideas.
I remember first learning about SPD in PT school and even in some beginner pelvic floor courses and the takeaway back then had me encouraging women to minimize the movement of their pelvis, minimize any asymmetrical positions, and to perform more isometric contractions (contracting a muscle without actually making the muscle shorter or longer).
Now, after taking a lot more courses and learning more in practice, I can say that my old way of treating couldn’t be further from what I recommend.
After gaining better understanding of the root cause of SPD, I now understand that this joint actually needs to be mobilized. The muscles that attach nearby need to be turned on and that it is actually a good thing to move into some asymmetric positions!
Oftentimes, women are afraid at the thought of doing movement at the joint due to the fear of pain. One of the first exercises I like to have them try is a very supported position laying on their back (if they can tolerate this while pregnant) with feet on the wall and just working on some breath work focusing on expanding into their back. In this position, if the feet are positioned slightly wider than hips, this can help to relax the glute muscles, get better relaxation in the low back and back half of the pelvic floor, and it gently turns on the adductors (inner thigh muscles).
Another potential exercise to move into is hip shifting. Again, this can be done laying on the ground as shown in the video below or seated and the goal is to work on just getting gentle movement throughout the front and back of the pelvis using the pull of the inner thigh muscles to assist.
Finally, a third potential exercise is getting clients up on their feet and working on turning on their adductors (inner thigh muscles) while taking a step and pausing to breathe into this position as shown below.
These are just a few sample exercises that might help. There are tons of other positions that might match the individual better but the main goal is to work on getting relaxation in the back half of the pelvic floor, getting mobility reintroduced throughout the pelvis pain-free, and then activating the inner thigh muscles to better support the joint.
If you are experiencing SPD, please know, this is NOT something you just have to live with especially if you are pregnant. Please seek out a skilled pelvic floor therapist to help address this pain early on so you can get back to moving with more comfort quickly!
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