Are you having pain in your pelvic area? This could be the Pubic Symphysis!

Have you ever felt a strange pain or discomfort in your pelvic area, that is, your groin? Maybe you hear a little clicking sound when you walk or turn to the side? Today we are going to talk about a joint in our body that we don't talk about much, but it is very important. It is called `Pubic Symphysis`. Although the name is a little strange, this place performs a very important function in our body.

What is this `Pubic Symphysis`? Let's understand it simply.

Okay, now let's see what this `Pubic Symphysis` is. Simply put, this is the joint where your two pelvic bones, that is, your two hip bones, join together in front. While your elbows and knees move a lot, this `Pubic Symphysis` joint doesn't move that much. Its main job is to hold your right and left pelvic bones in place. However, it does make some small movements. These movements help distribute the weight of your upper body evenly across your pelvis. During pregnancy, the movements of this joint increase even more. At that time, this joint becomes flexible, because it needs to help the pelvic bones widen a little to make it easier for the baby to come out.

So what is the main thing about this `Pubic Symphysis`?

The Pubic Symphysis joint does a very important thing. It connects your right and left pelvic bones together, creating a strong pelvis that can support your body's weight. It also helps you to stretch during childbirth. It is because of this joint that the two pelvic bones are exactly the same as if you were looking through a mirror. Your pelvic bones come together, distributing the weight of your upper body between your legs and feet. The Pubic Symphysis joint can move about 2 millimeters and rotate about 1 degree. This movement is what allows your pelvis to absorb the shocks that occur when you walk and run. This joint is especially important if you are pregnant. As you approach childbirth, this joint becomes very flexible. Then the pelvic bones widen, making it easier for the baby to come out through the birth canal.

Where is this `Pubic Symphysis` located?

Your pubic symphysis is located at the bottom of your pelvis, where your left hip bone meets your right hip bone. This joint is about 3 to 5 millimeters wider in front than in back. It is also located in front of your bladder, above your clitoris in women, and above your penis in men. The tendons of some muscles in your abdomen and thighs attach to ligaments at the pubic symphysis. For example:

• The tendons in your thigh muscles (especially the gracilis muscle).
• The tendons of the muscles on the sides of your abdomen (`obliquus externus`).
• The tendon of your rectus abdominis muscle.

These connections provide additional strength and stability to the pelvic area.

What is the `Pubic Symphysis` made of?

Your pubic symphysis is made up of two types of cartilage and four ligaments. These are what keep the pelvic bones together, but they're also flexible. This joint is more flexible than the joints in your skull, but less flexible than joints like your elbow. Let's take a look at its main parts:

• Fibrocartilage disk: This is made mostly of fibers called Type I collagen . This type of collagen is what gives connective tissues like bones , skin, tendons, and joints their strong structure. This fibrocartilage disk is located at your pubic symphysis joint as a strong, fibrous disk. Ligaments and tendons attach to this disk, helping to keep it in place.

• Hyaline cartilage coating: Hyaline cartilage is made up mostly of Type II collagen. This is the main ingredient in cartilage. This hyaline cartilage covers the ends of your pelvic bones. That fibrocartilage disc mentioned earlier sits between the hyaline cartilage on your left pelvic bone and the hyaline cartilage on your right pelvic bone. It's like a sandwich.

• Ligament connectors: Four types of ligaments attach to this fibrocartilage disc, preventing it from sliding or moving too much. These ligaments are: the superior pubic ligament, the inferior pubic ligament, the anterior pubic ligament, and the posterior pubic ligament.

What are the diseases and disorders that affect the `Pubic Symphysis`?

Symphysis Pubis Dysfunction, or SPD, is a general term for a collection of symptoms caused by changes in your pubic symphysis. SPD is often caused by pregnancy.During pregnancy, hormonal changes cause the ligaments that hold the `Pubic Symphysis` (pubic symphysis) together to loosen. This loosening of the ligaments makes the joint more flexible. This flexibility is what allows the pelvic bones to move apart as the baby comes out during childbirth. However, these changes can sometimes be painful. Not only pregnancy, but other conditions can cause changes in your `Pubic Symphysis` (pubic symphysis):

• Joint jamming and dislocation: The pubic symphysis widens slightly when you spread your legs apart. Sometimes, when you play sports or exercise, the joint can become too wide, causing the pelvic bones to dislocate or jam when they come back together.

• Metabolic diseases and disorders: Being overweight and obese puts more pressure on the pubic symphysis, making it more susceptible to injury . Some diseases can cause the joint to become wider (e.g., renal osteodystrophy) or cause calcium deposits within the joint (e.g., ochronosis).

• Joint diseases: Over time, the cartilage wears down and the support for the joint can decrease. This is called osteoarthritis .

• Infection: Bacteria such as Staph and Strep can attack the joint and cause it to become inflamed.

• Inflammation: The most common inflammatory condition affecting the pubic symphysis is Osteitis Pubis. This can be caused by injury, infection, pregnancy, osteoarthritis, or surgery.

What are the common symptoms of a condition affecting the `Pubic Symphysis`?

Depending on the problem affecting your `Pubic Symphysis` joint, you may feel sharp pain in your pelvic area. Sometimes this pain may feel like it's spreading throughout your abdomen, hips, and back. If you find it difficult to perform certain movements, it could be a sign that you have a problem with your `Pubic Symphysis`. Here are some of the symptoms:

• Loss of flexibility in your groin area.
• A grinding sound or sensation when moving the pelvis.
• Pain in the front of the pelvis or on the inner side of the thigh.
• Pain or a "clicking" sound when walking.
• Pain in the groin area when trying to run, kick, stand, or sit.
• Pain when turning the body or reaching out to pick something up.

If you have these symptoms, your doctor can help you determine if the cause is a problem with the `Pubic Symphysis`.

What are the common tests performed to check the health of the `Pubic Symphysis`?

Typically, your doctor will take your medical history, perform a physical exam, check how strong and stable your pelvic muscles and joints are, and get an idea of ​​the condition of your `pubic symphysis`. Most of the time, this is enough. However, very rarely, a doctor may do a `blood test` or `imaging`. If you are pregnant, your doctor will only recommend safe imaging tests that will not harm the `fetus`.

What are the common treatments for `Pubic Symphysis`?

Your doctor will help you manage the pain of an injury to your pubic symphysis until it heals.

• Getting more rest gives the body time to heal.
• Taking painkillers such as NSAIDs (non-steroidal anti-inflammatory drugs), applying ice packs, and using heating pads can help with pain. However, if you are pregnant, do not place heating pads on your lower abdomen.
• It may also be helpful to see a musculoskeletal specialist, such as a physical therapist or chiropractor. They can provide treatment and exercises to help stabilize and strengthen your pelvic area until your joint heals.

Remember, the best treatment for you will depend on the cause of your pain, so talk to your doctor about your options.

How do I keep my `Pubic Symphysis` healthy?

The best way to prevent injury is to move your body in a way that doesn't put strain on your pubic symphysis. It also helps to do exercises that strengthen the muscles that surround and support your pelvis. Your doctor may recommend the following:

• Doing exercises that strengthen the muscles in your pelvic floor, mid and lower back, hips, buttocks, abdomen, and vaginal walls (e.g., Kegel exercises ).
• Wearing comfortable shoes that fit your feet will reduce the pressure on your joints when you walk or run.
• Exercising on flat surfaces that are not too hard will reduce the amount of stress you put on your joints when running on hard ground.When running on flat surfaces, you are less likely to fall and injure your pubic symphysis, causing it to twist or pinch.
• When starting an exercise program, start slowly, rather than going all out. This will prevent unnecessary stress on muscles that are not ready for the work. Taking the time to gradually progress through an exercise program will help protect your joints in the long run.

Talk to your doctor about what exercises you can do to prevent injuries, and how to plan your workouts to reduce your risk of injury.

Finally, what to remember (Take-Home Message)

We often think of the most important joints as the knees and elbows, which are very flexible. However, joints like the ` Pubic Symphysis` also play a very important role. This joint helps your pelvis absorb the shocks that occur when you move. Also, changes in this joint during pregnancy are what allow you to give birth vaginally. Therefore, it is very important to protect your `Pubic Symphysis` from injuries. If you have any problems or pain related to this, do not be shy and see a doctor for advice. Then you can stay healthy and well!

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Pubic symphysis, pelvic pain, pregnancy, joint health, SPD, women's health, Sri Lankan health