Understanding Round Ligament Pain and Pubic Symphysis Pain During Pregnancy
Pregnancy brings many changes, especially to the pelvis, which must accommodate the growing baby. Among the common discomforts are round ligament pain and pubic symphysis pain, both of which can significantly affect a woman’s daily activities and overall comfort. However, understanding these conditions and utilizing pelvic floor therapy and targeted exercises can offer relief.
Round Ligament Pain: What Is It and Why Does It Happen?
The round ligaments are bands of connective tissue that connect the uterus to the groin region, helping to support the uterus as it grows during pregnancy.

Side view of pregnant woman’s abdomen showing round ligament attaching uterus to pubic bone.
Location of Pain:
Round ligament pain is typically felt on one or both sides of the lower abdomen. It often radiates down to the groin area and can be sharp or stabbing, especially when moving suddenly, such as standing up quickly or rolling over in bed.
Why It Happens:
As the uterus grows during pregnancy, the round ligaments stretch and become taut. This stretching creates tension, and since these ligaments are quite sensitive, they can become painful when overstretched. Rapid movements that pull on these ligaments can also result in sudden, sharp pain.
Triggers:
Round ligament pain is often triggered by changes in position, such as coughing, sneezing, or quick movements like standing up from sitting.
How to Treat Round Ligament Pain with Pelvic Floor Therapy:
- Pelvic Alignment: A pelvic floor therapist can assess and correct any misalignment of the pelvis or sacrum that might contribute to round ligament pain. Better pelvic alignment reduces the tension on the round ligaments.
- Breathing Techniques: Focused breathing can reduce tension in the abdominal and pelvic areas, easing the strain on the round ligaments.
- Gentle Stretching Exercises:
- Pelvic Tilts: Perform pelvic tilts by lying on your back with knees bent and feet flat on the floor. Slowly tilt your pelvis up and down, engaging the abdominal muscles.
- Forward Leaning or Forward Inversion Stretch: Lean forward on a wall, chair, or ball to reduce tension on the uterus. For a more intense stretch, sit on the end of a couch and place your forearms on the floor for a forward inversion stretch.
- Hip Flexor Stretches: Stretching the hip flexors can help relieve the pull on the ligaments, typically done in a controlled manner like a supported lunge.
- Strengthening the Pelvic Floor: Kegel exercises help strengthen the pelvic floor muscles, supporting pelvic stability throughout pregnancy.

Forward Leaning or Forward Inversion Stretch
Pubic Symphysis Pain (SPD): What Is It and Why Does It Happen?
Pubic Symphysis Pain, also known as Symphysis Pubis Dysfunction (SPD), occurs due to increased movement or instability in the pelvic joint, specifically at the pubic symphysis, where the two halves of the pelvis meet in the front.
Location of Pain:
The pain is typically located in the front of the pelvis at the pubic bone and may radiate to the inner thighs, lower abdomen, lower back, hips, or even down the legs. Some women experience a clicking or grinding sensation in the pelvis while walking.
Why It Happens:
During pregnancy, the hormone relaxin loosens ligaments and joints to prepare the body for childbirth. However, this can cause instability in the pubic symphysis joint, leading it to shift abnormally and cause pain.
Triggers:
Activities like walking, standing on one leg, rolling over in bed, climbing stairs, and even getting dressed can exacerbate SPD pain, as they place more strain on the pubic symphysis.
How to Treat Pubic Symphysis Pain with Pelvic Floor Therapy:
- Pelvic Stabilization Techniques: A therapist can teach techniques to stabilize the pelvis, such as using a pelvic support belt to reduce strain on the pubic symphysis.
- Strengthening Pelvic Floor and Core Muscles: Pelvic floor exercises (such as Kegels) and exercises to strengthen the transverse abdominis (deep abdominal muscles) help provide support for the pelvic joints. Strengthening the glutes and hip stabilizers also helps distribute weight more evenly across the pelvis.
- Safe Exercises for SPD:
- Bridge Exercise: Lying on your back with knees bent and feet flat on the floor, lift your hips while engaging the pelvic floor and glutes. Slowly lower your hips back down to strengthen the pelvic and gluteal muscles.
- Modified Squats: Stand with your feet wider than shoulder-width apart, gently squat while keeping the pelvic floor engaged. Ensure the movement is slow and controlled.
- Clamshell Exercise: Lying on your side with knees bent, lift the top knee while keeping the feet together. This strengthens the muscles around the hips and pelvis, promoting stability.
- Postural Adjustments: Correcting posture by maintaining a neutral spine and avoiding movements that overstretch or destabilize the pelvis can help reduce symptoms.
The Role of Pelvic Floor Therapy in Pregnancy: Why It’s Beneficial
Pelvic floor therapy offers a holistic approach to managing pregnancy-related pain, ensuring the pelvis is well-aligned, the muscles are strong, and ligaments are supported. Specific benefits include:
- Prevention of Pain Progression: Addressing round ligament pain and SPD early can prevent these conditions from worsening as pregnancy progresses.
- Improved Mobility: Exercises and alignment work improve mobility and reduce discomfort during activities like walking or transitioning from a seated position.
- Postpartum Recovery: Strengthening the pelvic floor and maintaining proper alignment during pregnancy lays the foundation for smoother postpartum recovery.
Conclusion: Managing Pregnancy Discomfort with Pelvic Floor Therapy
Round ligament pain and pubic symphysis pain are common, but they don’t have to define your pregnancy experience. Pelvic floor therapy and targeted exercises can offer relief by promoting pelvic stability, reducing strain on ligaments, and strengthening the muscles that support your growing body. By working with a pelvic floor therapist, you can reduce pain, improve mobility, and support a healthier, more comfortable pregnancy.
Looking to optimize your pregnancy journey with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.