From the Research
Weight bearing guidelines for pubic symphysis dysfunction should prioritize a gradual return to activity based on pain levels, with the most recent and highest quality study suggesting that locking plate fixation can allow for early weight bearing 1. When managing pubic symphysis diastasis, the goal is to prevent further separation of the joint while allowing proper healing.
- Initially, patients should limit weight bearing activities that cause pain, using assistive devices like crutches or a walker if necessary.
- As symptoms improve, gradually increase weight bearing with a 10-20% increase in activity per week, stopping if pain worsens.
- During recovery, avoid single-leg activities, heavy lifting (over 15-20 pounds), and movements that separate the legs widely.
- Core strengthening exercises and pelvic stabilization work are beneficial once tolerated, as seen in a case report where a functional exercise program improved symptoms in a patient with symphysis pubis diastasis 2.
- Most patients can return to full weight bearing within 6-12 weeks, though this varies by individual.
- A pelvic support belt may provide additional stability during the recovery process.
- Pain should guide progression - if an activity increases pain, reduce or modify it until the body can tolerate more stress on the joint. The use of locking plates across the pubic symphysis has been shown to be safe with low complication rates despite early weight bearing, as demonstrated in a study of 46 patients with symphyseal disruptions 1.
- This study found that only 13 patients had evidence of radiological failure, and only 1 patient required revision surgery.
- Another study of 11 patients with symphyseal diastasis managed with locking plates also found low complication rates and no need for revision surgery 3. Overall, the current evidence suggests that a gradual return to activity based on pain levels, with the option for early weight bearing using locking plate fixation, is a safe and effective approach for managing pubic symphysis dysfunction.