How Postpartum Physical Therapy Can Ease Pubic Symphysis Dysfunction and SI Joint Pain

Katie Beckham • September 1, 2025

Pregnancy and birth change the pelvis in ways most women aren’t prepared for. What starts as “normal soreness” often turns into sharp pain in the front of the pelvis or a deep ache in the lower back and hips. These aren’t just random pains—they’re signs of pubic symphysis dysfunction and sacroiliac (SI) joint dysfunction or pelvic floor dysfunction. All three conditions that may present in isolation or altogether.

In my Houston clinic, I meet women every week who struggle to walk comfortably,turn in bed, or lift their baby without wincing in discomfort. The good news is that with the right postpartum physical therapy, these problems will lessen.


What Is Pubic Symphysis Dysfunction?

The pubic symphysis is the joint where the two halves of your pelvis meet in the front. During pregnancy, hormones like relaxin soften the ligaments that normally hold this joint stable. That flexibility helps prepare your body for birth, but it can also leave the joint vulnerable and painful.


Common signs of pubic symphysis dysfunction include:


  • Sharp, splitting pain in the front of the pelvis.
  • Clicking or grinding sensations in the pubic bone.
  • Pain with stairs, walking, turning in bed, or standing on one leg.
  • Trouble getting dressed or getting in/out of a car.


When I evaluate women with this condition, they often tell me it feels like their pelvis is “coming apart.” This pain is very real, and if you’re dealing with it, you may need focused help. I regularly provide care for pubic symphysis dysfunction in Houston, Texas, and I’ve seen how life-changing it can be when symptoms are resolved.


What Is Sacroiliac (SI) Joint Pain?

The sacroiliac joints sit at the back of the pelvis, connecting the sacrum (base of the spine) to the hip bones. Like the pubic symphysis, these joints are stabilized by strong ligaments. When pregnancy hormones loosen them, the joints can move more than they should, creating instability and pain.


Typical symptoms include:


  • A deep ache in the lower back, buttocks, or hips.
  • Stabbing or shooting pain that can mimic sciatica.
  • Pain when sitting too long, climbing stairs, or bending forward.
  • Discomfort lying on the affected side.


Many women come to me for back and SI joint pain therapy in Houston, Texas after months of frustration. Some have been told it’s “just low back pain” or even mistaken for a disc problem. But once we test the SI joints specifically, the pattern becomes clear—and targeted therapy makes a real difference.


How Pubic Symphysis Dysfunction and SI Joint Pain Are Connected

The pelvis is a closed ring. That means what happens in the front (pubic symphysis) affects the back (SI joints), and vice versa. Research supports this: a radiographic study found that women with SI joint disorders had visible changes in the pubic symphysis almost every time.


Here’s how they connect:


  • Hormonal changes: Relaxin loosens ligaments throughout the pelvis, affecting both joints.
  • Pelvic instability: Extra mobility in one joint stresses the other, forcing it to compensate.
  • Biomechanical stress: The weight of pregnancy and shifting posture amplify the strain.
  • Pelvic girdle pain (PGP): Clinically, both PSD and SI joint pain fall under this broader diagnosis.


When women come to me for pubic symphysis dysfunction therapy in Memorial, it’s rare that they don’t also have some degree of SI joint involvement. The pain often travels from front to back, showing how linked these structures are.


Symptoms That Shouldn’t Be Ignored

Both conditions can disrupt daily life in ways that go far beyond “normal postpartum soreness.” Warning signs include:


  • Pain that makes walking or climbing stairs difficult.
  • Clicking, grinding, or shifting sensations in the pelvis.
  • Pain radiating into the thighs, groin, or buttocks.
  • Difficulty sleeping because turning in bed is painful.
  • Trouble caring for your baby—feeding, lifting, carrying.


Persistent pain can even affect mood and confidence. I’ve worked with women who felt anxious, frustrated, or afraid to move. That’s why early care matters.


How Postpartum Physical Therapy Helps

Physical therapy is the first-line treatment for both pubic symphysis dysfunction and SI joint pain. Every session I provide is private and tailored to what your body needs most.


Treatment may include:


  • Manual therapy to ease tension, mobilize stiff joints, and improve alignment, balance muscle function, and those that attach to the pelvis.
  • Stabilization exercises that strengthen the deep core and glutes, providing support where ligaments can’t.
  • Breath and posture retraining to reconnect the diaphragm, core, and pelvic floor.
  • Movement retraining for daily tasks like rolling in bed, lifting your baby, or getting out of the car.
  • Supports when needed—pelvic belts, pillows, or comfortable sleep positions.


This is why women often seek back and SI joint pain therapy in Houston, Texas, with me: because therapy doesn’t just treat symptoms, it restores stability to the entire core.


Simple Tips You Can Try at Home

While therapy provides the most progress, a few small changes at home can reduce strain:


  • Keep your knees together, supported by a pillow, gently kegel when turning in bed.
  • Use a pillow between your knees for sleep.
  • Sit down to get dressed or pick things up.
  • Avoid carrying your baby on one hip.
  • Take shorter, frequent walks instead of long ones.


I always give my patients a few targeted exercises and strategies that fit into busy postpartum life.


When to Seek Help

Some soreness is expected after pregnancy, but these are signs it’s time to see a professional:


  • Pain that doesn’t improve within 6–8 weeks postpartum.
  • Difficulty walking, standing, or sleeping due to pain.
  • Clicking or grinding in the pubic bone.
  • Fear of movement because pain feels unpredictable.


If you’re considering postpartum physical therapy in Spring Branch, know that early treatment usually means faster, smoother recovery.


Local, Personalized Care in Houston

Every woman’s recovery looks different. That’s why I provide private, one-on-one sessions instead of giving generic exercise lists. Whether you’re struggling with pubic bone pain, SI joint instability, or a mix of both, the care plan is built for you.


I provide treatment for pubic symphysis dysfunction in Houston, Texas, as well as pubic symphysis dysfunction therapy in Memorial, and I regularly see women from Spring Branch, Bellaire, Katy, and Bunker Hill Villages.


Final Thoughts

Some pelvic pain after birth is common, but it isn’t something you should have to push through. With the right plan, I’ve seen women return to walking, lifting, and caring for their babies with comfort and ease.


If you’re in Memorial, Spring Branch, Bellaire, or the greater Houston area and you’re dealing with pubic symphysis dysfunction or SI joint pain, I am here to help. 


Reach out today to get started with one-on-one postpartum physical therapy.


By Katie Beckham July 29, 2025
That deep, persistent ache in your buttock that may radiate down your leg and makes sitting for long periods or moving in specific ways nearly impossible is more than frustrating. You may have been told it’s sciatica or piriformis syndrome. You’ve followed the usual advice: glute stretches, foam rolling, resting from activity. Yet the pain keeps returning, often without any clear reason. When common strategies don’t lead to meaningful relief, it’s time to consider whether something else might be contributing to the issue. Here’s something many people aren’t told: What if your piriformis isn’t actually the source of your pain? What if the true cause lies deeper, in an adjacent structure that’s often overlooked? If your symptoms haven’t improved with typical piriformis treatments, there’s a good chance something else is involved. The Usual Suspect: What Is Piriformis Syndrome? The piriformis is a small, triangular-shaped muscle that lies deep in your buttock. Its main job is to help rotate your hip outward. The sciatic nerve provides the motor function to the piriformis muscle, the largest nerve in your body. When the piriformis tightens, spasms, or gets irritated, it can press against that nerve and cause pain that mimics traditional sciatica. That’s what we call piriformis syndrome. The symptoms can be intense. Pain when sitting, soreness that radiates down the leg, difficulty walking, or sleeping. It’s a real condition—and it’s often the first thing doctors or trainers suggest when someone describes “sciatic pain.” But here’s the problem: Piriformis syndrome gets blamed for a lot of pain it isn’t causing. And that’s why so many people don’t get better with standard approaches like stretching or foam rolling. The Hidden Culprit: Your Pelvic Floor’s Role in Sciatic Pain The piriformis doesn’t operate in isolation. It’s part of a broader system of deep hip and pelvic muscles. And one of the most important—and most overlooked—players in that system is your pelvic floor. The pelvic floor is a group of muscles at the base of your pelvis. These muscles support your bladder, bowel, and reproductive organs, but they also help stabilize your hips and spine. One pelvic floor muscle in particular—the obturator internus —sits right next to the piriformis and also runs close to the sciatic nerve. If the obturator externus is tight or in spasm (a common feature of pelvic floor dysfunction), it can irritate the sciatic nerve in the exact same way the piriformis can. Your brain can’t always tell which muscle is doing the irritating—it just feels the nerve reacting. Think of it like a doorbell. It doesn’t matter whether the piriformis or the obturator internus presses on the nerve. The bell rings angrily either way. And in this case, the bell is your sciatic pain. That’s why so many women come to me for women’s pelvic floor dysfunction treatment in Memorial after months—sometimes years—of chasing the wrong diagnosis. How to Tell the Difference: Clues That Point to the Pelvic Floor If piriformis stretches haven’t helped—or seem to make things worse—it may be time to consider another source. Here are some signs your pain might be related to pelvic floor dysfunction instead: Ask yourself: Do you ever feel pelvic pressure or heaviness? Do you have urinary issues like leaking, urgency, or frequency? Is constipation or straining part of your routine? Have you experienced pain with intercourse? Do you notice tailbone or low abdominal discomfort? Do you have a low back or hip pain? These symptoms aren’t typically caused by piriformis syndrome. They may be closely tied to dysfunction in the pelvic floor. Getting to the Root: Why the Proper Diagnosis Matters The body is a connected system. A problem in one muscle often creates symptoms elsewhere. That’s why chasing pain rarely leads to lasting relief. You need a full-body evaluation, not just a local, myopic look. That’s exactly what I do during sessions for women’s pelvic floor dysfunction treatment in Memorial . I assess how your hips, back, core, and pelvic floor are all working together (or not). Sometimes the pain is coming from multiple sources. But more often than people realize, the pelvic floor is the missing piece. Consider consulting a pelvic floor physical therapist. Your Next Step Toward Real Relief If you’ve been stretching, massaging, and guessing your way through sciatic pain with no results, it’s time to try something different. You don’t have to live with chronic buttock pain or vague sciatica that keeps returning. I offer one-on-one sciatica pain physical therapy in Spring Branch that includes a full pelvic floor evaluation when appropriate. My practice is private, and focused entirely on helping you get to the root of your symptoms, not just mask them. Whether you’re recovering from birth, managing pelvic floor changes with age, or simply haven’t gotten real answers yet, women’s pelvic floor dysfunction treatment in Memorial might be the missing link. You deserve a treatment plan that looks at your whole body, not just one muscle. If you're ready for that kind of care, I am here to help.
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By Katie Beckham May 28, 2025
Most men rarely think about their pelvic floor—until something starts to feel off. Whether it's persistent groin pain, frequent trips to the bathroom, discomfort during intimacy, or unexplained lower back or hip pain, these issues are often silently endured and misunderstood. What many don’t realize is that these symptoms may be tied to a condition called pelvic floor dysfunction (PFD) . This condition is more common than most people—and many healthcare providers—realize. Thankfully, with the right care, it’s also highly treatable. What Is Male Pelvic Floor Dysfunction? The pelvic floor is a group of muscles, ligaments, and connective tissue at the base of your pelvis. In men, these muscles support important organs, including the bladder, rectum, and prostate, and are critical for bowel and bladder control, sexual function, and core stability. Pelvic floor dysfunction occurs when these muscles are too tight, too weak, or poorly coordinated . Instead of relaxing properly to allow urination or bowel movements, the muscles stay tense, leading to a wide range of symptoms that may affect everyday life. Common Symptoms in Men Pelvic floor dysfunction can show up differently for each person, but most symptoms fall into one or more of the following categories: Urinary Issues Frequent urge to urinate with little output Hesitation or difficulty starting the urine stream A sensation of incomplete bladder emptying Pain or burning during or after urination Dribbling after urination Bowel Dysfunction Constipation or straining during bowel movements A feeling of incomplete evacuation Pain before, during, or after bowel movements Gas or stool leakage Sexual Dysfunction Pain with arousal or ejaculation Erectile dysfunction or trouble maintaining erections Testicular, penile, or perineal pain Numbness or decreased sensation during sex Musculoskeletal Pain Pain in the perineum, tailbone, or sit bones Lower abdominal or groin pain Hip, lower back, or sacroiliac joint discomfort Tightness in the inner thighs or pelvic muscles These symptoms can be confusing and deeply personal, often leading men to delay seeking help. At Beckham Physical Therapy and Wellness, I frequently work with individuals who have struggled in silence for months or even years. Why the Condition Often Goes Undiagnosed One of the most frustrating realities of male pelvic floor dysfunction is how often it’s misdiagnosed . Many men are treated repeatedly for prostatitis , often with rounds of antibiotics—even when there’s no infection present. Unfortunately, most urologists receive little or no training in pelvic floor disorders during medical school, which means they may not recognize when muscle dysfunction, not infection, is the root cause. In fact, studies show that men with pelvic pain often spend up to seven years seeking an accurate diagnosis. During this time, symptoms may worsen, and quality of life may decline. This is why finding a knowledgeable pelvic floor therapist for men in Bellaire, Texas, is so crucial. What Causes Male Pelvic Floor Dysfunction? The causes of pelvic floor dysfunction can vary. Often, multiple contributing factors are at play. Some of the most common include: Post-surgical trauma (such as prostatectomy or vasectomy) Orthopedic injuries (spine, hip, or pelvic injuries) Excessive exercise or poor lifting mechanics Chronic constipation or habitual straining Long hours of sitting or a sedentary lifestyle Psychological stress, anxiety, or trauma Practices like jelqing or attempts at genital enhancement Not every case is tied to a dramatic event—sometimes, it’s the accumulation of stress, poor posture, or muscular imbalance over time. How Pelvic Floor Physical Therapy Helps The good news? Pelvic floor dysfunction is highly treatable, without surgery or medication. Working with a trained pelvic floor specialist allows men to address the root of the problem, not just the symptoms. As a leading pelvic floor physical therapist in Memorial, Texas , my approach includes: Manual therapy to release tight or spastic muscles Neuromuscular retraining to improve muscle coordination Breathwork and core training to restore pelvic stability Education on bladder/bowel habits, posture, and stress management Personalized exercise programs to support recovery at home I treat each individual holistically, recognizing that the pelvic floor is interconnected with the rest of the body—and that healing often involves addressing emotional and psychological components, too. Why Choose Beckham Physical Therapy and Wellness At Beckham Physical Therapy and Wellness, I specialize in one-on-one pelvic health care for both men and women. My setting in West Memorial is private, welcoming, and designed to put patients at ease. Many of my male clients tell me it’s the first time they’ve felt truly heard and understood. I’m proud to be a trusted pelvic floor therapist for men in Bellaire, Texas , offering: Over 40 years of clinical experience More than 15 years dedicated exclusively to pelvic health Gentle, evidence-based techniques Individualized treatment plans in a relaxed home-based setting And while this blog focuses on men’s health, I also offer expert care from a pelvic floor physical therapist for women in Memorial, TX , addressing conditions such as postpartum recovery, incontinence, pelvic organ prolapse, intercourse pain, endometriosis, and more. Whether you're navigating new symptoms or have been searching for answers for years, I am here to support your journey. Take the First Step Toward Relief If you’re experiencing pelvic pain, urinary urgency, bowel issues, or sexual discomfort, you’re not alone—and you don’t have to keep guessing. These are treatable conditions, and recovery is absolutely possible. Connect with a compassionate, experienced pelvic floor physical therapist in Memorial, Texas, who understands the unique challenges men face. At Beckham Physical Therapy and Wellness, I’m here to help you get back to living fully and comfortably. Relief begins with the right support. Schedule your consultation today.
By Katie Beckham February 24, 2025
HOUSTON – The pelvic floor is a set of muscles that works as a support system for the organs of the pelvis, including the bladder and the uterus. As those muscles weaken, the organs can fall south. However, new therapies allow for physical therapists to teach patients how to strengthen the pelvic floor muscles and eliminate a lot of problems. During a consultation for pelvic floor physical therapy, Katie Beckham, Houston Methodist West Hospital pelvic floor physical therapist, tells women how it works. She said weakening or over-tightening of the pelvic floor can happen after having children, after cancer treatments or simply with age. “One of the biggest mistakes people make, trying to pull up and exercise the pelvic floor but they’re holding their breath,” Beckham explained. ‘Then we perform the activity like picking up our grandchild carrier seat, we have to let that pressure out somewhere or we’re going to dribble.” Lacking support in the pelvic floor can lead to lower back pain, urine urgency or difficulty emptying the bladder. “A physical therapist that specializes in this, teaches a patient how to maintain its proper pressures, how to use body mechanics properly, how to strengthen the pelvic floor muscles, how to let them go, how to let things in and out,” Beckham said. Beckham teaches that by showing patients which lower ab muscles to strengthen. “Tightening two big sets of muscles, the lower abs, which I teach as skinny jeans,” she explained. “So, if you want to put on a pair of size 2 jeans and you really need a 12, you’re going to have to hollow out your belly, you’re going to have to pull your belly button towards your spine.” Showing patients with an internal exam is an option. Although maybe awkward, Beckham said it leads to fast, positive results. “Then the other big set, I teach it like an elevator, it’s the pelvic floor muscles, those are the muscles that shore up and close the opening to the urethra in the vagina and the rectum. So, we want to pull those up, it’s as if I had an exam finger in your vagina and I asked you to close the door of the elevator and pull the elevator up into your belly.” This kind of physical therapy can take anywhere from three weeks to three months. There are pelvic floor physical therapists at Texas Children’s Pavilion for Women, The Woman’s Hospital of Texas and these locations for Houston Methodist.