What we check
- Pubic symphysis tenderness and tolerance to gentle load
- Sacroiliac joint motion on each side and how they compare
- Pelvic rotation, shift, and side-to-side symmetry
- Adductor, glute, and deep hip muscle tension and guarding
- Webster analysis of pelvic muscle and ligament balance
- Single-leg loading tolerance and which movements provoke pain
- Whether pelvic floor physical therapy referral is warranted
- INSiGHT nervous system scan findings
What to expect
We'll get you comfortable before we do anything, including how you get onto the table. The exam focuses on your pelvic joints individually and how they behave together, plus the muscles gripping around them. After an INSiGHT nervous system scan, if care is appropriate that day, you'll receive low-force adjusting and hands-on soft-tissue work with your knees supported throughout. You'll leave with a short, specific list of movement changes for the highest-pain moments of your day, and a recommendation on whether pelvic floor physical therapy should be part of your plan.
Book a first visitWhat SPD and Pelvic Girdle Pain Mean
Your pelvis is three bones meeting at three joints: two sacroiliac joints in back and the pubic symphysis in front. Those joints barely move by design, but pregnancy hormones deliberately loosen the ligaments holding them, because the pelvis has to give during birth.
- When loosening outpaces your ability to stabilize, the joints move more than they should and surrounding tissue becomes irritated
- Pain at the front joint is often called pubic symphysis dysfunction (SPD)
- When the back joints are involved too — and they usually are — the whole picture is called pelvic girdle pain
- The hallmark is asymmetrical loading: stairs, stepping into the car, rolling in bed, putting on pants, pushing a cart with one hip leading
- Some women describe a click or grinding; many describe the front of the pelvis feeling bruised from the inside
Why It Can Escalate Quickly
Pelvic girdle pain tends to snowball, and the snowball is mostly mechanical.
- The joint gets irritated, so you brace
- Bracing means gripping through the hips, glutes, adductors, and pelvic floor, all day
- Gripped muscles pull on the same joints that are already irritated
- You move less, so the muscles that would actually stabilize you weaken and the joints get less support
- Then week 30 arrives with another five pounds
- Breaking that loop is the whole job: take stress off the joints, get the gripping muscles to let go, change the movements re-provoking it
- That is mechanical work, not disease treatment — we assess and ease mechanical stress, and we don’t claim to treat SPD as a condition
How We Assess Pelvic Pain in Pregnancy
This exam is careful and specific.
- How the two sacroiliac joints move relative to each other, and how the pubic symphysis tolerates gentle load
- Whether one side of the pelvis sits rotated or shifted compared to the other
- The muscles attaching into it all — adductors, glutes, hip flexors, deep hip rotators — which are almost always part of the story here
- Dr. Tori is Webster Certified through the ICPA: a specific sacral analysis and adjustment intended to balance the muscles and ligaments of the pregnant pelvis
- Webster is directly relevant here, because unequal ligament and muscle tension across the pelvis is exactly what drives the uneven loading
- An INSiGHT nervous system scan, since weeks of guarding a painful pelvis shows up as nervous system tension and tells us how gently to start
- Pelvic floor physical therapy is often a strong partner to chiropractic — a pelvic floor gripping for months needs its own attention, and that isn’t our scope. If you don’t have a pelvic floor PT, we’ll point you toward one.
Care Modified for a Sore, Loose Pelvis
Two sets of modifications apply, both important with SPD.
- Pregnancy modifications: side-lying and belly-supported positioning, never face down, low-force techniques only
- SPD modifications: knees kept together and legs supported during position changes, because one-leg-unsupported movement is what hurts most
- Getting on and off the table is often the worst part of a visit with SPD, so we choreograph it
- Alongside adjusting, we work the adductors, glutes, and deep hip muscles that have been gripping
- The daily list: sit down to put on pants; squeeze a pillow between your knees when you roll in bed; take stairs one at a time leading with the same leg; keep knees together getting into the car and swivel; skip lunges and wide-legged anything
- A support belt worn correctly helps many women considerably
- None of that is complicated — it’s just consistent
What Progress Looks Like
Improvement usually shows up in function before it shows up in pain scores.
- One wake-up in the night instead of five
- Stairs stop being an event
- Standing at the kitchen counter for the length of dinner prep
- Speed depends on how far along you are and how long this has been building
- Late third trimester we’re often managing rather than resolving — the ligaments are as loose as they’re going to get, and that’s biology doing its job
- Managing well still matters a great deal for how the rest of your pregnancy feels
- Pelvic girdle pain often persists into the early postpartum months, so we’ll talk about how care continues after birth
See a medical provider right away if you notice
- Inability to bear weight on one leg, or pain so severe you can't walk — needs medical evaluation promptly
- Vaginal bleeding or leaking fluid — call your OB or midwife immediately
- Regular contractions or tightening before 37 weeks — call your OB or midwife right away
- Fever with pelvic pain — seek same-day medical care
- Burning with urination, blood in your urine, or flank pain — possible urinary or kidney infection; call your provider today
- New numbness in the groin or saddle area, or loss of bowel or bladder control — go to the emergency department
- Calf pain, swelling, or warmth in one leg — possible blood clot; urgent care same day
- Decreased fetal movement, or severe headache with vision changes or sudden swelling — contact your OB or midwife immediately
Common questions
Can chiropractic treat SPD?
We don't frame it that way. What we do is assess where your pelvis is loading unevenly and where muscles are gripping, then work to ease that mechanical stress. Many women report they move and sleep better. Care is often most effective alongside pelvic floor physical therapy.
Is adjusting safe when my pelvis feels unstable?
The techniques used are low-force and specific — not forceful moves through a loose joint. We also position you with your knees supported so getting on and off the table doesn't provoke the front joint. If something isn't tolerable, we change it.
Will it go away after I deliver?
For many women it improves substantially in the first weeks to months as hormone levels and load change. Some need continued work postpartum, especially around the pelvic floor and deep core. We see plenty of women for exactly that.
Should I be wearing a support belt?
Often it helps, and it's inexpensive to try. Placement matters more than people realize — too high and it does nothing, too tight and it creates new problems. We'll show you where it should sit.
Should I keep exercising?
Usually yes, with the movements changed. Symmetrical, supported movement tends to be fine. Wide-legged, single-leg, and deep-range work tends not to be. Clear the specifics with your OB or midwife and your pelvic floor PT.
This page is educational and is not medical advice, diagnosis, or treatment. Chiropractic care does not treat or cure disease; it supports the function of the nervous system and spine. Please speak with your pediatrician or a licensed clinician about your family's specific situation, and seek immediate care for any urgent symptom.