Non-surgical Rehabilitation of Postpartum Pubic Symphysis Diastasis: A Rare Orthopaedic Case
Olubunmi Joy Olabode
Department of Human Kinetics and Health Education, Tai Solarin University of Education, Ijagun, Ogun State, Nigeria.
Patrick Chinazam Nwosu
Rehabilitation and Quality Department, San Remo Nursing and Rehabilitation Center, 3550 Shiloh Road, Garland, Texas, United States.
Cyril Ifeanyichukwu Ezugwu
Emergency Department, Ahad Al-Masaraha General Hospital, Jizan Region, Kingdom of Saudi Arabia.
Kirean Kelechi Eze
Emergency Department, Turaif General Hospital, Turaif, Northern Border, Kingdom of Saudi Arabia.
Chika Blessing Maduka
Caritas Aba, Abia State, Nigeria.
Gabriel Dogbanya
Department of Family Science, University of Maryland College Park, United States.
Uchechukwu Bethel Abioke
*
Department of Physiotherapy, Basic Medical Sciences, University of Benin, Nigeria.
Nneoma Hannah Akobundu
Department of Physiotherapy, Basic Medical Sciences, University of Benin, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Pubic Symphysis Diastasis (PSD) is a rare complication of childbirth, with an estimated incidence of 1 in 30,000 women. It is characterized by abnormal separation of the pubic symphysis joint beyond physiological limits. If left untreated, PSD can progress to chronic pain, gait disturbance, and long-term functional disability.
Case Study: A 36-year-old multiparous woman with no significant medical history presented with severe pelvic pain (NPRS 8/10), waddling gait, and inability to walk within hours of vaginal delivery. These findings raised concern for a traumatic event during childbirth. Radiological evaluation confirmed pubic symphysis diastasis with a 12 mm gap. Following initial medical management, she underwent an eight session structured physiotherapy rehabilitation program.
Interventions included transcutaneous electrical nerve stimulation (TENS), cryotherapy to the suprapubic region, transversus abdominis activation, pelvic belt application, progressive strengthening exercises, and functional retraining. Outcome measures such as the Numerical Pain Rating Scale (NPRS) and Pelvic Girdle Questionnaire (PGQ) demonstrated significant improvements in pain, mobility, independence, and activity participation.
Conclusion: This case underscores the importance of early conservative intervention in restoring function and improving quality of life in postpartum PSD. It further highlights the essential role of physiotherapists in postpartum rehabilitation, offering an effective non-surgical alternative to optimize recovery.
Keywords: Postpartum, pubic symphysis diastasis, orthopaedic diastasis, medical management, anatomical adaptations, intramuscular injection