What is Osteitis Pubis?
Osteitis Pubis is a medical term used to describe sports-related groin pain. Osteitis means ‘bone inflammation’, while pubis refers to the specific bone that is affected: the pubic bone. Osteitis pubis is usually an overuse injury that can sometimes be triggered by a specific event. It is characterized by pain deep within the front of the pubic bone, caused by inflammation. The area of the pubic bone affected is specifically known as the ‘pubic symphysis. There are a lot of muscles, tendons, joints and ligaments in this region around the pubic symphysis that interact with each other. Therefore the causes of osteitis pubis or groin pain can be multi-factorial and have mutliple structure involved.
This type of injury is common in load-bearing athletes such as runners. Other people commonly affected include soccer players and footballers, due to their frequent kicking actions.
Chronic groin pain is an often debilitating condition and one for which the recovery is rarely smooth. One of the biggest challenges when dealing with (research would suggest this occurs in over 40% of cases) meaning getting a clear answer or diagnosis can sometimes be difficult.
How does it happen?
Instability within the pelvic region is the primary cause of Osteitis Pubis, particularly if the instability occurs at the connection between the two sides of the pubic bones at the front of the body. The pelvis carries the weight of the upper body and is responsible for providing stability when walking, running and kicking. This means that the joint can easily become irritated and inflamed.
What are the signs and symptoms?
Osteitis pubis is aggravated by weight-bearing activities, with running and kicking being the two main culprits. Pain is usually experienced on one side, however, both sides can be affected. The pain is usually located at the front of the pelvis and may progress into the hip and groin area as it becomes more severe.
Sufferers of Osteitis Pubis tend to have a history of a previous groin strain, as well as lower back pain. They may also have a history of a sports hernia in the hip area. As with most inflammatory conditions, the pain may be worse when in use, better when resting, and worse overnight into the morning.
During the assessment, your physio will look at many different things to determine the cause of the condition. Muscle length, muscle strength and muscle control will all be assessed. Your posture in standing, walking and running will also be assessed to determine any irregularities.
Your physio will ask you to rest from sports for some time to allow some bony healing to occur. They will then progress you through a rehab program aimed at getting you back to the sport.
This rehab program, based on strengthening the core muscles, will retrain your muscles to stabilize the pelvis when walking, running and kicking. The muscles will also need to have relatively equal flexibility to help stabilize the pelvis. Your physio will give you specific exercises to target the strength and flexibility of these muscles. Finally, your physio will progress you to running or kicking, and allow you to gradually return to sport over a 3-to-6-month period.
The information in this blog is not a replacement for proper medical advice. Always see a medical professional for an assessment of your condition.