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.
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.

How does it happen?
Instability around 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 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 may 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.

How can Physio help?
Your physiotherapist can help this condition in several ways and will aim to get you back to your pre-injury sporting level.

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 can 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 rehabilitation program aimed at getting you back to sport.
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This rehab program will retrain your muscles to stabilise 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.