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 characterised by pain deep within the front of the pubic bone. 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?
Reduced stability within the pelvic region is the primary cause of Osteitis Pubis. The two sides of the pelvis connect together at the front in a vertical joint called the pubic symphysis. This joint is designed to be very stable with very little movement. It can be susceptible to vertical shear forces when you walk, run, or take load from one leg to the other, if our pelvic muscles lack the strength or co-ordination to secure the joint firmly together. This can mean 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.
How can Physio help?
Your physio can help this condition in several ways and will hopefully 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 functional muscle control will all be assessed. Your posture in standing, walking and running will also be assessed to determine any irregularities. Many factors can contribute to your pelvic stability including your core strength, your gluteal muscle strength, your foot control, your hip mobility and even the symmetry in your upper body can impact your pelvis! This is why it’s important to have a thorough assessment to determine the causes that might be impacting you specifically.
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 to help provide aimed at getting you back to the sport. Your rehab should include both core stability training as well as functional gluteal and adductor strength.
Watch here for some of our favourite functional gluteal strengthening exercises!
Did you know that many people get their core stability exercises wrong? Watch this video here to understand the common errors to avoid.