Osteitis Pubis (Inflammation of the pubic bone)

What is Osteitis Pubis?

Osteitis Pubis is inflammation of the joint where the pubic bone meets at the front. Pain can radiate around the groin but will be significant at the point in the middle of the groin at the front. It is caused mainly by overuse (one of my clients with this one used to run up hills with big bags of coal on his shoulders), or it can be caused as a result of direct impact.

Osteitis Pubis is not a common condition and is sometimes used as an umbrella term for long standing groin pain. It is most frequent in sports such as soccer and hockey as well as during pregnancy.

Symptoms include:

• Groin pain when running, doing sit-ups and squatting.
• Groin pain may develop gradually and be mistaken for a muscle strain.
• In bad cases you may walk with a waddling gait.
• An X-ray may demonstrate an irregular pubic symphesis (joint between the two pubic bones) with signs of bone thickening and inflammation.

What can the athlete do about it?

• See a specialist or doctor to confirm diagnosis and rule out a hernia.
• Rest is unfortunately the only form of treatment for this groin pain injury.
• In most cases you will rest for only a few days but bad ones might require up to 3 months of complete rest.
• See a sports injury professional who can advise on rehabilitation.

What can a sports injury specialist or doctor do?

• Prescribe anti-inflammatory medication e.g. ibuprofen. Always consult a Doctor before taking any medication.
• Advise on a rest period depending on how bad it is.
• Prescribe a rehabilitation programme such as the one below.
• Administer a corticosteroid injection

Rehabilitation of Osteitis Pubis

• Early stages (day 1 - improvement in daily pain): Rest, use cold therapy, Ultrasound, Anti-inflammatory medication (e.g. ibuprofen)
• Mid stages (improvement in daily pain - pain free daily activities): Adductor stretching if it is not painful. Hold for 30 sec's, repeat 5 times a day.
• Later stages (Pain free daily activities - onwards): If it is not painful, stomach crunches (3 sets of 10 reps a day), dorsal raises (3 sets of 10 per day), adductor exercises, abductor exercises, hip flexor exercises, also 3 sets of 10 per day. Gradually start doing more sports specific training.

If in doubt get advice from a sports injury specialist or medical professional as osteitis pubis can take months to recover sometimes.