Osteitis Pubis

Osteitis pubis, also known now as pubic bone Stress injury results in groin pain originating from the pubic bones at the front of the pelvis.

Osteitis pubis symptoms

Osteitis pubis symptoms involve pain in the groin or pelvis area when running, doing sit-ups or squatting exercises. Pain may develop gradually and often be mistaken for a muscle strain or groin strain. In severe cases the athlete may begin to walk with a waddling gait. An X-ray may show an irregular pubic symphesis which is the joint between the two pubic bones at the front of the pelvis. There may be signs of bone thickening and inflammation.

Osteitis pubis explained

Osteitis Pubis has previously been thought to be an inflammation of the joint where the pubic bones meets at the front. This is now thought not to be the case as investigations have shown no inflammation to be present. For this reason, as 'itis' refers to inflammation, it is now more accurately known as Pubic Bone Stress Injury.

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.

Treatment of osteitis pubis 

What can the athlete do?  

See a specialist or doctor to confirm diagnosis and rule out a hernia. See our expert interview with Surgeon Mr Simon Marsh on pubic bone stress injury. 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 do?

A doctor may prescribe anti-inflammatory medication e.g. ibuprofen. Always consult a Doctor before taking any medication. They will advise on a rest period depending on how bad the injury is and prescribe a rehabilitation program. In some cases they may also administer a corticosteroid injection

Rehabilitation of pubic bone stress injury

Early stages - Rest and use cold therapy. Anti inflammatory medication and ultrasound may also be prescribed.

Mid stages - Adductor stretching if it is not painful. Hold for 30 seconds, repeat 5 times a day.

Later stages - If it is not painful, stomach crunches (3 sets of 10 reps a day). Dorsal raises (3 sets of 10 per day). Adductor exercises (3 sets of 10 per day). Abductor exercises (3 sets of 10 per day). Hip flexor exercises (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.