Osteitis Pubis and Groin Pain - An Introduction

Whilst osteitis pubis can be the result a direct impact, normally it is caused by overuse through repetitive strain. Sports people who are most at risk of developing osteitis pubis are footballers, distance runners, weight lifters and dancers. It occurs either because the sportsmen have anatomical abnormalities (structural or functional) or through overtraining. A common factor amongst those who suffer from osteitis pubis is tight and inflexible muscles such as the adductors.

The most recognisable symptom of osteitis pubis is pain and tenderness at the front and centre of the pubic bone. The pain can be either sharp or dull and may also refer into the lower abdomen, the groin or even the thigh. Normally the onset of pain is gradual and is often aggravated by performing twisting/turning exercises, or for football players, kicking a ball. The general consensus is that osteitis pubis is the result of instability of the pelvic bones, in particular, the pubic symphysis. Any instability is enhanced when uneven forces are transferred through the pelvis through activities as kicking and running.

A suitably trained health care professional will diagnose osteitis pubis by assessing pain levels over the pubic symphysis and pubic ramus through palpation. Resisted contraction of the adductors muscles will also generate pain. Bone scans may indicate erosion and cysts of the pubic symphysis in advanced cases of osteitis pubis.

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Treatment of Osteitis Pubis
(Please note: to guarantee correct diagnosis and treatment it is advisable to consult a sports injury professional at the earliest possible opportunity to ensure the recovery time and the risk of long term damage is minimised)

The treatment for osteitis pubis is identical to any soft tissue injury at the time of the injury, namely Rest, Ice, Compression and Elevation. At the first symptoms the groin should be rested straightaway as movement of the symphysis will only exacerbate the condition and increase inflammation. Ice should be applied to reduce inflammation and pain (please note: never place ice directly on the skin and only apply for a maximum of 15 minutes at any one time). The application of ice should continue for 48-72 hours.

After the inflammation and pain begins to subside then normally the next stage of the treatment is to applying heat to increase the blood supply to the area and to begin gentle stretching of the adductors so long as stretching does not cause any pain. This will assist in reducing the forces on the pubic symphysis.

Mild stretching exercises can be performed to lengthen muscles around the groin and hips. This will reduce some of the force on the pubic symphysis due to tight muscles. A sport injury practitioner will use a number of techniques to mobilise and stretch relevant tissues and structures. Massage to the adductors and hip flexors may also be of benefit at this time.

Rehabilitation from osteitis pubis is usually results in modifying the activities that caused the condition in the first place. A suitably designed flexibility and strengthening exercise program should address any functional or structural abnormalities that increase the likelihood of osteitis pubis returning.

Early detection, rest and treatment of osteitis pubis is essential for ensuring that a sportsman can continue performing his sport. Carrying on through the pain is a recipe for long term damage which may ultimately mean the end of a potentially promising career.

Please note: if you are suffering from this condition (or think you may be) then you should consult your health care practitioner. The advice given here is only of a general nature and specific cases require specific treatment. Inner West Massage accepts no responsibility.

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