Osteitis pubis (aka athletic pubalgia) is a common sports overuse injury. It tends to occur in physical sports such as football, rugby and hockey and in conjunction with abnormal muscle forces acting on the pubic symphasis.
The pubic symphysis is a stiff joint between the two halves of the pelvis at the front of groin. The adductor muscles, as well as the abdominal muscles, attach at this joint. Imbalances between abdominal and adductor muscle groups can disrupt the equilibrium of forces around the symphysis pubis, predisposing the athlete to chronic microtrauma and pain.
Pain can also be caused by a sudden shear force on a weakened symphysis joint, such as a sudden sprint or kick.
Commonly caused by activities which combine high running loads, rapid changes in direction and kicking.
What do I feel?
- Aching in pubic and upper inner thigh region, often worse after activity.
- Sharp pain with sprinting and kicking;
- Pain may be present with coughing and sneezing;
- Tenderness in the front of the groin is usually present and often pain can be experienced when legs are squeezed together.
What can I do?
- Reduce activity until pain free (usually two to four weeks). Particularly, reducing loading and impact activities like running, jumping and lunging;
- Take pain medications regularly as prescribed by your health professional;
- Compression garments may help reduce discomfort during rest and rehabilitation;
It is recommended that through liaison with your physiotherapist that you engage in an active rehabilitation programme with to strengthen and stabilize the groin. The main aim of rehabilitation would be to address any muscle imbalances that would have led to this condition. As with any muscle rehabilitation, strengthening can take up to 12 weeks to make a significant effect and therefore recovery from this type of injury can be longer than most.
Osteitis pubis is usually a chronic condition which can develop slowly over a period of time.. The groin may therefore take a while to heal, but be patient, continue to do your exercises, and follow guidance from your physiotherapist.
Return to full sport usually takes three to nine months. It is essential that the injury is managed appropriately and that you are committed to completing the rehabilitation programme to ensure a full recovery.
This information is intended as a guide only. For specific information regarding injury assessment and management, you should always consult your health professional.