Osteitis Pubis

Orthopaedic & Spine Center

 

Boyd W. Haynes III, MD

Pelvic disorders and overuse injuries aren’t as common as a hip or knee injury, but can be seriously detrimental to an athlete’s well being. The pelvis is made up of three bones, two of which connect at the front of the pelvic girdle at a point known as the pubic symphysis. The pubic symphysis is made up of cartilage, which helps to absorb strong forces between the two bones that connect at the front of the pelvis. When the muscles surrounding the public symphysis contract, a pulling force can be exerted on the area. When these muscles are overused, damage and inflammation may occur in the pubic symphysis, creating a condition called osteitis pubis.

Osteitis pubis usually occurs from repetitively doing a physical activity or activities that place heavy strain on the pelvic area. Runners who go long distances and athletes who play sports that involve changing directions at a quick, sharp angle are likely to develop this condition. Doing repetitive abdominal exercises can also cause pain in the pubic symphysis.

What are the risk factors?

  • Poor posture
  • Muscle weakness
  • Rapid increase in exercise intensity
  • Exercising on hard surfaces
  • Flat feet
  • Wearing inappropriate shoes when exercising
  • Tight muscles in the hip, groin, and buttocks 
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Typically, groin pain will develop over time, and it can be either a sharp pain or dull ache.  Pain can be experienced on either side of the groin, as well as around the hips and abdominals. In some cases, patients may only feel pain following physical activity. If left untreated, the condition may cause a patient to limp because of the severity of the pain.

When an athlete comes to my office for a consultation, I perform a physical examination and ask many questions about onset, severity, what helps the pain, what makes it worse, etc.  I will order x-rays to rule out arthritis and other boney issues.  I may also order an MRI (Magnetic Resonance Imaging) scan to accurately diagnose the cause of the groin pain and view the severity of the condition.

Treatment of osteitis pubis is very dependent on the athlete’s ability to be patient and follow the treatment plan closely; however, most athletes have a difficult time with resting. Rest is vital to recovery from this condition, and all activities that cause pain should be stopped until the athlete has recuperated. Activities that place heavy stress on the groin such as running, sports that involve kicking, and abdominal exercises should be minimized as well. By giving the body a break, this will allow the tissues time to heal without interruption.

If there are activities that do not cause pain or stress on the pelvis, they may be continued with caution. Applying ice to the area several times during the day and anti-inflammatory medications (NSAIDS) can reduce pain and inflammation of the affected area. Physical Therapy can help strengthen the abdominal and pelvic area to prevent future injury.

Returning to physical activity and sports should be done very gradually. Patients should not jump into physical activity without having been cleared to do so by me.  Unfortunately, this happens too frequently when the athlete dives back into sports, “relapses” and the pain returns.

If you are an athlete, an ounce of prevention is worth a pound of cure, so heed the following:

  • Wear appropriate footwear when exercising. This will keep the hips stable and support them during physical activity.
  • Warm up before exercising. This will prepare the muscles and joints of the body for activity.
  • Strengthen the muscles around the pelvis. Abdominal and flexibility exercises are helpful in keeping this area in good condition.
  • Drink water during and after exercise. Hydration is very important to keep your body functioning optimally.

 

 

Make an appointment with Dr. Haynes or another OSC provider by clicking the “Request Appointment” button below or by calling (757) 596-1900.