Osteitis pubis, often referred to as groin strain, is a painful debilitating condition. While anyone can experience osteitis pubis, two groups of people are susceptible for different reasons. In athletes, particularly footballers in all codes, hockey players and runners, osteitis pubis is usually an overuse injury. In pregnant women about to engage in one of humankind’s peak endurance events, it’s a consequence of the softening of pelvic and other ligaments in preparation for childbirth.
What is osteitis pubis?
Osteitis pubis is a painful inflammation of the pubic symphysis and the ligaments attached to it. The pubic symphysis is a thin joint that joins the two halves of your pelvis. The pelvic bones form a ring with the pubic symphysis at the front and sacro-iliac joints at the back.
A healthy, correctly aligned pubis symphysis hardly moves at all. In osteitis pubis and other forms of groin strain, an x-ray will usually show that your pubis symphysis is misaligned and more mobile than it should be.
What causes osteitis pubis?
Osteitis pubis is most common in sports that involve twisting, kicking and sprinting and other sudden changes of pace and direction. While it is essentially an overuse injury, a single incident can trigger the pain.
In pregnant and postpartum women osteitis pubis is a consequence of hormone Relaxin’s loosening of pelvic and hip joint ligaments. The stability of the pubic symphysis and sacro-iliac joints are particularly affected by Relaxin’s essential role in preparing the body to deliver a baby. Furthermore, a rigorous labour can also contribute to displacing the pubic symphysis.
Surgery or injuries to your back or pelvis can also trigger osteitis pubis.
What are the symptoms of osteitis pubis?
Not all groin strains are caused by osteitis pubis. However, a feeling of ‘groin strain’ aptly describes its most striking symptom. Central or one-sided pain in the groin or the lower stomach is common. The area in front of your pelvic bone can feel tender and sore to touch. You might feel ‘lopsided’ or weak and hear or feel a ‘click’ in your pelvic area. You could also develop a limp or being to have difficulty standing or walking.
Physiotherapy for osteitis pubis
Our physiotherapists aim to relieve the pain and address the causes of osteitis pubis by focusing on:
- Realigning your spine and your pelvis to aim to restore your normal mobility range of movement
- Strengthening and stretching your muscles to help restore balance and flexibility
- Improving your posture to support healthy functioning of all your body’s systems
- Correcting sport-specific form and technique to help protect and improve your performance
- Tailoring a rehabilitation program to support you to make a speedy, safe return to your sporting and other activities
All musculoskeletal injuries, including osteitis pubis, can have complex causes. Our care pathway begins with a complete case history and a thorough biomechanical assessment designed to pinpoint any and all possible reasons why your osteitis pubis or groin strain occurred in the first place.
Recovering from osteitis pubis
Being sidelined by osteitis pubis can be tough physically and psychologically. We support athletes of all levels and pregnant and postpartum women to stay fit and focused for the two to three months it typically takes to make a full recovery.
- Helping relieve pain with dry needling, and demonstrating how to rest, ice, compress and elevate (RICE) correctly.
- Setting and supervising exercise programs that aim to stabilise and strengthen all the relevant muscle groups including, pelvic floor muscles, abdominals, glutes, hip adductors and latissimus dorsi
- Building fitness programs around swimming or cycling help retain cardiovascular fitness and reduce stress without impacting the pubic symphysis
- Retraining to correct flawed techniques that can undermine recovery and limit athletic performance
“Osteitis Pubis can be quite debilitating and frustrating to deal with without the right help. Whether it’s stopping you from performing at your best in sports or it’s making it difficult for you to look after your newborn, there is no need to put up with the pain. We are here to help you overcome this with the right treatment and exercises”
– Caroline Sui – Women’s Health and Musculoskeletal Consultant of The Brisbane Spine Clinic