Osteitis pubis in athletes
Osteitis pubis is a condition that affects the symphysis pubis (the joint between the pubic bones). The joint is affected by stress and shearing forces and this causes inflammation in the joint.
- Osteitis pubis usually causes pain in the groin, lower abdomen and inner thigh area.
- The pain is often related to exercise, and is frequently made worse by certain activities, such as running, pivoting or kicking across the body.
- Usually the pain comes on gradually, and its onset is often associated with an increase in training.
Osteitis pubis is generally thought to be the result of repetitive stress or shearing on the symphysis pubis and the tendons which attach to it.
It commonly occurs as an overuse injury in weight-bearing and kicking sports such as running and football.
The same condition can occur in pregnant women, due to stretching of the pelvis.
If you suspect that you have osteitis pubis you should seek medical attention so that an accurate diagnosis can be made. Sometimes groin pain may be due to other conditions, which may include hip damage, so it is important to have it investigated, as accurate diagnosis allows appropriate treatment.
The diagnosis of osteitis pubis first involves the doctor taking a history of the mechanism of the injury, symptoms and performing a clinical examination.
X-rays may show some abnormalities but they can also be normal, especially early on in the disorder. A bone scan or magnetic resonance imaging (MRI) scan will confirm the inflammation at the symphysis pubis.
In the acute (short-term) stage, treatment may include the use of ice and an anti-inflammatory medicine to help reduce the inflammation. It will also usually involve rest from activities that produce the pain, and possibly may involve the use of a sacral belt, if the underlying cause is due to increased mobility of the joints of the pelvis.
The mainstay of treatment is physiotherapy along with exercise rehabilitation of the muscles of the groin and lower abdomen. Your doctor will advise you as to the most appropriate treatment.
Time out from sport will vary depending on the severity of the injury, but may range from 3 months to 12 months. Women generally take longer to recover than men. Very rarely, surgery may be required if the usual treatment is not effective.
Last Reviewed: 19/10/2015
Hiti CJ, Stevens KJ, Jamati MK, Garza D, Matheson GO. Athletic osteitis pubis. Sports Medicine 2011; 41 (5): 361-76.
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