Osteitis pubis is a term given to lower abdominal and / or pelvis pain that can occur in athletes.
It is an inflammation which is usually caused due to stress or overuse of the soft tissue and bone around the pubic symphysis. Typically, it causes pain towards the middle of the pelvis, at the front. This is also known as “pubic bone stress injury”.
The pubic symphysis, is the joint that connects the right and left halves of the pelvis and also has several muscle groups like the lower abdominal muscles and the hip abductor muscles linked to this area.
Due to the inflammation caused, the most common symptom when it comes to this condition is that of pain. As this weakens the muscles around the area, everyday movement can get restricted. The pain would intensify if you apply pressure to the area.
The common symptoms you will witness are:
- The inflammation could cause a dull, constant pain while you are sitting
- The pain would seem to originate from the center of your pelvis area and be radiating in an outward direction. You may also witness lower abdominal pain again originating from the pelvic area.
- Pain with running, twisting, turning, kicking and lying on your side.
- You may also feel pain while walking, climbing stairs, coughing, or sneezing. While walking, the pain could be so severe that it could impact your gait. People who suffer with osteitis pubis may seem to walk with a waddle to minimize the pain.
- Some even sense a click and a pop when shifting positions.
Primary cases of Osteitis Pubis
There are, undoubtedly, some cases of osteitis pubis that are “primary”. That is, they are not caused by something else.
In many cases, in athletes and sportsmen and women, it seems that the “stress” is coming from the many muscles and tendons that insert into the pubic bone at the front (the pubic tubercle). It is often seen as part of the symptoms of a “groin disruption” (also known as sportsman groin or Gilmore’s Groin). In these cases, it is the muscles pulling hard on the pubic tubercle at the front of the pelvis that causes the pubic symphysis to pull apart and become frayed. The muscles pull so hard that they tear off their normal attachments causing a groin disruption (sometimes referred to as being like a muscle dislocation).
These cases can be particularly difficult to treat.
Treatment may include non-steroidal anti-inflammatory painkillers, also “bisphosphonates” which directly affect the bone and can sometimes help. Also injecting steroids or platelet rich plasma in the area where there is pain.
In these cases, treating the symptoms will not cure the problem; the groin disruption needs to be repaired. Repairing the muscles in an anatomical fashion restores the normal structure and function of the groin and can cure the symptoms.
After surgery it is important to undergo thorough rehabilitation and to continue with exercises that strengthen the core muscle and reduce the risk of any further problems in future.