Osteitis Pubis And The Athlete

Osteitis Pubis As A Common Cause Of Chronic Groin Pain In Athletes

Osteitis Pubis is a fairly common cause of chronic groin pain experienced across the football codes and running athletes. It is an overuse injury caused by repetitive stress rather than a specific trauma. Anatomically the pubic bone, is one of three bones that make up the wing of each side of the pelvis, with the other two bones making up the pelvic “wing” including the ischium and ilium. The joint where the pubic bones meet at the front of the pelvis as can be seen in the image below is called the pubic symphysis. Repeated kicking, running, jumping stress loading this area in the athlete may lead to the development of osteitis pubis.

Potential Causes Of Osteitis Pubis

Osteitis pubis generally affects individuals who are very physically active. Being particularly common, but not exclusively experienced amongst soccer players. Repetitive running, kicking, jumping… can put strain on the front of the pelvis, stressing the pubic symphysis and it is therefore easy to see why soccer players are a population of athletes often impacted by osteitis pubis.
Other potential causes may include:

• Childbirth
• Injury to the pelvis
• Prior surgery in the pelvic region

However, although non-repetitive loading triggers like child birth are documented as potential causes it is generally thought to be the product of repetitive shearing stress exerted on the pubic symphysis (again see figure above) and the local soft tissues. Asymmetrical loads placed through the pelvis such as occur with running and kicking in the presence of instability of the pelvic bones, in particular the pubic symphysis can cause osteitis pubis. Actions that are normally handled well in the stable pelvis, are capable of causing irritation and injury when the same forces are applied to a pelvis where there is lumbopelvic instability present.

Possible Symptoms Experienced Include:

As with most conditions the presentation is mixed from one individual to the next and each athlete may have a different experience regarding symptoms and symptoms severity. Some of the potential symptoms associated with osteitis pubis include: 

• With osteitis pubis any pain is usually experienced in the groin region and lower abdomen and there may be tenderness with palpation and pressure applied to pubic bone area.
• The pain is often felt to be related to exercise and frequently made worse with activities, such as kicking, running and pivoting.
• The onset of pain is generally gradual and not uncommon to be associated with a rapid or progressive increase in training load. Although gradual in onset the pain may become constant and progress to the stage that can even cause walking to be uncomfortable.
• Seeing as the condition is considered to be related to functional instability in the pelvis it isn’t uncommon for the individual to have a history of other ailments such as lower back pain, groin strains or hernias either concurrently or a recent past history of such complaints.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Osteitis Pubis And The Athlete should consult his or her general practitioner, sports medicine specialist, personal trainer or physiotherapist.