Osteitis Pubis is a debilitating condition common in athletes, especially in running and kicking sports. It affects an area of the groin called the pubic symphysis, where the two pubic bones join at the front of the pelvis. The pubic symphysis is made up of cartilage that absorbs the force generated when we move our legs.
There are muscle groups attached near this area that contract when we perform certain movements such as running and kicking, sending a pulling force through the pubic symphysis area. When this force is either repetitive, high intensity, or both, the pubic symphysis can become damaged and irritated.
This condition is most commonly associated with overuse and repetitive activities that strain or place prolonged force through the pubic symphysis. Some of these activities include:
- Overuse and repetitive strain through running larger distances or increasing your training intensity.
- Sports that involve repeated kicking motions or changes of direction such as football, netball, tennis, soccer and athletics.
- Pregnancy and childbirth.
- Poor or abnormal biomechanical function in the foot, feet or legs. This can be as a result of tibial torsion contributing to duck feet or pigeon-toe.
- Weak gluteal muscles, hip muscles and hip rotators.
- Inappropriate footwear for your exercise of activities.
- Major trauma such as a fall or car accident.
Osteitis Pubis can affect you in different ways depending on the severity of your condition. Most patients describe pain that increases gradually over time. Some of the symptoms you may experience include:
- Sharp or dull pain that results from activities like running, changing direction, pivoting on one leg and kicking.
- Pain when the abdominal muscles are contracted.
- Tenderness, pain or discomfort when applying pressure to the pubic bone at the front of the pelvic area.
- Pain when squeezing your legs together or moving one leg away from the centre line of the body.
- Discomfort from lying on your side.
Dan Everson Podiatry will ask questions about your symptoms and health history. A thorough physical examination including stress tests, range of motion and other mobility testing will likely be performed. In some cases a CT scan or MRI may be helpful to examine for abnormalities or irregularities.
Most sufferers of Osteitis Pubis recover fully after taking the appropriate treatment measures. In extreme cases, surgery may be required. Some or all of the below treatment options may be recommended:
- Rest and avoid performing any physical activities that cause pain to the area.
- Use pain-relief and anti-inflammatory medication.
- Ice and heat packs to the area may provide temporary relief.
- Stretching and strengthening exercises as prescribed by your podiatrist.
- If you have a foot imbalance or biomechanical abnormality contributing to your condition, Kinetic Orthotics from Dan Everson Podiatry may be prescribed and inserted into your footwear to help balance weight loading in the foot and correct motion during walking and running.
- Using a walking stick or crutch during the healing process to keep weight off the pelvis when you walk.
It is common for Osteitis Pubis to reoccur. Some of the preventative measures Dan Everson Podiatry recommends are:
- Stretching and strengthening exercises for the stabilising muscles.
- Warming up properly before you exercise.
- Reducing your exercise or training workload to limit the amount of time your pubic symphysis is exposed to force, stress and trauma.
- Seeking advice from your podiatrist on the most appropriate footwear for your needs.
- Orthotics may be prescribed to help prevent an occurrence of this condition in those with an imbalance or poor biomechanical function.