Osteitis Pubis: Symptoms, Causes, Treatment, Exercises

Key Takeaways

• Osteitis pubis often results from repetitive stress activities, muscle imbalances, and improper training techniques, particularly in sports involving running and kicking.

• Treatment approach includes rest, targeted strengthening exercises, and gradual return to activities.

• Core stabilisation exercises like the dead bug, bird-dog, and side plank are particularly effective for supporting recovery and preventing recurrence.

• At MSK Doctors, we offer modern care without GP referrals, utilising advanced AI movement analysis to create personalised treatment plans for osteitis pubis and long-term pelvic health.

Osteitis Pubis: Pelvic Pain Unwrapped

Osteitis Pubis is a condition that many athletes and active individuals encounter. It involves inflammation where the two pubic bones meet at the front of the pelvis, known as the pubic symphysis. (image courtesy of Cleveland Clinic) 

This condition can cause significant discomfort and can keep you from engaging in the activities you love. 

Symptoms of Osteitis Pubis

You might notice it more when you're walking, running, or even just standing for long periods. Pay attention to these signals from your body as they can guide you toward seeking the right treatment.

Pain and Discomfort

The symptoms of osteitis pubis can vary, but they often center around pelvic pain. This pain might start as a dull ache and become sharper with certain movements. Its symptoms can range from mild discomfort to severe pain.

The most common symptom is a pain that radiates from the groin area. This pain can extend to the lower abdomen and thighs, making daily activities uncomfortable. It often starts as a dull ache and can become sharper with specific movements.

Activity-Related Pain

Activities such as running, kicking, or even walking for extended periods can exacerbate the pain. You might notice an increase in discomfort during or after physical exertion. This activity-related pain is a key indicator of osteitis pubis and should not be ignored.

Physical Examination Indicators

During a physical examination, a healthcare provider might apply pressure to the pubic area to check for tenderness or swelling. They may also assess your range of motion and look for any signs of pain during movement. 

Causes and Risk Factors

Sports Activity

Sports activities significantly contribute to the development of osteitis pubis, particularly in athletes involved in weight-bearing and kicking sports. The condition is often caused by repetitive stress and shearing forces on the pubic symphysis, which can occur during activities like running, kicking, pivoting, and rapid changes in direction. 

Sports such as soccer, rugby, and distance running are commonly associated with osteitis pubis due to the high frequency of these movements. 

Muscle Imbalances

When certain muscles around the pelvis become stronger or tighter than their counterparts, they can create uneven tension across the pubic symphysis. 

This imbalance often leads to misalignment and stress - exacerbating inflammation and pain. For example, if the adductor muscles on the inside of your thighs are stronger than your abductor muscles on the outside, this can pull the pelvis out of alignment - leading to increased strain on the pubic area. 

Relevant Medical Conditions

Aside from physical activity, certain medical conditions can increase the risk of developing osteitis pubis. Pregnancy, for example, can alter the pelvic structure and increase the likelihood of inflammation. Similarly, pelvic surgeries can weaken the area, making it more susceptible to stress and injury.

Effective Treatment Options

Treating osteitis pubis often begins with rest and allows the inflammation to subside. This might mean taking a break from high-impact activities or sports. Anti-inflammatory medications can also be beneficial in managing pain and swelling. 

Physical therapy plays a crucial role in recovery, as targeted exercises can help strengthen the muscles around the pelvis, providing better support and reducing stress on the pubic symphysis.

• Targeted Exercises for Relief: Exercises that focus on strengthening the core and pelvic muscles, improving flexibility, and ensure proper alignment. Perform these exercises correctly to avoid further strain. 

• Rest and Rehabilitation: Rest doesn't mean complete inactivity. Instead, modify your activities to avoid those that cause pain. During this period, gentle exercises like walking or swimming can keep you active without overloading the pelvis.

• Medications: Medications can play a supportive role in managing osteitis pubis. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and alleviate pain, making it easier to engage in physical therapy.

• Surgical Interventions: Include releasing tight muscles or stabilising the pubic symphysis. However, surgery is usually a last resort, and most people find relief through non-surgical means. 

Exercises for Osteitis Pubis

Strengthening Techniques

Exercises like pelvic tilts, bridges, and planks target these areas effectively. Start with a few repetitions and gradually increase as your strength improves.

Flexibility & Stretching Routines

Flexibility exercises help alleviate tension and prevent muscle imbalances. Stretching the hip flexors, hamstrings, and adductors can improve mobility and reduce stress on the pubic symphysis.

• Incorporate stretches like the butterfly: stretch and hip flexor stretch into your routine. Hold each stretch for 20-30 seconds and repeat several times for optimal results.

• Yoga and Pilates can be excellent additions to your flexibility routine: these practices focus on controlled movements and stretching - promoting overall flexibility and muscle balance.

Core Stabilisation

Core stabilisation exercises are vital for maintaining pelvic alignment and reducing stress on the pubic symphysis: 

• Engaging in exercises like the dead bug: a core-strengthening movement performed by lying on your back with arms and legs extended, then slowly lowering one arm and the opposite leg toward the floor while maintaining core stability - before returning to the starting position and repeating on the other side

•  Bird-dog exercise: a core-strengthening movement performed on all fours, where you simultaneously extend one arm forward and the opposite leg backward, holding briefly before switching sides - to enhance core stability, posture, and mobility.

• Side plank involves: lying on your side with feet stacked and hands under shoulders, then lifting your hips off the ground to form a straight line from head to heels, holding this position - to strengthen the core. 

These exercises focus on activating the deep core muscles, providing a solid foundation for the pelvis and reducing the risk of further injury.

Proper Training Routines

Start by evaluating your current training regimen. Are you overloading your body with repetitive, high-impact activities? Consider incorporating cross-training to balance the stress on your body. Activities like swimming or cycling can maintain cardiovascular fitness while reducing impact on the pelvis.

Ensure your training includes a warm-up and cool-down period. This helps prepare your muscles for activity and aids recovery afterward. Effective stretches before exercise and static stretches post-exercise can enhance flexibility and reduce injury risk.

Improvements in Sports Techniques

Improving your sports techniques can significantly impact your recovery and prevention efforts. Focus on proper form and biomechanics. Engaging in sports with incorrect posture or technique can exacerbate the strain on your pelvis. Work with a coach or physical therapist to refine your movements and ensure you're using your body efficiently.

For example, if you're a runner, focus on exercises that strengthen your lower body and core, promoting stability and power.

Get Back in Action

Importance of Persistent, Gradual Progress

Gradual progress is key to a successful return. Start with low-impact activities like water aerobics and stationary biking and slowly reintroduce more intense exercises. Monitor your body's response and adjust your routine accordingly. If you experience pain or discomfort, it may be a sign to scale back and allow more time for recovery.

Comprehensive Care for Your Osteitis Pubis Recovery

At MSK Doctors, we understand that osteitis pubis can significantly impact your daily activities and athletic performance.

Our approach to treating this challenging condition extends beyond simply addressing your symptoms – we focus on identifying and resolving the underlying causes for long-term relief and prevention.

Our team of leading orthopedic consultants specialises in musculoskeletal conditions like osteitis pubis, utilising our state-of-the-art MAI Motion AI platform to analyse your unique movement patterns. 

This technology provides invaluable insights that help us develop a personalised treatment plan targeting your specific needs – whether you're an athlete looking to return to competition or someone seeking relief from daily discomfort.

With no GP referral needed, you can access our expertise immediately and receive a tailored program that combines targeted exercises, proper training techniques, and ongoing support. Our 5-star rated care ensures you receive not just treatment, but education about your condition and tools to maintain pelvic health long-term.

Don't let pelvic pain hold you back from the activities you love. Contact MSK Doctors today to begin your journey toward comprehensive recovery and improved pelvic stability.

Frequently Asked Questions (FAQ)

How long does it typically take to recover from osteitis pubis?

Recovery time varies depending on severity, but most patients see improvement within 6-12 weeks with proper treatment. Some cases may take longer, especially if the condition has become chronic. Our personalised approach helps optimise your recovery timeline.

Can I continue exercising while recovering from osteitis pubis?

We typically recommend modifying your activities rather than stopping completely. Low-impact exercises like swimming or cycling can maintain fitness while allowing the pubic area to heal. We'll help you develop an appropriate activity plan based on your specific condition.

What makes osteitis pubis different from a groin strain?

While both conditions cause groin pain, osteitis pubis specifically involves inflammation at the pubic symphysis (where the pubic bones meet), often causing pain that radiates to the lower abdomen and inner thighs. Our diagnostic approach ensures accurate identification of your condition.

How can I prevent osteitis pubis from recurring?

Prevention focuses on maintaining proper muscle balance, using correct techniques during sports, and incorporating core strengthening exercises into your routine. We provide comprehensive guidance on preventive strategies for your activities and body mechanics.

What imaging tests might be needed to diagnose osteitis pubis?

At MSK Doctors, our approach ensures you receive the right diagnostic tools for your specific situation. While we can often diagnose based on physical examination, MRI or ultrasound imaging may be recommended to confirm the diagnosis and rule out other conditions.