Osteitis Pubis is a common cause of chronic groin pain in the football codes. It is an overuse injury. That is, it is caused by repeated trauma rather than a specific incident. However, it is not uncommon for a specific incident to trigger the symptoms.
Diagnosis is usually made in the advanced stages when the pubis bones have began to erode at the pubic symphysis. Early diagnosis can prevent the condition progressing beyond the stage of "bone stress".
What Causes Osteitis Pubis?
The main cause is instability of the pelvic bones and in particular the pubic symphysis.
The instability is aggravated when asymmetrical loads are placed through the pelvis such as when running or kicking. These activities are normally well accommodated in the normal "stable" athlete but with poor lumbopelvic control the additional forces are uncontrollable and will cause injury.
Due to the instability in the region it is not uncommon for the athlete to have experienced a previous history of groin strains, a "sportsman's" hernia or low back pain.
How to Diagnose Osteitis Pubis
Pain is usually experienced over the pubic symphysis with referred pain into the inguinal region and the groin. Palpation of the pubic symphysis and the pubic ramus is acutely tender. Resisted muscle contraction of the hip adductors and flexors will elicit pain. Likewise stretching into abduction and extension can elicit pain in the acute stage. Coughing, sneezing and performing a sit up will reproduce pain. This athlete is often unable to lie flat on their back or prone.
Treatment for Osteitis Pubis
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