Osteitis Pubis (OP) is long-standing exercise-related groin pain.  The pubic symphysis becomes inflamed and painful due to shearing forces.

Signs & Symptoms

  • Groin pain which gradually worsens

  • Pain may refer to the testicles or adductors

  • Pain on coughing, sneezing, or straining

  • Pain with the Valsalva manoeuvre which increases intra-abdominal pressure

  • Possible bulge

  • Aggravated with kicking

  • Common in sports involving kicking

  • Often bilateral

  • Tender pubic tubercle

What Causes It?

  • Weakness of the abdominal wall

  • Increased intra-abdominal pressure = increased strain

How to Self Manage

  • Rest

  • Seek assessment by a physiotherapist or hernia specialist


  • Conservative management should be trialled first.  If not successful then surgery may be required.

  • Surgery for a hernia is relatively common, especially in sports such as football.  Return to sport may be possible after 3-4 months post-surgery.  It must be noted that surgery can be successful, however recurrence is possible post-surgery.

How Physio Helps

  • Confirm the presence of a hernia

  • Assess lumbopelvic stability

  • Correct tendency to increase intra-abdominal pressure

  • Prescribe a conservative management program involving strengthening of transverse abdominals, obliques, adductors, and hip flexors

  • Refer to a hernia specialist if necessary

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