WHAT IS IT? OSTEITIS PUBIS / LONG STANDING GROIN PAIN
Osteitis Pubis (OP) is long-standing exercise-related groin pain. The pubic symphysis becomes inflamed and painful due to shearing forces.
Signs & Symptoms
Pain around the pubic symphysis, lower abdominals, adductors
Pain with exercise (run, kick)
Muscle tightness following exercise
Pain the morning following exercise
Short-term relief from anti inflammatory medication
Crepitus
Pain on resisted adduction
Loss of power with kicking, sprinting
Tender on palpation (spring test)
Weak adduction (squeezing of the knees together)
What Causes It?
Excessively tight adductor muscles
Excessively tight rectus abdominal muscles
Decreased lumbopelvic stability
Reduced hip range of movement
Dysfunction of the lumbar spine
Dysfunction of the sacroiliac joint
How to Self Manage
Rest
Avoid adductor and rectus abdominal exercises
Stretch adductors
Wear Skins or compression tights to control pain and keep the muscles warm
Prognosis
It is extremely important with long-standing groin pain that rehab is not rushed. By progressing rehab exercises too quickly, you do not allow healing and strengthening to occur. Ultimately this will just prolong your pain and affect your level of performance.
It is likely that rehabilitation following progressive stability band strengthening work will take 8-12 weeks.
If conservative management is unsuccessful, then further investigation may be warranted, and injection or surgery considered.
How Physio Helps
Assessment to determine if the pubic symphysis is the structure which is painful.
Identification of muscular imbalances
Core stability and exercise rehabilitation program specific to sports requirements
Soft tissue release of tight muscles
Stretching of tight muscles
Mobilisation of hip, lumbar spine, and or SIJ
Dry needling
Neural stretches