WHAT IS IT? OSTEITIS PUBIS
Osteitis Pubis (OP) is a term given to long-standing exercise-related groin pain. The pubic symphysis can become inflamed, degenerative, and painful due to shearing forces.
Signs and symptoms
- Pain around the pubic symphysis, lower abdominals, adductors
- Pain with exercise (running, kicking)
- Pain on resisted adduction
- Loss of power with kicking, sprinting
- Tender on palpation (spring test)
- Weak adduction (squeezing of the knees together)
- Muscle tightness following exercise
- Pain in the morning following exercise
- Short-term relief from anti-inflammatory medication (if not contraindicated)
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​WHAT CAUSES IT?
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Excessively tight adductor muscles
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Excessively tight rectus abdominal muscles
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Decreased lumbopelvic stability
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Reduced hip range of movement
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Dysfunction of the lumbar spine
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Dysfunction of the sacroiliac joint
HOW TO SELF MANAGE
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Implement the R.I.C.E.R. protocol
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Stretch adductors
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Wear Skins or compression tights to control pain and keep the muscles warm
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Avoid adductor and rectus abdominal exercises
PROGNOSIS
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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.
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It is likely that rehabilitation following progressive stability and strengthening work will take 8-12 weeks.
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If conservative management is unsuccessful, then further investigation may be warranted, and injection or surgery considered.
HOW PHYSIO HELPS?
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Assessment to determine if the pubic symphysis is the structure which is painful.
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Identification of muscular imbalances
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Core stability and exercise rehabilitation program specific to sports requirements
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Soft tissue release of tight muscles
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Stretching of tight muscles
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Mobilisation of hip, lumbar spine, and or SIJ
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Dry needling
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Neural stretches
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