Ostitis Pubis
(Inflammation of the pubic bone)

What is Ostitis Pubis?

Ostitis Pubis is inflammation of the joint where the pubic bone meets at the front. Pain can radiate around the groin but will be significant at point in the middle of the groin at the front. Causes
Osteitis Pubis is predominantly caused by repetitive contraction of the muscles that attach to the pubic bone and the pubic symphysis, and while many things can be attributed to this, they can all be categorized into two main groups: Overload (or training errors); and Biomechanical Inefficiencies.

Overload (or training errors): Osteitis Pubis is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. Other overload causes include:

• Exercising on hard surfaces, like concrete;
• Exercising on uneven ground;
• Beginning an exercise program after a long lay-off period;
• Increasing exercise intensity or duration too quickly; and
• Exercising in worn out or ill fitting shoes.

Biomechanical Inefficiencies: The major biomechanical inefficiencies contributing to Osteitis Pubis are faulty foot and body mechanics and gait disturbances. Other biomechanical causes include:

• Poor running or walking mechanics;
• Tight, stiff muscles in the hips, groin and buttocks;
• Muscular imbalances; and
• Leg length differences.

Symptoms include:

• Pain when running, doing sit-ups and squatting.
• Pain may develop gradually and be mistaken for a muscle strain.
• In bad cases you may walk with a waddling gait.

What can the athlete do about it?

• See a specialist or doctor to confirm diagnosis and rule out a hernia.
• Rest is unfortunately the only form of treatment for this injury.
• In most cases you will rest for only 3 to 5 days but bad ones might require 3 months of complete rest.
• See a sports injury professional who can advise on rehabilitation.

Rehabilitation:

• Day 1-3: Rest, Ice, Ultrasound, Anti-inflammatory medication
• Day 3-5: Adductor stretching if it is not painful. Hold for 30 sec's, repeat 5 times a day.
• Day 5 onwards: If it is not painful, stomach crunches (3 sets of 10 reps a day), dorsal raises (3 sets of 10 per day), adductor exercises, abductor exercises, hip flexor exercises also 3 sets of 10 per day. Gradually start doing more sports specific training.
• After the acute stage, apply heat and wear a heat retainer.

Stretching the Groin and Hip flexor Muscles

• 

Short adductor muscles stretches

Stretching the hip flexors can take pressure off the groin also so do both sole and assisted Stretch for Hip flexor as below.

NB**Assisted should only be assisted by qualified body therapist as it can have serious consequences if done incorrectly!!**

Solo Hip flexor stretch Assisted Hip Flexor Stretch

Lastly Core Strengthening and stability will play a big part in the rehab of this Injury.

I would strongly advise anyone with it to join a Pilates Class. It will make a huge difference but tell the Pilates instructor the problem before commencing.