When you frequently participate in activities like these or have had bladder or prostate surgery recently, the spot at the front of your pelvic girdle where your right and left pubic bones join can become inflamed. This area is called the pubic symphysis.
What Is Osteitis Pubis?
Osteitis pubis can happen when the pubic symphysis is overused during activities like kicking or running and tissue damage occurs. This repetitive damage can cause inflammation in the area and groin pain.
The two bones of the pelvis meet at the pubic symphysis. There is cartilage in the area to provide a barrier between the right and left bones, which assists in absorbing friction. Attached nearby are numerous abdominal and adductor muscles. These muscles constrict when you are doing certain types of physical activity and the area is strained. When this occurs too often and when overly exerted, damage to the symphysis or pubic bones can occur and thus causes inflammation. This is known as osteitis pubis.
Causes of Osteitis Pubic
The typical cause of osteitis pubic is the prolonged or overly repetitive use on the pubic symphysis. Excessive contractions of your abdominal muscles can also result damage in this region. Activities that are commonly associated to the condition include long distance running, football, soccer and hockey. A person may develop a problem in the area as well if they do not receive adequate rehabilitation after surgery.
Symptoms of Osteitis Pubic
Osteitis pubis symptoms can start off mild and over time increase in frequency and intensity. Osteitis pubis symptoms include:
- Swelling, pain and discomfort in the pubic symphysis area
- Development of a limp when running or walking
- Pain which spreads from the front of the pelvis to the inner thigh, groin or lower abdomen
- Worsening pain while running or when suddenly changing direction, especially when performing activities that involve jumping, kicking, climbing stairs and rotating on one leg
- Clicking noise in the front pelvic area
- Worsening pain with stretching of the leg and thigh areas
Sometimes there are no obvious osteitis pubis symptoms at all.
Osteitis Pubis Treatment
Osteitis pubis treatment involves a lot of rest. The damaged tissue, muscles and joints all need time to recover.
1. Rest
Give this area of your body a break. Because the condition is caused by acute inflammation, your body will need time to heal. More times than others, this is the only course of treatment needed. However, if you are experiencing severe osteitis pubis symptoms, you may need to utilize a cane, crutches or even a wheelchair.
2. Medications
Take nonsteroidal anti-inflammatory medications. Again, inflammation is the culprit in this condition. By taking this type of medication, you are assisting your body in battling the root of the cause and thus alleviating your pain.
3. Ice and Heat Application
Apply ice or heat. Which technique to use is a common concern. Generally, the rule of thumb is to use ice on acute injuries that have occurred within the last 48 hours. This will help control the pain by reducing inflammation around the area of injury. Heat is typically applied when you are suffering from a chronic condition. It helps loosen and relax tissue and is commonly used for conditions like osteitis pubis and other overuse injuries. Your doctor will advise you on whether to use ice or heat in your case.
4. Physical Therapy
Try physical therapy. Therapists can instruct you on the correct exercises and how to prevent your condition from happening again. Although rest is needed in order for you to recover, you will need to learn how to regain your mobility and strength so you can return to your pre-injury activity level.
Osteitis Pubis Exercises
Common exercises prescribed by a physical therapist to battle and prevent osteitis pubis include transversus abdominal retraining, bridging and the adductor stretch. It is recommended you perform the exercises around three times a day as long as they don’t increase your discomfort or pain.
Transversus Abdominus Retraining
The transversus abdominal retraining exercise involves using your stomach muscles to pull your belly button slowly away from your pants waistline. You can perform this movement in either the standing or lying position.
You want to breathe normally when doing it so that your rib cage is not elevated. You know you are doing it correctly if you can feel your muscle contracting when you press at the bony area of the pubic symphysis. You should practice doing this exercise during everyday activities like walking and repeat three times each day. However, it is important to discontinue the exercise if it aggravates your symptoms.
Bridging
Bridging is an exercise conducted in the lying position. Pushing through your feet, you begin by lifting your bottom slowly. You do this until your shoulder, knee and hips are in a straight line. As you do the exercise, tighten your gluteal muscles. Hold for two seconds. You should repeat the movement ten times as long as it does not cause discomfort or pain.
Adductor Stretch
The adductor stretch is performed in the standing position with your feet apart about twice your shoulder width. While keeping one knee straight, gently lunge towards one side. You will know you have done it right when you feel a stretch in the pubic symphysis area and it is pain-free. Hold the position for 15 seconds and repeat four times. Discontinue if it increases your symptoms.
