Osteitis Pubis

David Smith · Jan 19, 2011

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Hi all

Had a customer in today, a young male of about 20years old who plays football and rugby, who had been diagnosed with Osteitis Pubis. He had been told a gait analysis / biomechanical assessment would be useful to hep in some way.
I wasn't sure what to tell him, I could do an assessment and I could point out poor posture, unusual gait, which bits were too stiff, too compliant, misaligned etc but how this might affect the condition and how changing them might improve the condition, I just don't know. Reading up there seems to be little known about aetiology or treatment and rehab - rest and wait and see seems as good as anything. Anyone have any suggestions or experiences of this condition and its treatment?

Regards Dave Smith

mike weber · Jan 19, 2011

David Smith said: ↑

Hi all

Had a customer in today, a young male of about 20years old who plays football and rugby, who had been diagnosed with Osteitis Pubis. He had been told a gait analysis / biomechanical assessment would be useful to hep in some way.
I wasn't sure what to tell him, I could do an assessment and I could point out poor posture, unusual gait, which bits were too stiff, too compliant, misaligned etc but how this might affect the condition and how changing them might improve the condition, I just don't know. Reading up there seems to be little known about aetiology or treatment and rehab - rest and wait and see seems as good as anything. Anyone have any suggestions or experiences of this condition and its treatment?

Regards Dave Smith
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Hi Dave I´ve teated a couple, You don´t mention it by LLD is very important when treating these Ive found.

Rest, ice, Core work, stretching, dealing with biomechanical issues also important but LLD the key in my option, goes against some research but heel lift made significant difference to one that the whole treatment from me to complement the Physio was a heel lift.

Hope that helps

Griff · Jan 19, 2011

Hey Dave,

I unfortunately have personal experience of this condition - it's what stopped me being able to play football 2 years ago. (It has a lot to answer for - now I get dragged to all sorts of places on a Saturday afternoon by my Mrs)

Most important underlying biomechanical factor to assess (and address as necessary) in my opinion is the recruitment characteristics and the timing of the hip abductors/gluteii

Admin2 · Jan 20, 2011

Osteitis pubis

Medical condition

Osteitis pubis is a noninfectious inflammation of the pubis symphysis (also known as the pubic symphysis, symphysis pubis, or symphysis pubica), causing varying degrees of lower abdominal and pelvic pain. Osteitis pubis was first described in patients who had undergone suprapubic surgery, and it remains a well-known complication of invasive procedures about the pelvis. It may also occur as an inflammatory process in athletes. The incidence and cause of osteitis pubis as an inflammatory process versus an infectious process continues to fuel debate among physicians when confronted by a patient who presents complaining of abdominal pain or pelvic pain and overlapping symptoms. It was first described in 1924.

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HansMassage · Jan 21, 2011

Dave
Disregard Descartes, The young man came to you for your trained perception. Give it to him and hope he has the wisdom to act on it appropriately.
I have seen some pelvic X-ray film of older males that played through the pain that were pretty ugly. Like one ramus higher than the other with ostiophites bridging the gap.

Hans Albert Quistorff, LMP
Antalgic Posture Pain Specialist

NewsBot · Nov 7, 2013

Pelvic Biomechanical Overload Syndrome : Osteiitis Pubis/Gilmores Groin Renamed

NewsBot · Jun 11, 2015

The Effectiveness of Non-Operative Rehabilitation Programs for Athletes Diagnosed With Osteitis Pubis
Scott Cheatham, Morey J. Kolber, and Kathryn Kumagai Shimamura
JSR In Press

Clinical Scenario: The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is one pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football.1 Conservative non-operative treatment is often prescribed first prior to surgical intervention. Of particular interest, are the outcomes of non-operative rehabilitation programs and their effectiveness to return athletes to pre-injury levels of participation. The most recent systematic review in 2011, examined the spectrum of treatments for osteitis pubis and found only level 4 (case report or case series) evidence with varying approaches to treatment.1 Due to the amount of time since the last published review, there is a need to critically appraise the recent literature to see if more high quality research has been published that measure non-operative interventions for athletes with osteitis pubis.

Clinical Question: Is there evidence to suggest that non-operative rehabilitation programs for osteitis pubis are effective at returning athletes to their pre-injury levels of participation?

Summary of Key Findings: Four studies met the inclusion criteria. Only level 4 evidence was found. All studies reported using a structured non-operative rehabilitation program with a successful return to pre-injury participation between 4 to 14 weeks. Except for one study reporting a successful return at 30 weeks. Successful long-term follow-up was reported between 6 to 48 months for all patients.

Clinical Bottom Line: There is weak evidence to support the efficacy of non-operative rehabilitation programs at returning athletes to their pre-injury levels of participation. Strength of

Recommendation: There is grade D evidence that a non-operative program for osteitis pubis is effective at helping athletes return to their pre-injury level of participation. The Centre of Evidence Based Medicine recommends a grade D for level 4 evidence with consistent findings.
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Osteitis pubis

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