Osteitis pubis (aka athletic pubalgia) is a common sports overuse injury. It tends to occur in physical sports such as football, rugby and hockey.

The pubic symphysis is a stiff joint between the two halves of the pelvis at the groin. The adductor muscles, as well as the abdominal muscles, attach at this joint. Imbalances between abdominal and adductor muscle groups disrupt the equilibrium of forces around the symphysis pubis, predisposing the athlete to chronic microtrauma which leads to pain.

Pain can also be caused by a sudden shear force on a weakened symphysis joint, such as a sudden sprint or kick.

Injury

  • Commonly caused by activities which combine high running loads, rapid changes in direction and kicking.

What do I feel?

  • Aching in pubic and upper inner thigh region, often worse after activity.
  • Sharp pain with sprinting and kicking.
  • Pain may be present with coughing and sneezing.

What can I do?

  • Reduce activity until pain free (usually two to four weeks).
  • Take pain medications regularly as prescribed by your health professional.
  • Compression garments will reduce discomfort during rest and rehabilitation.
  • Engage in an active rehabilitation program with a physiotherapist to strengthen and stabilize the groin.

Osteitis pubis is usually a chronic condition which can develop slowly over a period of time, but may also suddenly increase during exercise. The groin will take a while to heal, but be patient, continue to do your exercises, and follow guidance from your physiotherapist. Return to full sport usually takes three to nine months. It is essential that the injury is managed appropriately and that you are committed to completing the rehabilitation program to ensure a full recovery.