Osteitis pubis

eroo

Was reading an article in the Indo's sports section today that told the story of Cavan footballer Nicholas Walsh. He took the opportunity to play Aussie Rules with the Melbourne Demons. He was 17 when he did. However, his ambitions were cut short when he was diagnosed with the condition known as Osteitis pubis. It came about as a result of him adding too much bulk to his body, with the result being that his core muscles were not able to cope with the added bulk. I'd never heard of this condition before, but it seems to quite prevalent in the AFL.

Osteitis pubis is a medical condition which is prevalent among footballers, runners and other athletes, particularly players of Australian rules football. In Australia the condition is increasingly being referred to as simply "OP", especially in media covering the Australian Football League.

Osteitis pubis, first described in 1924,[1] is characterised by inflammation of the pubic symphysis, which is the joint at the front of the pelvis between the two ends of the pubic bone. This inflammation leads to sclerosis and bony changes of the pubis symphysis, causing both acute and chronic groin pain. The condition can render sufferers incapable of sustained physical activity. There is no specific treatment for the condition and it can seriously affect the careers of footballers affected by it.

http://en.wikipedia.org/wiki/Osteitis_pubis

Makes for interesting reading!

amacachi

I may get given out to for this, but I'd be surprised if mass was the problem, it's not like AFL players are the hugest athletes going.

kierskoe

Hi Guys,

Unfortunately i've had the mispleasure to find out it's not an injury brought on by muscle gain.

I'm 25 and have only recently been diagnosed with Osteitis Pubis and i'm really struggling for answers on how to get back playing football. The physio and specialist are really not inspiring any confidence for recovery, I have been told I will more than likely never make a full recovery and enjoy 90mins pain free on a pitch again... which is killing me, playing football is my life and I can't even begin to imagine going without. I'm determined to prove them wrong and get back to being able to play.

The injury is so frustrating adn very painful. I have been feeling its affects for 4-5months now, it's a gradual build up of pain which is extremely difficult to spot and diagnose.... though I do attribute my unwillingness to rest when my body is clearly telling me to as a major factor in this, stupidly I just can't turn down a game of football!.

Any form of excercise which involves moving around on my legs now causes serious amounts of pain, my groin flares up, my stomach aches and the morning after im left feeling like a 90yr old man. At the moment I can feel constant aggravation around my lower abdominal area and pain when I cough and sneeze. It's unbelievably frustrating. It's a massive change in lifestyle for me as I had always previously put a lot of effort into working on my fitness.

I have been resting for the past month, limiting myself to a fair bit of seated upper body work in the gym (which I was given the ok for), but I really dont feel any improvement in my condition. I have read on some aussie forums that core strengthening can help so I am getting a routine together at the moment. If anyone else has been affected by this condition I would really appreciate any tips for excercises or treatments you can recommend and we can swap information here.

trentv

Hey Kierskoe, I feel your pain.. in more ways than one, i too was recently diagnosed with Osteitis Pubis, I too love my football and regularly played when clearly I shouldn't and i have done 4 weeks without football now with the physio telling me i have 8 to go. I am not convinced that i'll be able to return to it like i could when i was healthy since the pain is still very much there when i exercise.
But i am still able to run, swim and cycle to keep the fitness up and this hardly affects me at all, besides from this i am working overtime on the core muscles and really believe that this is the only thing (without surgery) that will fix the problem.
I never worked the core before and though i'm pretty fit i was seriously weak in that area and hardly able to do a couple of situps. So now i am doing lots of different variations of situps daily, lots of adductor and abductor hip strengthening and i'm noticing a big difference in my general posture and balance and i am hopeful that as i strengthen the core that the pressure will be taken off the hip/groin area and fingers crossed i'll be back playing in a couple of months.

I wouldn't recommend just throwing yourself in to new exercises, get the physio to go through ones that would be ok and gradually build in to it.... you might forget in a month, but if you get playing ball again post a message.

Racing Flat

kierskoe wrote: »

Hi Guys,

Unfortunately i've had the mispleasure to find out it's not an injury brought on by muscle gain.

I'm 25 and have only recently been diagnosed with Osteitis Pubis and i'm really struggling for answers on how to get back playing football. The physio and specialist are really not inspiring any confidence for recovery, I have been told I will more than likely never make a full recovery and enjoy 90mins pain free on a pitch again... which is killing me, playing football is my life and I can't even begin to imagine going without. I'm determined to prove them wrong and get back to being able to play.

The injury is so frustrating adn very painful. I have been feeling its affects for 4-5months now, it's a gradual build up of pain which is extremely difficult to spot and diagnose.... though I do attribute my unwillingness to rest when my body is clearly telling me to as a major factor in this, stupidly I just can't turn down a game of football!.

Any form of excercise which involves moving around on my legs now causes serious amounts of pain, my groin flares up, my stomach aches and the morning after im left feeling like a 90yr old man. At the moment I can feel constant aggravation around my lower abdominal area and pain when I cough and sneeze. It's unbelievably frustrating. It's a massive change in lifestyle for me as I had always previously put a lot of effort into working on my fitness.

I have been resting for the past month, limiting myself to a fair bit of seated upper body work in the gym (which I was given the ok for), but I really dont feel any improvement in my condition. I have read on some aussie forums that core strengthening can help so I am getting a routine together at the moment. If anyone else has been affected by this condition I would really appreciate any tips for excercises or treatments you can recommend and we can swap information here.

Have you tried a serola belt?







www.serola.net


When i had it, it was really difficult getting out of bed in the morning, but wearing a serola belt quite tight allowed me to play. Obviously we're all different and so what worked for me might not work for you, but the belt, which compresses the pubic symphysis makes it more stable and possibly less painful. This is ultimately what you want to train your muscles to do, through exercises, which hopefully your Physiotherapist will show you, but in the meantime the belt might help...

Sideways and twisting movements and kicking across the body can be difficult. If so, in the meantime, running in stright lines might be more comfortable, so you may at least be able to keep fitness up.

With ongoing groin/op problems aswell as knee cartilage issues all related to twisting components of playing soccer I was in a fair bit of pain. Now I only run competitively (10k races and that kind of thing) and I've no problems at all...I think the body got a bit old for football :mad:

Racing Flat

eroo wrote: »

I'd never heard of this condition before, but it seems to quite prevalent in the AFL.

Although you'd never herad of osteitis pubis you probably came across it a lot referred to as groin strain, chronic groin pain, hernia and other things like that. Would be fairly common in any kicking or twisting sports, but maybe not always identified as osteitis pubis. Many of the top Premiership players would have had this...

kierskoe

Some quick responses here... cheers guys!

@trentv sorry to hear you are also suffering but its good to hear you seem to be on the mend.

Running is out of the question for me at this stage, a 5 yard jog is all my body needs to let me know its not up to it. I am cycling a bit up the gym with no problems, I am really going to work on my swimming over the next few months.

My abdominal area was in pretty good nick prior to the injury, but I didn't fully understand the complete core workout. I have been browsing video's online for tips on core strengthening and have come up with a program I have just started, a few of the excercises I got from here: http://www.youtube.com/watch?v=Ne7bv88_kno

I have also heard Pilates can help a lot, have you tried this?

I will keep updates on how i'm getting on, hopefully you can do the same and we can both benefit!

@Racing Flat, cheers for the info, I have seen those mentioned alright, but I am wary of using support devices and letting the body become dependant on such.

kierskoe

Racing Flat wrote: »

Although you'd never herad of osteitis pubis you probably came across it a lot referred to as groin strain, chronic groin pain, hernia and other things like that. Would be fairly common in any kicking or twisting sports, but maybe not always identified as osteitis pubis. Many of the top Premiership players would have had this...

Just to point out that it is not the same as groin strain, chronic groin pain or hernia.... the way you phrased the post sounded kind of misleading.

Racing Flat

kierskoe wrote: »

@Racing Flat, cheers for the info, I have seen those mentioned alright, but I am wary of using support devices and letting the body become dependant on such.

Sorry, I thought you said you wanted to play.

You can exercise until it is better, probably take a few months and not play during this time.

Or you can exercise for a few months and in the meantime play with the belt, if it provides you with pain relief - as long as you are doing the exercises, and gradually weaning yourself off it, you shouldn't get dependent on it. Kind of like wearing strapping for the first few weeks after an ankle sprain, but then not any more...

trentv

Some quick responses here... cheers guys!
I have also heard Pilates can help a lot, have you tried this?

Yea i heard this too, i am looking for some local yoga/pilates courses at the moment so i'll let you know if i start them how it goes.

Just to point out that it is not the same as groin strain, chronic groin pain or hernia.... the way you phrased the post sounded kind of misleading.

Apparently from a bit of reading up on the various chronic groin conditions the doctor and physio professionals have little to distinguish between Gilmores Groin/Sports Hernia and Osteitis Pubis in diagnosis.
I think generally the Osteitis will develop into the other if not monitored, and once the Sports Hernia develops there is only a surgical solution from what i've read.

Lets hope it doesn't come to that.

toggle

Osteitis Pubis is not a nice thing to have I feel your guys' pain.

There are a few options as regards to treatment.
As mentioned previously rest and core stability work is important for recovery from the injury.

I would recommend you get some form of soft tissue work if not having treatment at the moment (Active Release Techniques, Graston Technique or Myofascial Release) focusing on the adductor group. If the muscles are chronically tight or have scar tissue from previous tears or overuse then they will continue to pull on the pubic bone leading to a chronic cycle.

Ice (10 minutes 3-4 a day) will help reduce any inflammation in the area. Beware of cold dangle berries!

All those things failing the likely route is cortisone injections or surgery.

mcnewberson

Anyone have any more information or updates on this injury, and how they are no getting on?

mcnewberson

Toggle - good Advice here, I got some deep tissue treatment recently on tight groing/Glutes, Felt better immediatly, have to do some work on core now

Racing Flat - I used this belt for 6 weeks and it definatly helped. I stopped after 6 weeks as I was afraid that I would get too dependant on it

This is a long term injury and thankfully I think I have turned a corner

UUJ_Lad

Hey guys, dont much post on the board, mostly look about but this thread is pretty close to home. I am currently coming to the end of a 2 month complete rest due to something similar to this. I've been given some core excercises to do, including an interesting one that has me sort of tensing up my muscles - much like you would do to stop yourself from urinating and doing this anywhere, in work, at home etc.
I havent even attempted to do anything while resting which in itself has been pretty hard - i would be active enough with Judo and football. But the pain when sneezing is definitly subsided, also too I found it extremely painful to get into the plank/press up position and this seems to have eased it up.
I am really hoping the rest cures my problem - I had it all through the summer which more or less left me a cripple about 5 minutes after every game but I played on like a fool.
Also another thing that helped me was a homemade ice bath after every training session - basically a barrel in my back garden filled with water. It relieves pain.
Anybody else with problems/advice?

d'Oracle

amacachi wrote: »

I may get given out to for this, but I'd be surprised if mass was the problem, it's not like AFL players are the hugest athletes going.

Eh.... They are big enough!

Paulmee

Hi guys,
Came across this post by chance.
Im about to go for an mri to find out what is wrong with me.
I have v similar symthoms to what all of you have described here. Time out playing soccer, physio(who mentioned Osteitis pubis) and the doctor have been unable to help.
Is this how ye found out? An mri?

mcnewberson

UUJ_Lad wrote: »

Hey guys, dont much post on the board, mostly look about but this thread is pretty close to home. I am currently coming to the end of a 2 month complete rest due to something similar to this. I've been given some core excercises to do, including an interesting one that has me sort of tensing up my muscles - much like you would do to stop yourself from urinating and doing this anywhere, in work, at home etc.
I havent even attempted to do anything while resting which in itself has been pretty hard - i would be active enough with Judo and football. But the pain when sneezing is definitly subsided, also too I found it extremely painful to get into the plank/press up position and this seems to have eased it up.
I am really hoping the rest cures my problem - I had it all through the summer which more or less left me a cripple about 5 minutes after every game but I played on like a fool.
Also another thing that helped me was a homemade ice bath after every training session - basically a barrel in my back garden filled with water. It relieves pain.
Anybody else with problems/advice?

These were the exact symptoms I had, started last June and had me crippled until I went to my doc, who in turn sent me to the right people. I too was crippled after each game, I struggled but my fitness was a mess and I was too stubborn to stop. It is important to stop and get this seen to. I doubt you will fully know until you start running different lines or kicking even. If symptoms persist an MRI is needed to tell for sure. Your Physio should have done a test where you lie on your back with knees bent. They will put their fist in between your knees and you try to close your knees, If this hurts your ticking all the boxes.

mcnewberson

Yes an MRI is a good way to find out as I mentioned in earlier post. A physio should be able to help, you could ask before does the physio have any experience with this complaint

mcnewberson

Potato Man wrote: »

Hi guys,
Came across this post by chance.
Im about to go for an mri to find out what is wrong with me.
I have v similar symthoms to what all of you have described here. Time out playing soccer, physio(who mentioned Osteitis pubis) and the doctor have been unable to help.
Is this how ye found out? An mri?

Yes an MRI is a good way to find out as I mentioned in earlier post. A physio should be able to help, you could ask before does the physio have any experience with this complaint

Paulmee

mcnewberson wrote: »

These were the exact symptoms I had, started last June and had me crippled until I went to my doc, who in turn sent me to the right people. I too was crippled after each game, I struggled but my fitness was a mess and I was too stubborn to stop. It is important to stop and get this seen to. I doubt you will fully know until you start running different lines or kicking even. If symptoms persist an MRI is needed to tell for sure.

mcnewberson wrote: »

Your Physio should have done a test where you lie on your back with knees bent. They will put their fist in between your knees and you try to close your knees, If this hurts your ticking all the boxes.

That was the test the physio did with me, it was only my right groin that hurt.
Im currently waiting on an MRI appointment, after my physio and then doctor referered me to a sports injury clinic in santry i think

mcnewberson

Potato Man wrote: »

mcnewberson wrote: »

These were the exact symptoms I had, started last June and had me crippled until I went to my doc, who in turn sent me to the right people. I too was crippled after each game, I struggled but my fitness was a mess and I was too stubborn to stop. It is important to stop and get this seen to. I doubt you will fully know until you start running different lines or kicking even. If symptoms persist an MRI is needed to tell for sure.

That was the test the physio did with me, it was only my right groin that hurt.
Im currently waiting on an MRI appointment, after my physio and then doctor referered me to a sports injury clinic in santry i think

Ya you will prob deal with a doctor called eanna falvey, He knows his stuff, Pay heed to what recovery time etc he gives you. dont rush back

would be good to hear how you got on, It is actually hard to come across info on this injury. seems to be alot of guys developing this

bubbleking

ok some interesting stuff in this thread. From what iv read it would appear that the majority of you Do not have osteitis pubis!!

Chronic groin pain can be broken into 4 different categories;
(1) Adductor related
(2) Abominal wall related
(3) Iliopsoas Related
(4) Hernia related

The root of chronic groin pain can be very difficult to diagnose and requires a very VERY detailed assessment to out-rule all the possible causes. Osteitis pubis is a diagnosis usually given when all the other causes have been out-ruled and it literally is a degeneration of the pubic bone (it will have a moth eaten appearance on an MRI scan.

Osteitis pubis is usually treated with complete rest and maybe some ultrasound. However all other causes of chronic groin pain usually require some sort of active rehab in order to make a full recovery

Mcnewberson you said

Your Physio should have done a test where you lie on your back with knees bent. They will put their fist in between your knees and you try to close your knees, If this hurts your ticking all the boxes.

- that is a tell tale sign of Adductor related Chronic groin pain not osteitis pubis and that requires an active rehabilitation programme not complete rest.

Oh and just in case anyone thinks I have no basis for this - I have completed an Undergrad in Athletic Therapy and Training and am currently doing my masters the title of which is "injuries in field based sports with a special emphasis on groin injuries"

mcnewberson

bubbleking wrote: »

ok some interesting stuff in this thread. From what iv read it would appear that the majority of you Do not have osteitis pubis!!

Chronic groin pain can be broken into 4 different categories;
(1) Adductor related
(2) Abominal wall related
(3) Iliopsoas Related
(4) Hernia related

The root of chronic groin pain can be very difficult to diagnose and requires a very VERY detailed assessment to out-rule all the possible causes. Osteitis pubis is a diagnosis usually given when all the other causes have been out-ruled and it literally is a degeneration of the pubic bone (it will have a moth eaten appearance on an MRI scan.

Osteitis pubis is usually treated with complete rest and maybe some ultrasound. However all other causes of chronic groin pain usually require some sort of active rehab in order to make a full recovery

Mcnewberson you said - that is a tell tale sign of Adductor related Chronic groin pain not osteitis pubis and that requires an active rehabilitation programme not complete rest.

Oh and just in case anyone thinks I have no basis for this - I have completed an Undergrad in Athletic Therapy and Training and am currently doing my masters the title of which is "injuries in field based sports with a special emphasis on groin injuries"

bubbleking - i am not going to say I know what I am talking about here but all I can say is what Eanna Falvey told me and the pain that I felt.

but you seem to be correct that I did have issues with adductors and and glutes after I get the injection and some abdominal pain.

do you agree that this is becoming a more common problem or is it that chronic injuries like this are now being diagnosed better?

bubbleking

mcnewberson wrote: »

bubbleking - i am not going to say I know what I am talking about here but all I can say is what Eanna Falvey told me and the pain that I felt.

but you seem to be correct that I did have issues with adductors and and glutes after I get the injection and some abdominal pain.

do you agree that this is becoming a more common problem or is it that chronic injuries like this are now being diagnosed better?

Eanna is a great guy iv a lot of respect for him and in fairness chronic groin pain is always going to be a grey area so people will always disagree

hmm its hard to know if its becoming more of a problem - one of the theory's is that certain types of training methods are leaving people susceptible to developing the condition (i.e. training involving cutting and overloading the pelvis) However I have no basis for this (yet) but its something I hope to uncover in my masters.

But to answer your question more directly - if I was to see 10 injured people today i can guarantee you at least 3 would have some form of CGP. whether there will be a trend in this over a longer period of time it is hard to tell.

Paulmee

Thanks for all the info guys.
As I said Im waiting for the MRI scan. Ill give you some background to my injury, which Id love to know what exactly is wrong. I play soccer mainly 3/4 times a week. I don't go to the gym, but I play tennis and jog the odd time
It started last june, I felt soreness after training around the groin(right), lower stomach i.e I was unable to do situps, and Id notice a pain getting out of bed and driving.
Hence an appointment to the doctor, who gave me painkillers and told me to rest to 2 weeks. This didnt help, so more rest etc, then in november I went to the physio. 5 sessions later there was no improvement, so more rest(and the physio used to have me close to tears with the massaging and trying to get read of the dead tissue!
In December I went to the doctor to get referred, so as of today Im waiting on an appointment.
The pain is hard to describe, but its mainly a sharp pain in my right groin, a very stiff hamstring, and soreness of my pubic bone, gluts, and around the general area of my lower stomach etc. Apologies for he lack of medical terms, its the type of injury thats hard to describe.
Rest helps a bit, but once I go back playing, the pain returns. I can play grand, but it gets progressively worse during a game, resulting in me struggling to run and even walk after 60mins etc. Im continuing to play once/twice a week, but am taking it easy(stupid some might say), but I feel that I cant make the injury worse(thats my opinion, others would disagree). Im playing because resting it does nothing for the pain, only a temporary disappearance, if that makes sense!

Excuse the long post!

Akabusi

Guys just to share my experience with ye. I went through two years of pain in my groin and lower stomach with all the same symptoms in the other posts. The first season with it wasn't so bad, I would be a bit sore after a match or training. I went to my physio near the end of the season and he suggested rest over the winter and to do core exercises. I did this but when we started the pre season training i was as bad as before and as we got into the season it was getting worse. My physio then decided to send me to a sports doctor and even he wasn't sure whether it was Gilmores groin or osteitis pubis. All the time I was still playing through a lot of pain and I was on anti inflamitaries and wearing a support belt. The doctor referred me to a well known surgeon who used to play with Meath, he diagnosed gilmores groin and that it could be repaired with surgery. I decided to finish the season and then have the operation. That was twelve months ago last december, and its been a complete sucess. I have no pain now and i am back enjoying sport. Regarding the operation there is quite a rehabilitation program to follow, the next day after the operation I had to walk for ten minutes and it was even hard to get out of bed. The surgeon told me for the operation to be a sucess the program had to be followed to the letter. Also at the same time a teammate was going through similar pain in his groin, his condition was diagnosed as being osteitis pubis and there is no operation for it only rest core evercises and cortisone injections, he missed the whole of last year to get it right for this year. He has started back trainng last week and says he is pain free again

UUJ_Lad

mcnewberson wrote: »

Your Physio should have done a test where you lie on your back with knees bent. They will put their fist in between your knees and you try to close your knees, If this hurts your ticking all the boxes.

Yeh, sorry should have said. I have this done - and yeh it did hurt that much, wasnt really painful. But very hard to do, alot more effort than it should have taken.
But I have noticed myself recently i'm alot more confident in things arent hurting as they used to, just every day things. I'm going to Edinburgh next week then the monday i'm starting back to training.....Will hope that the rest has done me good combined with these excercises. Hoping to avoid any sort of surgury to be honest. But this is certainly the most bothersome injury i've ever had, i'd rather the broken bones lol

mcnewberson

Hi,All

I was wondering if I could get some advice,

As I mentioned in my earlier posts that I was being treated for chronic groin pain/Osteitis Pubis,
I have started to joging/straight line running in conjunction with some Circuit training and gym work (Bike, rower, Ski Machine) again these past weeks but I find that I get an ache in my lower back and groin if i push too hard? tried a game of 5 a side on tuesday night and definatly felt a tightness in the lower back an dgroin, NOthing really bad but moticable all the same. Is this weak simply muscle? SOme of the more knowledgeable guys (Transform etc) talk about foam rolling for glutes and hamstrings, Would this be an option?

mcnewberson

Just bumping this up, hopefully someone can help

nafo

im 16 and had this for the last 6 months and didnt run since but it was never as sore as the rest of the people who had well it was very sore when last played on it but ever since it was only slighty but i can stil feel it... so is mine just a less serius case of it? and im wordering will i ever be back fully been able to play cause its a young age to get this type of injury and its driving me mad and i feel like ill never be back?

bubbleking

mcnewberson wrote: »

Just bumping this up, hopefully someone can help

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