The pubic symphysis is the connective tissue attachment of the bony pelvis anteriorly. Inflammation of the pubic symphysis results in a condition known as osteitis pubis. Osteitis pubis is a relatively common condition however it’s mechanism of injury is uncertain. It is however most likely caused from muscular traction in the pelvis that causes excessive movement at the pubic symphysis resulting in inflammation.
Osteitis pubis therefore appears to be an overuse injury associated with excessive kicking and abdominal muscle use. In some cases this condition can be acute due to direct trauma to the pelvis.
Symptoms of Osteitis Pubis
• Dull aching pain that is difficult to localize but usually maximal over the pubic symphysis
• Aggravated by standing on one leg
• Tenderness over the pubic symphysis
• There may be pain on contraction of the abdominal and some thigh muscles
• There may be associated restricted hip movement
Diagnosis and treatment
Your physiotherapist will be able to diagnose and treat this condition. Initially pain provoking activities must be avoided so that the condition is not worsened. Physiotherapy initially would aim to reduce inflammation which may include the use of electrotherapeutic modalities. Your physiotherapist would also assess and treat any associated pathology (e.g. low back or hip stiffness) as well as any abnormal biomechanics that may be predisposing you to the condition. Also as pelvic instability is a feature of this condition your physiotherapist would also work on strengthening your stability muscles – pelvic and lower back.