Pubic region is the place where the right and left pubic bones meet each other. This point is called as pubic symphysis and swelling of this region is osteitis pubis. It can cause severe groin pain due to the tissue damage of pubic symphysis. At this point many muscles of the abdomen and the groin fuse together and contract vigorously during exercise. Osteitis pubis commonly occurs for runners and weight lifters. The main cause of this problem is overuse of pubic symphysis involving in repeated contraction of the muscles causing injury. Osteitis pubis can be treated by stretching exercises and physiotherapy.
The pelvic girdle is made up of two bones called hemipelvis which fuse together in the front portion at pubic symphysis. This point is made up of several tissues and cartilages to tolerate friction between the two bones. The muscles contract repetitively when a person runs, kicks or do sit-ups continuously building pressure on the pubic symphysis. The cartilages get torn causing inflammation of the pubic symphysis due to repeated muscle contraction while running or similar exercises. This causes intense pain and inflammation of pubic symphysis region.
Mild to severe pain can be felt on the groin region due to the swelling of pubic symphysis. The pain will not be sudden and develops gradually due to repeated exercise. For some people pain starts from the lower abdomen and radiates towards the groin. There can be stiffness and tenderness on the groin area which an expert doctor can feel while touching. Pain can be felt when firmly touching the pubic bone. The pain may subside while resting which again gets sharp when doing activities.
Sports persons who take part in distance running (like marathon), kicking involved in football and other sports are largely affected with osteitis pubis. Repetitive running with change of direction causes friction in the muscles leading to inflammation. Injury caused due to over-use and strain of pubic symphysis is the major reason for osteitis pubis. Doing exercises on hard surfaces or uneven ground, wearing poorly fitting shoes while exercising and increasing the intensity of exercises suddenly can cause friction of muscles of pubic symphysis. Biomechanical causes of osteitis pubis include poor running or walking methods, stiff muscles of groin and hips and muscular imbalance.
Symptoms like increased pain and stiffness in the groin area is enough to diagnose osteitis pubis. Your doctor or therapist would order for X-ray of pelvic bones to get accurate picture and severity of inflammation.
For mild degree of injury or inflammation of pubic symphysis taking complete rest is enough. Like many other muscle injury, RICE is highly effective treatment for osteitis pubis. RICE is the short term used to describe Rest, Ice, Compression and Elevation. Taking rest means restraining from any kind of physical activity. The area of groin should be totally immobilized. This would help in quick healing of torn tissues and ligaments. Application of ice over the area would reduce pain and swelling to large extent. The ice should be applied through wet clothing gently over the skin.
Compression can be either hot or cold. Gently apply warm compression over the affected groin to get relief from pain. Elevation means keeping the legs in elevated position which would increase blood flow. For moderate degree of injury you need to consult a physiotherapist. Often suitable stretching exercises done with the aid of therapist will heal the inflammation in most of the patients.
For severe ligament injury, the patient should take help of crutches while walking. This would give good support and would prevent further damage to the bones. Using crutches will also facilitate quick healing of damaged tissues. Ignoring the symptoms of pain and swelling will do more damage to the cartilages of pubic region. In such cases osteitis pubis becomes chronic and long-lasting requiring rehabilitation for specific period for complete healing. Until the wound is healed completely it is advisable to take complete rest. The person should not indulge in any form of exercises till the therapist gives clearance. Gradually sports activities can be resumed if there is not pain.
Over the counter anti-inflammatory drugs are useful in healing of torn tissues. Once you get back to running or other sports activities your therapist would monitor your health condition carefully. She should be able to formulate tailor-made activity program for successful return. Before getting on to the actual match training will be given in accelerating and decreasing speed of running drills.
In most of the cases osteitis pubis can be treated fully and the person can get back to normal sports activity within weeks. Severe cases of injury may need total rest and rehabilitation for months together.
Tips for Prevention :
If you are a sports-person you need to follow the instructions of the trainer closely. A good warm up is needed to prepare your body for the vigorous activity. Be careful in avoiding activities that can induce pain. Take enough rest so that the soft tissues would heal and recover from damage. Practice stretching and strengthening exercise alternatively. Use proper shoes that give ample support and cushioning effect to your legs.