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Osteitis pubis is a term given to lower abdominal and / or pelvis pain that can occur in athletes. Typically it causes pain towards the middle of the pelvis, at the front. This is also known as “pubic bone stress injury”.

There are, undoubtedly, some cases of osteitis pubis that are “primary”. That is they are not caused by something else. These cases can be particularly difficult to treat.  Treatment may include non-steroidal anti-inflammatory painkillers, also “bisphosphonates” which directly affect the bone and can sometimes help. Also injecting steroids or platelet rich plasma in the area where there is pain.

In many cases, in athletes and sportsmen and women, it seems that the “stress” is coming from the many muscles and tendons that insert into the pubic bone at the front (the pubic tubercle). It is often seen as part of the symptoms of a “groin disruption” (also known as sportsman groin or Gilmore’s Groin). In these cases it is the muscles pulling hard on the pubic tubercle at the front of the pelvis that causes the pubic symphysis to pull apart and become frayed. The muscles pull so hard that they tear off their normal attachments causing a groin disruption (sometimes referred to as being like a muscle dislocation).

In these cases treating the symptoms will not cure the problem; the groin disruption needs to be repaired.  Repairing the muscles in an anatomical fashion restores the normal structure and function of the groin and can cure the symptoms.

After surgery it is important to undergo thorough rehabilitation and to continue with exercises that strengthen the core muscle and reduce the risk of any further problems in future.

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