Dear Neil
I'm a forty-seven year old male who has been running for over thirty years. During that time I have had my share of injuries, but nothing like I'm currrently experiencing. My problem is a pain in my pubic area during and after running.
When I first noticed the pain I thought it was attributed to crunches and sit-ups and assumed I had torn an abdominal muscle. I refrained from running for about four weeks and my condition seemed to improve. But, as soon as I resumed running the pain returned. The day after is especially painful and I find it difficult to stand erect. As the days go by without running the pain subsides to the point where I don't even notice it. I'm able to cycle, climb stairs and weight train with no pain.
My only symptom is the pain associated with running. My doctor has checked me for a hernia and run blood and urine tests and found nothing abnormal. He wanted to schedule me for a colonscopy, but I not convinced he on the right track. I feel the pain is more of a muscular/skeltal condition. I have read the letters sent to you by other athletes with simular symptoms and was curious if my condition might be Osteitis Pubis. What do you think? If so, what exactly is this condition and what can I do to get back to running and prevent future recurrences? Thanks Mike
The message is:
I have Osteitis Pubis and It seems to take
forever to get over. I have been to therapy
twice and did the ice heat ultra sound and
still when I sneeze I tears me up.
How long does this take to go away it's been
going on 5 months and I need to train for spring
flag football what should I do?
I want to get rid of this as fast as possible.
Thank you.
The message is:
Port Elizabeth, South Africa
For the past month or so I have been struggling with Pubic Symphitiis / Osteitis Pubis (excuse the spelling). Although a little better than initially, it is still aggravated although does not prevent me from running or playing squash. Squash, with it's lateral movements, does seem to irritate the effected area, but is not a hindrance whilst playing (unlike a few weeks ago).
In the effected area (right side) small bumps can be felt, although I suppose could be trigger spots?
The pain is an area extending from lower pelvis/upper inner thigh up to lower abdomen muscles. Sit ups are impossible.
The morning after a game of squash the first kilometer or so of a run is a little sore, but thereafter ok.
With us preapring for two of our big South African ultra's (56km Two Oceans end of April and 87km Comrades in June), some quick resolution is required.
Any advice? (Although unlikely to impact, also experiencing runner's knee in left leg).
Much appreciated.
Andrew
Seems like everyone has Osteitis Pubis...so a gropu response to try and deal with the questions:
Pain around the pubic symphesis can be due to: 1. Proximal Adductor strain, 2. A stress fracture of the inferior ramus of the pelvis or 3. Osteitis pubis. Osteitis pubis is unusual (inspite of the rash of osteitis pubis questions I have been fielding lately). Running athletes are especially susceptable, more so the long distance runner. Pain and tenderness over the pubic symphesis are the typical presenting symptoms. In severe cases, the pain radiates into the inner thigh, and up into the lower abdominals.
Initially, anti-inflammatory meds combined with ice and rest is the best therapy. Occasionally, a severe case is best treated with a local injection of a corticosteroid, and occasionally, in very severe cases, an oral course of steroids is called for.
Once settled, rehab needs to emphasize the abdominals, and the adductors, especially in frontal plane activities - such as those one might do on the slide board). Cross training - roller blades or inline skates for runners is an ideal activity for cross training days. Manual therapy is not always helpful, but an iliac obliquity might be present, and can be resolved by a competent manual physical therapist.
