FAQ: Osteitis Pubis

Finn Diamond 26/03/26

What is osteitis pubis? This condition is defined as the inflammation of the pubic symphysis joint, which can cause pain in the groin and lower abdominals as well as tenderness on palpation around and directly on the joint (above the genitalia).

What causes osteitis pubis? It is often a repetitive strain or overuse injury where the body is struggling to deal with high impact demands of your sport. This can be due to muscle weakness at the adductors or lower abdominals as the pubic symphysis is a common attachment site for these muscles. Many hands make light work, if they are weak then the load has to be distributed somewhere and in this area it is the pubic symphysis joint.

Common sports:

• Soccer

• Rugby

• Footy

• Hockey

What are the symptoms? 

• Groin pain or lower abdominal pain

• Pain on palpation over the pubic bone and around the pubic symphysis

• Pain is worsened by activities such as sport, walking, sharp change of directions, walking up or down stairs and at times coughing and sneezing

• Clicking or crunching can be heard in certain cases as well

How is osteitis pubis diagnosed? MRI is often best to confirm inflammation around this region. However, a physical examination will often suffice initially and your physiotherapist or osteopath can assess the full picture and can determine if imaging is required.

How long does it take to recover? Recovery varies from case to case and depends on the severity. Mild cases: 4-8 weeks Moderate cases: 12-20 weeks Severe: 20+ weeks However, here at Limbr we can assess and gather valuable strength outcome measures to ensure we have targeted goals for strength and pain prior to returning to aggravating activities.

What is the treatment for osteitis pubis? Conservative management in the short-term can involve:

• Activity modification and better load management

• Anti-inflammatories

• Ice

• Release work through the adductors and lower abdominals

• Manipulation of the pubic symphysis joint

Conservative management in the mid and long-term:

• Individualised and tailored strengthening programme specific but not restricted to the hip and abdominals

• Graded return back into aggravating activities

I am big on treating what I find and that is throughout all stages of rehabilitation. In the short-term we want to improve pain. In the mid to late stages, we want to release what was tight and tender and strengthen what we found was weak to build your bodies resilience up to better handle the demands of your sport. Late stage is then more sport specific return to play activities and prevention/maintenance strengthening.

Can you continue exercising? This again will vary between cases and depends on how you present when tested in the clinic. In severe cases it may be a complete deload from the sport or activity that is the aggravating factor. In mild to moderate cases, it may be a deload from a training or restricted to certain drills or distances whilst running. An overall rule is, there should be minimal pain during and directly after and no pain the next day. If we can keep to this, we know that the pubic symphysis can get the recovery it needs whilst we are still completing some degree of loading. If you are struggling with your rehabilitation and are unsure about your hip or groin pain and it is inhibiting your ability to play your sport or complete the things you love then book in with Finn for a comprehensive assessment.