Osteitis Pubis: Pubic Bone Pain in Runners | E21 with Benoy Mathew, Physiotherapist
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- Опубліковано 26 чер 2021
- Osteitis Pubis is a relatively uncommon cause of pubic bone pain in runners. However, when it occurs it can be a real nightmare to get rid of it. A few months back I received a question about it from a listener...
"Hi Matthew, I’ve been watching your podcasts on UA-cam they’re really good. I can’t come to see you as live in England. I’m a 51 year old ________ trying for 5 years to beat 1hr45 for trail half marathon. Not sure if you can help but had to stop due to bilateral pubic rami osteitis (diagnosed on MRI) with medial groin pains radiating down my adductors during runs and for days afterwards. Literature is confusing, rest for 3/12 and lose all my conditioning? stretch or not to stretch? Continue weight training? Run to below 4/10 or not? Try cycling or rowing machine? Please can you advise, understand if you can’t for professional reasons etc. Thanks Adam _____"
Since I had little experience dealing with this problem I took to the internet. It's very hard to find any good information about managing pubic bone pain in runners. I did know just the person to ask though.
My guest today is an expert in the management of hip and groin pain. Benoy Mathew is a Physiotherapist and Extended Scope Practitioner, specialising in the management of complex lower limb pathology. Benoy completed his Masters in advanced physiotherapy from the University of Hertfordshire in 2014. He currently works in a senior clinical role in the NHS and privately at the Life Plus Clinic in London, UK consulting on complex hip and groin pain cases that have failed rehabilitation elsewhere. Benoy teaches his hip pain and running injury management courses to Physiotherapists and other clinicians all over the world.
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Solid overview and explanation. I fall into that 50+ male runner that started to feel a little abdominal and pubic bone pain the past couple weeks - after of course ramping up volume/intensity too quickly (adding in intervals / hill sprints while also increasing monthly volume). As the pain just started, isn't very severe, and doesn't persist for any long duration, I don't think I'm in the "waited too long" category but I will definitely be backing down intensity and volume this month and seeing if it calms down. I will also be adding in more recovery and/or cycling days. If it calms down, great. If not, off to the physio I go. I'll put myself on a very short leash though. If, even with the lowered intensity and extra rest, it is still heading in the wrong direction instead of calming down, I''ll head to the physio more immediately.
Hey, that sounds like a sensible strategy. Honestly though, I'd suggest you just go to Physio now. There's no point messing around with pubic pain.
I'd also recommend doing some hip flexibility work. Definitely see how you do on the Split Squat Benoy mentioned, here's a video of it:
ua-cam.com/video/uqI3GVwfToU/v-deo.html
If you need any specific help, just give get in touch:
matthewboydphysio.com/running-pain/
I started having issues after deciding to become a long distance runner in my late 30's. Then my hip felt like it was getting stuck, and my groin felt like it was weak and "pulling" while running. Then it felt like my pelvis was going to split in half. After that I started getting an internal burning sensation and was diagnosed "hypertonic " pelvic floor and pudendal neuralgia. 4 years later a radiologist casually mentioned he saw oseitis pubis on my MRI. This is after seeing 50+ providers in multiple states and having several unless gynecological surgeries. I'm hoping this can be fixed. I've been in pain 24/7 for 4 years. This can become a devastating debilitating condition when left untreated. And there is NO way I could ever sit on a bike seat to cross train, I haven't been able to sit in a chair for 4 years
Oh man, that's extremely rough Sharon 🙂
This sounds a little complex for my own skill level but you should reach out to Benoy, he might be able to help: www.linkedin.com/in/benoy-mathew-9202b56b/
Thanks for the videao,
my son is a young football player (16 years old) and he doesn't really have severe symptoms. He experiences discomfort in his hip flexor while sprinting, and it worsens with continued training. We did an MRI and he was diagnosed with OP. Currently, he has stopped training with the club and is undergoing rehab with the club's physical therapist. He doesn't have any issues in his day-to-day life. During the squeeze test of his adductors, he feels a discomfort level of 1 to 2 out of 10, and abdominal tests are pain-free. Do you think he is in early stage of OP? How long does it take to return to sports activities?
Thanks for your replies.
Hey Abdellah,
Sorry to hear about your son’s trouble.
I’m afraid it would be reckless of me to comment on his injury without a full evaluation. You could share this video with your physical therapist and ask them the same question though. They should be able to advise 🙂
I wish him a speedy recovery!
could this happen to a new runner who maybe did a bit too much too early ?
Absolutely. If you have pain in that area, definitely get it checked by a doctor or a physiotherapist 👍