Everything You Need to Know About Osteitis Pubis

What is Osteitis Pubis?

Osteitis pubis is a condition where the pubic symphysis, the joint at the front of the pelvis, becomes inflamed. It causes pain in the groin, lower abdomen, or pelvis, especially during running, kicking, or twisting movements. It’s an overuse injury, common in athletes, especially footballers, runners, and dancers.

An analogy…

Think of the pubic symphysis like a shock absorber between the left and right sides of your pelvis. If you overload it over time, it becomes inflamed and irritated, like a cracked rubber buffer that can no longer cushion properly.

What are other names that osteitis pubis can be called?

Pubic Symphysitis

What causes osteitis pubis?

The pubic symphysis is a cartilaginous joint where the two halves of the pelvis meet. It allows small but important movement for activities like walking, running, and twisting. Repetitive stress or imbalance across the pelvis, from tight muscles, weakness, or poor movement control, can cause inflammation, joint irritation, and microtearing of nearby tendons.

What are the signs and symptoms of osteitis pubis?

Groin pain or pain at the front of the pelvis
Pain worsens with running, kicking, sprinting, cutting, or twisting
Tenderness over the pubic bone
Pain when lifting one leg or squeezing the knees together
Stiffness or aching, particularly after exercise
Reduced flexibility in the hips or pelvis
Clicking or grinding in the pelvic area during movement

What tests are used to diagnose osteitis pubis?

Palpation: Pressing over the pubic symphysis reproduces pain.

Adductor squeeze test: Pain when trying to squeeze the knees together against resistance.

Single-leg stance test: Standing on one leg may cause pain if instability is present.

How long does osteitis pubis take to heal?

Mild to moderate cases may improve in 6 to 12 weeks with proper management. More stubborn or severe cases may take 3 to 6 months.

How does osteitis pubis happen?

Overuse from running, kicking, twisting sports
Muscle imbalances
Pelvic instability or poor load transfer between sides of the body
Sudden increase in training load
Poor technique during running, kicking, or change-of-direction drills
Previous groin or hip injuries

What treatment can help osteitis pubis?

Rest or modify activity
Ice therapy in the acute stages to reduce inflammation
Manual therapy (massage, joint mobilisation, soft tissue release)
Structured exercise rehab
Postural and movement retraining
Shockwave therapy

What exercises or stretches can I do for osteitis pubis?

Isometric adductor squeezes
Glute bridges and side-lying hip strengthening
Core stability exercises
Hip mobility drills
Balance and pelvic control exercises

What products can help with osteitis pubis?

Bridge with resisted hip abduction

Place a resistance band loop around both thighs, just above your knees.
Lie on your back with your knees bent and feet flat on the floor.
Place legs hips width apart so that there is tension in the band.
Raise your hips up into a bridge, keeping the knees hips width apart.
Control the movement back down to the start position, maintaining constant tension on the band.

Seated adduction ball squeeze

Start in a seated position.
Place a ball between your knees.
Squeeze your knees together, placing pressure on the ball while activating the inner thigh muscles.

Hamstring stretch supine (both legs straight)

Lie on your back with both of your legs straight.
Bend the leg that you would like to stretch and bring your knee in towards your chest.
Clasp your hands together behind your thigh.
Allow your thigh to rest in your hands with your arms straightened.
Keeping your upper body relaxed, slowly straighten your knee, bringing your foot up towards the ceiling.
Hold the position when you feel a stretch at the back of your thigh.
To ease off the stretch, bend your knee again.
Repeat.

Hip flexor stretch

Stand up straight next to a wall or supporting surface.
Take a large step backwards with your affected leg.
Keep your back heel slightly off the ground with the knee soft.
Slowly lower your back knee towards the ground while pushing your pelvis forwards.
Keep your body upright.
You should feel the stretch at the front of the back hip.
Hold this position.

Pelvic floor – goblet sumo squat

Hold a dumbbell, keeping it close to your chest.
Stand with your feet placed wider than your hips and turn your toes out slightly.
Squat down, bending your knees out over your toes and keeping your back straight.
Squeeze and lift your pelvic floor as you return to the start position, fully straightening your knees.