Osteitis Pubis Injury Question

I'm sorry to hear this. While I haven't suffered from this, I have a number of running friends who have been through it (male and female!). Have you talked to your doc about cortisone? While I'm typically anti-cortisone, it's actually pretty good for that area.

good to hear other male runners have seen this problem.

I have been visiting a physiatrist with specialty in sports and physical medicine. He is extremely reluctant to give me a cortisone until all rehab has been exhausted. He is saying minimum 6 months of rehab before he considers it. Unfortunately the muscles attaching to pubic symphysis are so irritated any kind of movement is extremely painful. I've tried to convey that im in constant pain even without exercise.

I am not sure he understands this and is treating it like any normal OP injury. I am starting to wonder if they missed a tear in on of my deep pelvic muscles as I am having spasms in my abdominal muscles, sexual dysfunction, spasm of my unrinary muscles causing constant pressure and a constant dull ache from the front of my pubic bone to my anus. Ive relayed all this symptoms to my dr. but he dismisses them. I know they are related to this injury because I didnt have them before, and increased physical activity increase the symptoms 10 fold. Ive never read anything about OP causing this level of trauma.

I will push him for a cortisone shot since it helped other people

thank you

Had severe case of OP many years ago. Managed for while with anti-inflammatory meds. Finally got accurate diagnosis and was told 9-12 months of no running. Being a competitive athlete, I had to make the decision to retire (other reasons as well)...I have always thought that my gait had something to do with additional torque to the symphysis's area. I was running 100+ mile weeks to give you an idea of intensity. I hope you can overcome I would hope after 40 years they have found a better way to treat.

I had this in my late 30’s. Pretty much caused a year of only light jogging. Good news is I recovered and with regular work to keep the hips strong it hasn’t recurred.

I ran through it because I had no idea what it was. I thought it was a groin injury. It took me about 4 months altogether to fully recover. Mind you. I was doing some really slow miles because it was impossible to power off when you're hurting in that area. It could have been a coincidence but I iced the hell out that area 3 times per day. That did the trick. I didn't care if I would lose my sperm count because the docs were saying not too ice that area too long. I think doing that for like 2 weeks is what healed me. How I got hurt was I was speeding down a hill on a snowy day and there was a bad step due to ice patches leftover from previous snow storm below the new blanket of snow. That somehow crushed the pubis area with pelvic bones. So it was just pure bad luck. I assure you I am 100% recovered. No residual anything.

Maybe our situations are different but I too was pretty much hopeless because it simply wouldn't go away. I was already well past 40 when this happened and I finally had time to train again. All I can say is hang in there. The injury went away with no sign. It just did. One day I was like, "Can this be true?" And it just happened and I was pain free.

I had it - and still have it. About 1.5 years. I think for some it just becomes chronic.

I had a friend who had it show me a number of PT prescribed strengthening excercises. Those have helped. I have had other injuries that have stopped me running and the OP typically comes right back when I start running again. It actually gets better for me with more regular activity.

I have no doubt eventually it will dissappear. Pain went from 8 out of 10 initially to maybe a 2-3 now. Find some excercises to stre ngthen the area. I think it will eventually dissapate.

Coming back from a hernia surgery a few years back, I began to have this extraordinary pressure on the pubic bone while running; so intense it felt as if it could 'explode' with one wrong step. The bone itself was also extremely tender to the touch. Finally, it got to the point that I had to stop running. That was a year ago. I'm starting to run again, but slowly--these days I feel as if I will pull my groin each time I run. I will experiment with cortisone if it comes back.

Wondering what kinds of strengthening exercises you had luck with?

I had osteitis pubis about 15-18 years ago at age 52-55. (Can't remember the exact dates.) It's an inflammation where the pubic bones rub together in front. In the OPs case, it's obviously from overuse, even though the onset appeared suddenly. There aren't many nerves there so it can be severe before you notice it when it seems to flare up. The pain is felt in other locations. I had previously had a sports hernia so I went straight to a specialist... a former doctor to the US Olympic Team. The X-rays were shocking. The ends of the bones were disintegrating!

I was told no physical activity of any kind for six weeks. Another X-ray showed progress at six weeks so I was able to aqua jog for the next six weeks... no biking, spinning, elliptical, or even swimming... because they all move the pubic bone. Just water running. At 12 weeks, he said my recovery was remarkable for someone my age and I was allowed to return to running.

I suspect the OP ran past the point I did and as a result did more damage.

My suggestion for the OP is to get a 2nd opinion right away. See a sports doctor or orthopedic doctor. We think of medicine as a science and it is up to a point, but a doctor's level of expertise with a certain injury may vary widely from another doctor's expertise. I think, although I'm not sure, that Osteitis Pubis is more common in soccer players so the OP might ask who local soccer teams use for bone-related injuries.

It's a bone injury so strengthening isn't necessarily going to help, in my opinion. The OP needs to reduce the rotation of the pelvis when running, reduce the impact of landing, and reduce the volume of impacts. For me, it was easy to identify the cause of my injury. I was doing multiple hill repeats every week and although I wasn't racing down the hill, I was landing hard with each step to get down quickly. I eliminated downhills for a while when I returned and now I never race the downhills in my workouts. In the OPs case, it was probably done from landing hard on the downhills in all those marathons he ran in a short period of time. When you get tired, the quads tend to lose their shock-absorbing ability and that impact going up the chain to the hip joints and in this case, to the pubic bone.

tl;dr

See another doctor ASAP.

I'm a 37 year old man & I'v been suffering from this for about 3 years. Also had an MRI to confirm. I'm not nearly as good a runner as you but I do like to run every day. My symptoms are not nearly as bad as you either but if I run hard for multiple days in a row it's hard to walk up and down stairs, roll over in bed or just start walking if I've been standing in place for to long. So once I had the MRI back in 2019 I took about a month off and then had a CT Scan guided cortisone shot in Jan. 2020. I took 2 months and then was able to run like I wanted to. The problem started again over the summer and I'm back to square 1. Late in 2020 I was trying to run 1 day then take 2 days off so I could at least run a few days a week. Jan 2021 I saw my doctor again and he recommended I stop running completely and said this could take a long time to fix. He sent me to a running specific PT clinic. I had a full biomechanical assessment and they determined I had such weak core muscles and upper leg lateral strength I started an intense PT program. I've been going for 8 weeks now and I can see a huge improvement in my strength. I haven't run 1 step but they think in the next 4 weeks they want to start me on a walk to run program. Basically the plan is to walk for 4 minutes, run for 1 minute x 6 (30 min) every other day for week. If no pain then I would start 3 min walk/2 min run and so on. My marathon PRs went from: 2015: 4:08 spring 2015: 3:31 fall 2016: 3:25 fall 2017: 3:16 fall I felt like I was close to breaking through to a sub 3 but I haven't been able to run more than 6 or 7 miles since 2018.

It’s not a bone injury. It’s a joint injury. You pubic symphysis is a joint “ The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones.”

fisky wrote:.

It's a bone injury so strengthening isn't necessarily going to help, in my opinion..

very interesting, lots of good info here.

looking back, even though I was averaging high miles 90+ per week, and 14+ marathons a year, 2020 was the first year I ran a downhill marathon, and I happened to run not just 1 but 3 in a 4 month period. It makes sense that all that hard pounding would eventually put too much strain on that joint.

I've always been an anomaly in running, as i'm 195 lb muscular runner in a traditionally smaller body size sport. Im built more like a tight end than a runner.

This has always been a positive for me as my size and strength has allowed me to pound the miles and races with little regard to recovery and injury. This is actually my first ever injury in the 6 years since I started running.

Very surprising to me that this injury popped up out of the blew though, I thought for sure that there would be warning signs before this level of trauma. The MRI showed stage for Osteitis Pubis, which is the worst stage. I just cant understand how a week before this injury I was able to run a 2:35 marathon in Arkansas.

I have been working with a PT specialist and he has me doing a million core exercises . Anything that uses the abdominal muscles I can do fine, but as soon as I do any adductor strengthen exercises my OP goes bananas. Right now im just trying to get it to the point where I can function in everyday life, after that I will start looking at a return to running.

Thanks for all the help and suggestions