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Treating and Preventing Osteitis Pubis in the AFL: The importance of pelvic stability.

Osteitis pubis is a condition that involves pain and inflammation of the pubic bones, pubic symphysis, and adjacent structures. Unfortunately, it has such a high incidence of occurrence in the Australian Football League (AFL) that it is second only to hamstring injuries.

Not only does osteitis pubis have an impact on the athletes, but this condition was estimated to cost the 16 AFL clubs over AU$1.7 million in player unavailability in 20061. Additionally, 41% of athletes who are diagnosed and treated for osteitis pubis go on to experience continued pain and weakness when playing after treatment that included 3 months of time away from play.

Characterised by chronic groin pain, osteitis pubis predominantly occurs in sports where athletes engage in kicking, rapid changing of direction movements, and stopping and starting at speed. According to Pizzari, Coburn & Crow (2008), a key factor in preventing osteitis pubis is ensuring pelvic integrity, where the pelvis is correctly aligned, equally strong on both sides, and that there is neither too much or too little movement in the hip and sacroiliac joint, in the athletes.

Given the importance of pelvic stability in helping athletes prevent and recover from osteitis pubis, here is a list of best practice methods to increase pelvic stability:

  1. Prevention Programs: These types of programs include stability, flexibility, and core strengthening exercises including Pilates, core stability, Swiss ball work, and flexibility training as well as strength and conditioning sessions. Increasing the stability and strength of the muscles surrounding the pelvis and ensuring that the sacroiliac and hip joints are not too tight or too hyper-flexible are key in preventing chronic groin injuries such as Osteitis Pubis.
  1. Compression garments that include pelvic support. Not all compression garments are created equal, but a medical grade compression garment such as Supacore CORETECH, with its patented waistband, provides specific support to the sacroiliac region, essentially it builds in a sacroiliac joint belt into performance sports clothing. Clinically, physiotherapists have noted both an immediate reduction in the amount of pain experienced by osteitis pubis patients, and a faster return to play. Compression becomes doubly important post-injury recovery as the recurrence of pain and debilitation for osteitis pubis is 41% post recovery.
  1. Physical Therapy: A physiotherapist or other sports medicine professional with experience in the treatment of chronic groin injuries/osteitis pubis is an absolute must. Having a professional help release tight joints and muscles, as well as create a proper stretching and rehabilitation regime is crucial for short and long-term management of the condition.

Pelvic instability testing and assessment, combined with the methods outlined above are key factors in the prevention and treatment of osteitis pubis.

Read more about Osteitis Pubis here

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1. Pizzari, T, Coburn, P & Crow, J 2008, "Prevention and management of osteitis pubis in the Australian Football League: A qualitative analysis", Physical Therapy in Sport, vol. 9, no. 3, pp. 117-125.
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