Inflammation at the pubic symphysis causing groin and lower abdominal pain, commonly seen in athletes. Frequently associated with underlying hip pathology that requires assessment alongside the pubic joint.
(03) 9573 9659
Osteitis pubis is inflammation at the pubic symphysis – the joint at the front of the pelvis – causing groin and lower abdominal pain. It is common in athletes involved in kicking sports, running and activities requiring repetitive hip flexion and adductor loading. It frequently occurs alongside underlying hip pathology, and a thorough assessment of the hip joint is an essential part of its evaluation.
Osteitis pubis is caused by repetitive stress or shear forces at the pubic symphysis. When the hip joint is mechanically abnormal — due to impingement, dysplasia or restricted range of motion — the pelvis compensates, increasing the load through the pubic symphysis. For this reason, osteitis pubis and hip impingement frequently occur together, and treating only the pubic joint without addressing any contributing hip pathology often produces incomplete or temporary relief.
Pain over the pubic symphysis and in the inner groin, which may radiate into the lower abdomen or adductor region. Pain is aggravated by kicking, running, single-leg activities and rapid direction changes. Tenderness directly over the pubic symphysis is a characteristic finding on examination.
Diagnosis is based on clinical examination and imaging. X-rays may show changes at the pubic symphysis. MRI provides more detail on the degree of bone marrow oedema and any associated soft tissue pathology. A thorough assessment of the hip joints is performed to identify any contributing impingement or dysplasia.
Initial management is non-surgical and includes rest, activity modification, physiotherapy, anti-inflammatory medication and, in some cases, a cortisone injection into the pubic symphysis. Most patients respond to conservative management over a period of several months, particularly when any contributing hip pathology is also addressed. Surgical intervention is rarely required and is reserved for cases that do not improve with sustained conservative treatment.
(03) 9573 9659
Mr Balakumar is one of a small number of surgeons in Australia with formal training in both paediatric and adult hip surgery. His fellowship at Harvard’s Children’s Hospital in Boston, under some of the world’s leading specialists in hip preservation, gives him a depth of expertise that is difficult to find in a single practice.
His approach is the same whether the patient is 6 months or 65 years old – thorough assessment, honest options, and no pressure toward surgery until the clinical picture clearly supports it.
(03) 9573 9659
A common cause of lateral hip pain, ranging from tendon degeneration through to partial or full-thickness tears. Treatment depends on severity and includes physiotherapy, injection and in some cases surgical repair.
Abnormal movement at the joints of the pelvis causing pain and difficulty with weight-bearing activities. Assessment includes evaluation of the hip, pelvis and lumbar spine together.
Hip and groin injuries in athletes range from labral tears and adductor strains through to stress fractures. Accurate diagnosis is essential as many conditions in this region can mimic each other.
Progressive loss of cartilage within the hip joint causing pain, stiffness and reduced function. At least 80 per cent of hip osteoarthritis has a structural cause that can be identified and, in suitable patients, addressed.
Melbourne Orthopaedic Group is home to a team of experienced orthopaedic surgeons, providing comprehensive care for sports injuries and orthopaedic conditions. Whether it’s joint replacement or sports injuries, our specialists provide comprehensive orthopaedic care.
