Osteitis pubis or sports hernia

December 12, 2019

Hi

I have been suffering with pain in my groin for the last 8 or so years that started off with groin strains. Over the past 2 years I have been seeking treatment as on some days I cannot even walk without pain. (walking and any sports activity causes a flare up of sorts).

I have had multiple MRI’s done as well as an X Ray and Ultrasound, all which tell me different things, or come back inconclusive. I believe I have Osteitis Pubis. I can tell my whole pelvis is out of alignment, causing my weight to be imbalanced.

Any time I stretch my groin (which I do not do any more due to me just resting it constantly) I get extreme pain.

How could I differentiate OP from a sports hernia (I had an ultrasound done a while ago that suggested sports hernia but all MRI’s since then have come up negative for that. Orthopaedic hip surgeon said MRI was ‘ultimate scan’)

I am looking for a physio in London who would know how to approach this situation for me. I am sick of being sent back and forward without knowing what is wrong with my body.

Sorry for the long message and thank you.

Alex
December 12, 2019

Hi Alex

Andy F-M wrote a pretty good article a few years back http://www.drandyfranklynmiller.com/so-you-are-still-calling-it-gilmores-sportsmans-hernia-or-osteitis-pubis/ and the over riding conclusion then, and still today is progressive, respectful and functional loading of your lower limb – from top to bottom.  It’s absolutely not about stretching and just strengthening as you need to be able to control what you do rather than just get stronger.

What reads OK is that you don’t have any definitive diagnosis on imagining indicating that you’ve got a functional issue (ie what you’re doing to your groin) rather than a structural issue (what you’ve got) and this is why your rehab is key to allow you to start loading.

If you don’t do enough, then the tissue is underloaded and this becomes the norm, and so anything normal is overload and that’s just painful. Same being for doing too much too soon, your tissue continually breaks down and can’t repair.

We’re pretty good at dealing with things that don’t get better as expected. It starts with “does this make sense” as a simple solution to often a complex situation always saves the day.

Don’t expect over night results but if you can understand what’s up and why, it goes a long way to providing you with a really good long term solution.

Sounds fair?

The Guru

Guru Responded

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