68 replies to this topic

[brizza]

guys,i've been doing some research into this thing and the news is not good,the people i have found(three bods)who have had surgery have had very good to excellent results,the rest(you lot plus two others) are having ongoing vague,esoteric,apparently unrelated problems which seem to go on for years.At this stage noone is admitting to having had osteitis pubis and fully recovered.more work to be done-briz

[John Dawlings]

Hi Brizza,
There are other threads on this topic but I had osteitis pubis many years ago which put me out of any form of running for 9 months and have fully recovered.  I have had injuries since of course (and am currenetly out injured) but entirely unrelated.  No surgery - just masses of exercises given by a physio.

[adamsof]

Hi, I have just been diagnosed with osteitis pubis after about 2 months of very bad pain in my quad and top of my knee. I had an MRI scan which confirmed the result. I was about 12 weeks out from a marathon when it happened which is now totally off the cards. I've only been running once a week for the last 2 months. It's one of the most frustrating injuries I've ever experienced.

I'm seeing Gary Zimmerman who is the Western Bulldogs club doctor in a couple of weeks - he is apparently the guru on OP and has successfully nursed several AFL players through the injury.

Hopefully he can help, because not only can I not run, but I can't walk for more than 20min without experiencing quite a lot of pain down my thigh.

If anyone has any treatment/rehab ideas, I'd be very grateful to read them.

OP is now my nemesis but I will win the good fight.

[Jonesy]

Comrades

Yes - I had it 3 years back and tried to run through it.  That lead to a hernia for which I had surgery.  Then the 8 weeks off post hernia surgery allowed the OP to heal.

You must see a good sports physician.  The AFL guys are best because the injury is most common in AFL.  If they say take 8 weeks complete rest, then DO AS THEY SAY.  Otherwise you will have a complex myriad of injuries.

For the record I have been running better for the last two years than before my OP.

Good luck buddy.

Jonesy

[vat]

Yay, I'm a test case!  I'm actually working with Brizza on my 'post Osteitis Pubis'.

A read of my blog from Jan to Sept last year (it trails off after that for some reason...) shows the symptoms I was managing prior to breaking down in September and really doing little to nothing after that.

To summarise, I was tracking issues through my upper right leg, from the hip itself down the quad and just above the knee.  I managed it through my Gold Coast Marathon campaign, but a series of hilly races, including the NSW Aths event at Bankstown, C2S and the Bridge Run finally did me in

The O.P. has now basically cleared, but I'm still having quite bad problems in my pelvis/hip (indeed, I can feel it right now), and am exploring options including surgery.  I'll try to keep posting here with progress.

[Jonesy]

I must add that in my case after the surgery, I got some excellent postural advice from a clever Osteopath.  I had a sway back (poking out my tummy) and that put undue strain on my pelvic region and led to my problems.  I now practice standing very tall and straight and carrying that into my running.

I do believe that has stopped the condition recurring.

Jonesy

[vat]

Jonesy, on Apr 25 2007, 09:17 AM, said:

I must add that in my case after the surgery, I got some excellent postural advice from a clever Osteopath.  I had a sway back (poking out my tummy) and that put undue strain on my pelvic region and led to my problems.  I now practice standing very tall and straight and carrying that into my running.

Jonesy, are you doing abdominal exercise to help with that?

[bud]

zimma is great, used to work with him when i was at PSM, massage will be helpful aswell. mainly, adductors, psoas, abdomnals and some neural srectching will also compliment your rehab.

adamsof, on Apr 24 2007, 07:57 PM, said:

Hi, I have just been diagnosed with osteitis pubis after about 2 months of very bad pain in my quad and top of my knee. I had an MRI scan which confirmed the result. I was about 12 weeks out from a marathon when it happened which is now totally off the cards. I've only been running once a week for the last 2 months. It's one of the most frustrating injuries I've ever experienced.

I'm seeing Gary Zimmerman who is the Western Bulldogs club doctor in a couple of weeks - he is apparently the guru on OP and has successfully nursed several AFL players through the injury.

Hopefully he can help, because not only can I not run, but I can't walk for more than 20min without experiencing quite a lot of pain down my thigh.

If anyone has any treatment/rehab ideas, I'd be very grateful to read them.

OP is now my nemesis but I will win the good fight.

[Jonesy]

Jonesy, are you doing abdominal exercise to help with that?

Too right mate - ABs of steel!

We had no idea of ab strength back in the 70's - amazing what a difference it makes at the end of a race.

[Paulag]

Brizza,
I had same problem for 2 years. It came on suddenly and the pain was in the groin. My sports dr. said give up running. X ray, MRI, nuclear scan all showed OP plus bone growth bridging the PS. Went to Dr. John Garvey who specilaises in this area but because of the bone4 growth would not operate. He has a web site and is world renown. Lectures in UK.
He referred me toorftho. surgeon in Melb. Ray Crowe. Operation removed bone, scrapped Pub. Symph. and cut the adductors muscles. Within 8 weeks I was running very gingerly but NO GROIN PAIN. I can't describe how grateful I was to the team that fixed my problem. Ran today for 75 minutes 12.56 km and includes some hills. Not too bad for a 64 yo.

[vat]

Well, I have a nice cortisone shot into the pubic symphysis next Friday, should be interested, but I'm told the results are generally pretty positive, so I'll let you know how it goes.  Seems pretty scary though.

[FakePlasticTrees]

Vat, if it helps I've had a couple of cortisone shots and they aren't that bad. There is a slight risk of muscle/tendon rupture but that's more in smaller muscles.

[jeckyl]

vat, on Apr 24 2007, 04:25 PM, said:

The O.P. has now basically cleared, but I'm still having quite bad problems in my pelvis/hip (indeed, I can feel it right now), and am exploring options including surgery.  I'll try to keep posting here with progress.

Vat

I'm progressing along with repair of my OP & torn RH adductor from last Nov '08.. the OP was diagnosed after the adductor tear,  the only pre sign I had was when I sneezed there was discomfort in the lower Ab region (weak Ab's has been a pre-condition of my troubles)...  we have similar run times & your Blog has been of interest,  
for me a slow recovery regime provided from the physio & sports physician , restricted to 1x5km bike ride & 2x swim sessions per week plus Ab exercises...  how did you obtain the all clear from OP condition to move forward ( continue running at pre OP pace??) reading your recent blog it appears the bike is your new  nemesis  or is it just the hot weather steering you away from runs?? LoL
Would be great on a update

[Action]

Ironkid94, on Jan 26 2009, 07:54 PM, said:

What's osteitis pubis???

Your pelvis has two parts, the left and right, and they are joined at the bottom (behind your pubic area) by some cartilage.  That cartilage joint needs some mobility, but if it gets too much it inflames and generates horrible pain. Been there, done that, didn't like it!  That is OP.

[Woodenlegs]

Ironkid94, on Jan 26 2009, 06:54 PM, said:

What's osteitis pubis???

To me it means pain, lots of physio and a long recovery time.

[Sunset]

Hmm... I'm doing some reliable self-diagnosis/investigations pending the real thing, and now I'm wondering if I have this?

I've had left groin pain which has made me unable to run for probably about 6 or 7 weeks now.  The pain is subsiding but I am still conscious of it - particularly first thing in the morning.

I've had a bone scan which came back negative for a stress fracture.
I am having an MRI next Monday but I'm really wishing I didn't have to ($300 out of pocket! Yikes!)

[Woodenlegs]

Sunset, on Jan 27 2009, 12:17 PM, said:

Hmm... I'm doing some reliable self-diagnosis/investigations pending the real thing, and now I'm wondering if I have this?

I've had left groin pain which has made me unable to run for probably about 6 or 7 weeks now.  The pain is subsiding but I am still conscious of it - particularly first thing in the morning.

I've had a bone scan which came back negative for a stress fracture.
I am having an MRI next Monday but I'm really wishing I didn't have to ($300 out of pocket! Yikes!)

Sunset, the good news is you don't have Osteitis Pubis as this will show up on a bone scan, the bad news is you will have to spend the $300 on the MRI.

[Sunset]

thanks, Woodenlegs

I'm just wanting an answer - a name to put on my condition!

[Zappa]

I have what feels like a strain down the left side of the front of the groin, about 5cm off centre.  It's not in the middle so I am thinking it's not osetitis pubis.  

When running about 10k my left leg can start to feel a bit nervy.  Could it be this?

[vat]

Zappa, on Apr 30 2009, 04:21 PM, said:

I have what feels like a strain down the left side of the front of the groin, about 5cm off centre.  It's not in the middle so I am thinking it's not osetitis pubis.  

When running about 10k my left leg can start to feel a bit nervy.  Could it be this?

The fact that it's not presenting in the middle isn't an excluder for osteitis pubis - mine presented pretty much exclusively down my right thigh.  That said, that symptom could be just about anything, including an actual strain!  Any other issues

[Aching Hammie's]

I developed OP during my pregnancy (confirmed by Sports Physician, CT and bone scan). I just wanted to add to this thread that you certainly do NOT always have to experience pain in the centre of the pubic region, as I didn't. This was frustrating though as no one (3 x physio's, a GP and a chiro) would diagnose me with OP, but from my research and anatomy knowledge and symptoms I really felt I did. Finally got my diagnosis, and interestingly as I started to get better and recommenced running, when stretching after a run I DID get some of that midline pain (very mild though).

Anyway, my point is OP can present itself with many different symptoms!

[2b]

Hi all,
One of my favourite topics!!!!!!!!! I had OP and have had the Adductor Tenotomy. I must say I think mine was a total success. Maybe not. Within two years I also had a groin reconstruction! They repaired a sport's hernia, repaired  a tear in the conjoint tendon and released a trapped orbturaitor nerve. After operation everything going very well and running my best times.
About 18 months later suffered SOMETHING on the same side as the OP. Thought OP had come back. Saw many specialist. Finally, saw top surgeon in Melbourne and he operated within 2 days. I had a hip arthroscopy! They totally removed my Labrum, removed A "Ganz" lesion from my pelvis, cut my femur and rotated my hip. They chiselled a new ball and groove in order to fit into the socket at a better angle.
What they now believe is that my femur to hip alignment was out (Genetically) and the forces of running exposed me to all my problems. I am now back running, just taking it easy.
  After adductor tenotomy I have never felt that area agian, so I believe that mine was a total success. Saying that though I don't know if all my other operations have also helped eleviate all of my symptoms associated with OP.
Take Care

Edited by 2b, 01 May 2009 - 11:59 AM.

[Zappa]

2b, on May 1 2009, 11:56 AM, said:

Take Care

Thks for the comments everyone.

With 2b's story, I had better take case!  This pain has only recently turned up - I have a had it a little while and noticed it first when I coughed while running.  I had cut back on kms (down to 60 km per week now) but have added some hill repeats and intervals.  I guess I have some added some extra knee lift as a result and Perhaps this has brought it on.

I am wondering if ibuprofen will assist or whther i sohould just go get an Xray and avoid the loss of time.

??

[JMB]

2b, on May 1 2009, 11:56 AM, said:

Hi all,
One of my favourite topics!!!!!!!!! I had OP and have had the Adductor Tenotomy. I must say I think mine was a total success. Maybe not. Within two years I also had a groin reconstruction! They repaired a sport's hernia, repaired  a tear in the conjoint tendon and released a trapped orbturaitor nerve. After operation everything going very well and running my best times.
About 18 months later suffered SOMETHING on the same side as the OP. Thought OP had come back. Saw many specialist. Finally, saw top surgeon in Melbourne and he operated within 2 days. I had a hip arthroscopy! They totally removed my Labrum, removed A "Ganz" lesion from my pelvis, cut my femur and rotated my hip. They chiselled a new ball and groove in order to fit into the socket at a better angle.
What they now believe is that my femur to hip alignment was out (Genetically) and the forces of running exposed me to all my problems. I am now back running, just taking it easy.
  After adductor tenotomy I have never felt that area agian, so I believe that mine was a total success. Saying that though I don't know if all my other operations have also helped eleviate all of my symptoms associated with OP.
Take Care

[JMB]

Hi All,

Was interested in what "JB" was saying re ganz lesion.  I have recently had an MRI which diagnosed a couple of small tears in m labrum as well as a small ganz lesion.  At the moment I have stopped running altogether as it is too painful, even power walking leaves me aching for days.  I am trying to keep my fitness level up with swimming and was thinking I may be destined to smell of chlorine for the rest of my life!!  I am booked to see specialist but not in until end of Oct.  Am going to Melb too was wondering if it may be same guy you saw JB.  Have been lead to believe that this is the start of joint disease in hip (arthritis) and therefore my running days may be over.  What did Dr say re lesion, should I just stick with the swimming or is there hope? Also what was recovery time like? I am 42 and keen to keep going as long as I can without doing my body in!!

[2b]

JMB, on Jul 15 2009, 08:29 PM, said:

Hi All,

Was interested in what "JB" was saying re ganz lesion.  I have recently had an MRI which diagnosed a couple of small tears in m labrum as well as a small ganz lesion.  At the moment I have stopped running altogether as it is too painful, even power walking leaves me aching for days.  I am trying to keep my fitness level up with swimming and was thinking I may be destined to smell of chlorine for the rest of my life!!  I am booked to see specialist but not in until end of Oct.  Am going to Melb too was wondering if it may be same guy you saw JB.  Have been lead to believe that this is the start of joint disease in hip (arthritis) and therefore my running days may be over.  What did Dr say re lesion, should I just stick with the swimming or is there hope? Also what was recovery time like? I am 42 and keen to keep going as long as I can without doing my body in!!

Hi all,
I am guessing that "JB" is actually me, 2b. With that assumption I will answer the above question. Ganz lesions can only be removed surgically. It is a small spur like lesion that occurs on the hip. The pain comes from the hip continually hitting the spur. It does become worse and can cause a lot of damage it starts tearing the cartilage. My operation has been a total success. I am now running 80-100km a week and cannot feel the hip or groin. I am bowling in cricket!!
My doctor was Dr David Young. MAKE SURE THAT YOU HAVE ALSO BOOKED IN A SURGERY TIME ALSO,  BEFORE YOU GO DOWN. Luckily, I did this and was operated on 2 days after the initial consultation. Just make it a tentative booking. If you do not you will have to wait 4-6 months for a surgery time!
Good Luck.

Edited by 2b, 18 July 2009 - 07:46 AM.

[JMB]

Thanks 2B (got it right this time - sorry, crap typing!).  Am please to hear your recovery has been good and you are back running - gives me a more positive outlook and will make those laps in the pool a means to an end so to speak. It is not the same Dr I have booked to see John O'Donnell so hope all goes well with him.   I was only two months out from completing my first 1/2 marathon with my training going really well until hip blew up - so I hope my goal will still be achieveable - maybe just a little further off than originally planned!!

[jeckyl]

Hi All  ..my war story  on OP
I'm 12mths out from what was diagnosed  as OP  with separation of the  symphysis cartilage
and torn right abductor from the publis   remedial action is to stop running   .. kuput ..
with Strengthening the core ie, about strenghening the muscle around the symphysis to keep them strong and Stabilising the pubis symphysis.  I do 1-2 km swim per week & have joined a bike racing club.. previous to this I was a 3hr Marathoner , sub 38'  10km , I.m a 48YO male

I find this web site forum of interest .  in particular, conrtibution from a WA footballer...' FLASH'  who has been there done that & provided me sanity.. good luck all to readers &  patients of this forum.. OP can be a runners nightmare & & their is a fix  , not a quick one I admit but hang in there

http://injuryupdate....a...188&page=81

[Zappa]

Some reading with ref to endurance running:

http://www.ncbi.nlm....a00056-0032.pdf

http://jms1.ndmctsgh...PDF/2205253.pdf

Edited by Zappa, 02 November 2009 - 03:58 PM.

[Hermie]

Sunset, on Jan 27 2009, 12:17 PM, said:

Hmm... I'm doing some reliable self-diagnosis/investigations pending the real thing, and now I'm wondering if I have this?

I've had left groin pain which has made me unable to run for probably about 6 or 7 weeks now.  The pain is subsiding but I am still conscious of it - particularly first thing in the morning.

I've had a bone scan which came back negative for a stress fracture.
I am having an MRI next Monday but I'm really wishing I didn't have to ($300 out of pocket! Yikes!)

Sunset

I've had this condition and had it cured without long layoffs.Lucky really.
I took Whippet's advice( he's a sonographer?) and got myself down to the physiotherapists at Woolloongabba where the Lions' get treated.It's a common ailment for afl players apparantly.
Physio consults are way cheaper than what you're quoting.
My physio,Dolph,even let me continue running during treatment.

[climax]

I was diagnosed with OP yesterday by a sports physician from Queensland Sports Medicine. After initially being relieved to have finally discovered the reason for my pain, I am quite concerned what the future holds. I have been running for nearly 5 years and started getting pain in the pubis sym???? bone about 8 months after I started. A couple years ago I was averaging 100-120km per week but this year I am only averaging 50-70km.My pain has spread into my groin area to the extent where it is effecting me all the time now - not just during running. It was thought that I had a hernia but an ultrasound could find nothing. It seems the less I run, the worse it gets when I go for my next run. I am having an MRI in a couple weeks (including a hip angiogram) to see how bad it has become, but I am not expecting good news due to the length of time I have had it. I am yet to find out what sort of treatment I will require either, but was informed to expect a long lay-off from running   I will update when I receive the results from my mri.


PS.  As from Nov 01st this year, a Sports Physician is now recognised by Medicare as a "Specialist", therefore instead of having to pay $400plus for my mri, I will be bulk-billed and not pay a cent!

[undercover brother]

sorry to hear that climax.
i think you mean pubic symphysis and hip arthrogram.

just a quick word about the HIC specialist provider numbers and MRI costs.
for years sports medicine specialists have not been able to bill as specialists as the HIC (health insurance commission) did not recognise them as such.
which meant a gynaecologist could order an MRI of your injured knee and the government will pay a chunk, but for a sports med specialist's referral they would not!
pleased to see this has changed.
this however is different from being bulk billed and its probably important to point this out for CRs.
whether the MRI is bulk billed or not depends on the xray place as well as the HIC provider number.
obviously if you are referred by a specialist they will usually charge you less but not all xray services bulk bill for MRI especially if you are having an arthrogram as well.
as as example a centre for a 'simple' MRI could charge out of pocket $150 for specialist referred MRI ($550 then get the rest back off medicare) or $300 (out of pocket fee only) for non specialist.
many doctors also charge an out of pocket fee themselves too.

Edited by undercover brother, 13 November 2010 - 11:04 AM.

[jeckyl]

good luck ' Climax' with the MRI scan  ...all I can let on ( it's been 2 Yrs now on my found OP troubles) is there is a sanity fix called cross training with sports that don't transfer much violence to the hip area's..bike , swim
if sports doctor allows .....start doing body core workouts to ease the pressure on the publis synthesis

ensure your MRI store is experienced for sports cases & return to same store to compare results say 6mths down the track to see any improvement is made
at great forum can be found here  
http://injuryupdate....a...188&page=81       ..  which provides some relief on cases of life after OP

there's also ( if local to Melb ) a deep tissue massager Gary Miritis with some encouraging results of bods leaping for joy

[sportsphysio]

Two quick points to note before you have your MRI:

Your MRI may find multiple problems as 66% of long-standing groin pain (pain that has been around for 12 months or more) has co-existing pathologies. This means your pain no longer comes from just one source and that's why "fixes" for a specific problem may not completely relieve the pain. A global approach seems to be most effective ie. concurrent core training, cross training, hands-on treatment, etc.

MRI findings of bone marrow oedema (bone bruising) around the pubic symphysis, often incorrectly called osteitis pubis, doesn't correlate to the presence of symptoms and may not be the primary problem. A study of soccer players at the AIS found that players without groin pain had this oedema on MRI and players that had severe groin pain didn't necessarily have severe oedema on MRI.

The MRI is only one piece of the puzzle and your sports doc will already have a clinical picture of your groin (figuratively speaking, of course). Trust your sports doc and be patient (no pun intended) with the treatment approach.

Good luck

[Preecey]

I had this in 2005 from football....as usual.  I suffered on and off for the next 12 months.  I then found a good physio who put me onto a very good strength/ stretching program.  I found that the pain reduced quite a bit, but I could not run without quite a bit of discomfort.  In my usual style, I went with the approach that 'if it doesn't get any worse, then I will pig-headedly persevere'.  It was quite uncomfortable for a while, but the pain was not getting any worse, and eventually started improving.  I now run prtety much inhindered by it, but I still maintain a quite extensive stretching regime.  It reminds me it is still there every now and then, but it certainly has not returned in any big way and doesn't really hold me back, provided you don't count a dull pain in the groin or adductor soreness every now and then!

[dave1678]

Preecey, on Nov 14 2010, 11:41 PM, said:

I had this in 2005 from football....as usual.  I suffered on and off for the next 12 months.  I then found a good physio who put me onto a very good strength/ stretching program.  I found that the pain reduced quite a bit, but I could not run without quite a bit of discomfort.  In my usual style, I went with the approach that 'if it doesn't get any worse, then I will pig-headedly persevere'.  It was quite uncomfortable for a while, but the pain was not getting any worse, and eventually started improving.  I now run prtety much inhindered by it, but I still maintain a quite extensive stretching regime.  It reminds me it is still there every now and then, but it certainly has not returned in any big way and doesn't really hold me back, provided you don't count a dull pain in the groin or adductor soreness every now and then!

This also describes me quite well except it was footy umpiring rather than playing that
intially caused it.
Not doing speed work and doing regular core work has helped greatly. Though I never stopped running
long runs after games were tough for years.

Keep those adductors loose!

[SeanP]

dave1678, on Nov 16 2010, 12:45 AM, said:

This also describes me quite well except it was footy umpiring rather than playing that
intially caused it.
Not doing speed work and doing regular core work has helped greatly. Though I never stopped running
long runs after games were tough for years.

Keep those adductors loose!

make sure your doc/physio investigates FAI as a possible cause. see the (long) FAI thread for lots of histories - most still ongoing!

[stoneman]

A quick post to highlight there is life after OP!!

Just about recovered from OP....only rarely would I wish for a stress fracture but it would have been easier.

Having said that I went to a physio in double bay and religously followed the excercise - 5 weeks later I am almost ready - although I havent run for about 8-9 weeks now...

Physio highlighted problems elsewhere that resulted in more stress being on the pelvis - so excercises for stretching other parts but also strengthening of pelvis - all good, reckon I will be running better than ever.

[Kev]

stoneman, on 19 April 2011 - 01:19 PM, said:

A quick post to highlight there is life after OP!!

Just about recovered from OP....

I too have recovered from the dreaded OP... The underlying cause of mine was FAI (Femoral Acetabular Inpingement) and I had surgery last Novemmber. Before surgery I did extensive core strengthening and much of the pain of OP had subsided by that the time I had surgery.

I could not run for 12 weeks after my op, but have now been running for about 2 months.  I did Run4Kids in close to pb time and am back up to 30km long runs in preparation for Gold Coast Marathon in July.  To all those with OP, it is treatable, but getting a good physio and actually doing the core strengthening work is vital.

Kev

[Flash11]

Was actually going to start a thread on "those with chronic groin issues that run" but this thread will do.

Suffered OP back in 06 after playing 1st grade footy and training to be a long distance runner as a 17 year old due to over doing it.

5 years on the groin is significantly improved, and some days I do kick the footy around but usually pull up sore afterwards but will be fine the next day.

Basically I want to get back into running long distance but was just wondering how they went about it after a long lay off and knowing you have a a history of a chronic groin injury?

Would you suggest just doing "The couch to 5K program" to get back running then gradually move on to what I use to do before OP 10K - 20k but obviously monitor the groin on a weekly basis.

I guess what I am looking for is a monitoring system but I guess there is no secret way other than just seeing over the weeks if the groin can take the load and pull up fine the next day. Obviously I believe I will be a bit sore after most runs afterwards.

Preecy if you are there or anyone else who knows what I am talking about, I would appreciate some advice. Some of my worries are that I will gain shin splints for a 3rd time as I usually get this after trying the get back into running again and in addition I have just gotten over plantar fasciitis 4 months ago with the very rare stabbing pain if I run (possibily just scar tissue) *did not have surgery for it though.

Bit of a read but cheers guys if you can give some advice.

[halfwaydown]

I came through an 18 month period of OP related groin issues (surgery free thankfully) largely I believe through the combination of core strength exercise with flexibility.  Yoga was probably the key to my recovery - twice weekly 20 min sessions 'power' yoga from a video - which I only took up for the first time after the problem had been around a good while.  
That plus being patient and not aggravating the problem - which in my case meant building up slowly, backing off from high intensity/speedwork, cutting out the trails and uneven terrain, and avoiding coughing (by carrying a flask of warm water to down immediately after every run).
I can't say there was one moment when I realised my groin issues were behind me -  they just gradually went from the present into the past.

[vat]

I would imagine your not playing footy will take a fairly large contributing factor out of play.

I've been easing back into it for a few years now after getting hit with OP back in '06.  I don't run anywhere near the mileage I used to and mix it up with some cycling and swimming (well, more directional floating, but anyway...).  My OP was treated with a cortisone shot into the pubic symphisis (a procedure I wouldn't wish on anyone) but I didn't start back for a while.

After moving to Brisbane in late '07 I found a well travelled physio up here and did some work on my lower back, his experience being that OP was usually related to back issues.  We've come across some nerve impingement around L1-L2 which, if I've overdone the running, can see OP like symptoms with pain radiating down into my right quad.  This symptom was present during my running peak in '06, but the accompanying right hip pain has gone, and I can press on the very lower abdominal wall without pain, whereas before the cortisone shot this area was very tender.  We've come to the opinion that symptoms from both the OP (which was proven via MRI and a blood scan done when we suspected a stress fracture) and the nerve impingment were present through '06.

I've done a lot of work on stretching, particularly the hamstrings, and I think this has assisted with reducing tension and strain on my lower back and thus reduced the effects of the nerve impingement in my right leg.  I am running a little of late and am coming into a bit of form (can run 15k in under an hour again!) and haven't had these issues recur.  I've also been doing a fair bit of core work, doing bridges and the like a few times of week.  This has helped me maintain posture.

So, bearing in mind we're all an experiment of one, a summary of my post-OP management:
- lengthy rest
- find additional, complimentary cross training.  My predominant one has been cycling, along with a bit of swimming (and yes, dabbling a bit with triathlon as a result, which has been rewarding)
- having my lower back checked out
- regular stretching (esp. hamstrings) and core work
- building mileage slowly and close monitoring of how your body responds, particularly in areas where OP symptoms become evident

This last point is very important - as I mentioned above, one of the prime symptoms of OP is tenderness in the very lower abdomen (just above the, er, 'tackle').  If you're able to press hard there without pain, it's a good sign.

[stoneman]

Some great advice in these pages.

For me the recovery has been about Core and stretching - everything I have neglected over the last couple of years. Oh and also largely disregarding the advice from others who have been running longer and even more strangely not really following the physio advice - eventually of course they were right and I was wrong and it bit me and the wheels fell of!

My suggestion is a gradual build up of kilometres with avoidance initally of downhills and preferably running on grass...Lots of stretching and there are some great websites on stretching and strengthening of OP...Build it up and see how it goes...Don't run two days in a row... and stretch and build the core. Now, if only I can follow this advice!!!

I am on the mend after a good few months out of action...

Good Luck with your recovery

[climax]

I cant believe its been 6 months since my post on this forum and my "official" diagnosis of OP and FAI(life in Toowoomba this year seems to have gone up a gear). Unfortunately it has been 6 months since I last ran as well. Weekly visits to a physio combined with core strengthening exercises at home have resulted in my OP symptoms to cease, but the pain in my groin has not altered a bit. For the record, lifting my leg to put shoes on or getting in and out of a car, or performing the squeeze test whilst my feet are slightly raised, cause instant pain. I went back to my Sports Specialist this week and he has ordered me to go for a (3rd) ultrasound. He thinks I have tendonitis, and depending on the findings, I am to have a cortisone injection in either the pubis symphesis or directly into the area of pain in my groin. OMG - I am sure both areas will be painfull! My groin pain seems to come from the adductor muscle/tendon area but it is so hard to locate precisely. Regardless of the exact area, I am losing faith in curing this damn thing. Logically thinking, my exercises combined with a cease in running has been effective enough to beat the OP so my groin pain should have almost cleared as well too right? I just pray that the cortisone injection at least improves things as I am getting very frustrated!

I will update on here after the injections - before xmas I promise! Cheers.

[vat]

climax, on 13 May 2011 - 07:34 PM, said:

...I am to have a cortisone injection in either the pubis symphesis

...I am losing faith in curing this damn thing. Logically thinking, my exercises combined with a cease in running has been effective enough to beat the OP so my groin pain should have almost cleared as well too right? I just pray that the cortisone injection at least improves things as I am getting very frustrated!

A warning, and I'm not trying to put you off it, but, if you go the pubic symphisis injection, it will be awful.  They'll do it under ultrasound, and they will give you a local first so they can penetrate the pelvis capsule with the cortisone shot.  I try to imagine these things being as bad as possible and this was pretty damn close to what I'd imagined!

That said, when I walked out of the clinic with the local still in effect, my pelvis and groin felt the best they had in twelve months - walked back to work with a spring in my step, so that's something to look forward to during the procedure.

I would definitely recommend having your lower back looked at as well.

[Fastrunner]

I know for sure that natural treatment (cream based on herbs for ex) will not hurt anyway. Recently have a neck injury and Nature Medic Arthritis cream helped me.

[vat]

Fastrunner, on 17 May 2011 - 03:46 AM, said:

I know for sure that natural treatment (cream based on herbs for ex) will not hurt anyway. Recently have a neck injury and Nature Medic Arthritis cream helped me.

You might get some temporary pain relief that could be acheived by various means (I went with massage and acupuncture for a while, and later, drinking), but I can absolutely guarantee appliction of a cream will have zero effect on the swelling and inflammation of the pubic symphisis, a cartilaginous joint located fairly internally in the structure of the pelvis.

[Buakaw]

I thought I would share my current situation as I might also have OP. About 4 weeks ago I noticed pain in the lower abdominal area. It seemed to fade away so I ignored it. I then felt it come back until one day after a run it was starting to really hurt.

I saw a sport doc and he was 99% sure it was OP. We did an X-ray to confirm it but the X-ray came back clear.

We then did an MRI to investigate whether it is a muscle/tendon problem. I was referred to a hip/groin specialist sports doc to review the MRI etc. The MRI also came back clear. So he doesn't think it is OP but cannot completely rule it out and believes it is muscle/tendon. He said that I can ease back into running and see my physio.

I will see my physio tomorrow and see if he can assist with determining if it is either OP or muscular and offer some treatment/rehab exercises etc.

I don't feel pain when the pelvic bone joint is pressed firmly. I don't feel pain when I try and push my knees together. The feeling in my lower abs is more of a mild ache and after a short run this morning is a little worse.

Did anyone else come back clear on the scans only to later find out it is in fact OP?

[halfwaydown]

Buakaw, on 18 May 2011 - 03:12 PM, said:

Did anyone else come back clear on the scans only to later find out it is in fact OP?

My experience as a sufferer rather than a specialist - OP is an elusive one to diagnose as the syptoms/location of pain will vary all around the groin area.  I had scans done which showed up nothing - generally the pain was dull rather than acute except when I coughed - however when I visited the physio and he applied his thumb to the tip of my bone at the pubic symphysis I went through the roof.  I suggest your physio start there - its intimate.
Also - re diagnosis is often elusive - nearly all the responses on the thread seem to concur that core strengthening and stretching through yoga, pilates, plank etc form part of the lengthy recovery.  Whether you are diagnosed with OP now or not, I'd recommend improving on this area straight away to see if helps alleviate the issue.

[Buakaw]

Saw my physio. He also believes it to be a muscular problem and not OP but hasn't completely ruled it out. Stretch, strengthen and ease back into running, see what happens.

You're not wrong about the pubic symphysis "examination" halfwaydown. 3 guys have helped themselves in the last week and not one of them bought me a drink first...