General Pubic Symphysis Dysfunction:

The pubic symphysis is a very stiff, synovial joint that exists midline of the pelvis.  It moves on average, about 2 mm but becomes dysfunctional if it moves more or less.  The cause for pubic symphysis dysfunction can be attributed to hormonal changes, lengthening and weakening of pelvic ligaments, thoracolumbar fascia and muscles.

The symptoms one might have with this condition are pain in the pelvis while walking, pain to the pubic region, groin or the inside of the thigh, and clicking or grinding in pelvic area.  One may also experience pain with weight bearing, reciprocal activities or pain inter vaginally.

Treatment for pubic symphysis dysfunction is a combination of stabilization exercises, ice, positioning, and manual therapy.

Stabilization exercises reduce stress on the joint and improve stability.  Stabilization exercises include strengthening the abdominals, pelvic floor, gluteals, latissimus dorsi and hip adductors.  Doing a simple kegel by contracting the pelvic floor as if you are trying to stop the flow of urine, can help stabilize the pelvis.

Correct positioning may also help reduce stress on this joint

• Transitional movements- keep knees together
• Walking-take smaller steps
• Sleeping-put a pillow in between your legs and sleep on your side
• Try to avoid stairs-but if you have to go up, step up sideways one step at a time
• Sex but keep legs as close together as possible

Manual therapy provided by a physical therapist will also help such as massage to the pelvic region internally or externally, mobilization of the pelvis and use of contract relax. Also, using ice to the area for 15 minutes can help numb the pain and reduce any inflammation.

Osteitis Pubis

Osteitis Pubis is a very serious condition involving the pubic symphysis joint that needs immediate attention.  Osteitis pubis can be infectious or non-infectious condition in the pubis that is very painful.  It can be caused by staph or strep bacteria, non-infectious inflammation in pubis, pregnancy/childbirth due to pressure and causes laxity of ligaments.  Other causes include gynecologic/urologic surgery, athletic activities, major trauma, repeated minor trauma, rheumatologic or unknown etiology. Athletic activities can cause osteitis pubis due to overload or training errors such as exercising on hard surfaces, uneven ground, beginning an exercise program after a long lay-off period, increasing exercise intensity or duration too quickly, exercising worn out or ill-fitting shoes.  It can also be due to biomechanical inefficiencies such as faulty foot and body mechanics and gait disturbances, poor running or walking mechanics, tight and stiff muscles in the hips, groin or buttocks, muscular imbalances and leg length differences.

Symptoms of osteitis pubis include pain to the lower abdomen and pelvis, sharp pain to the pubic symphysis, loss of flexibility in the groin, dull aching pain in the groin and pain while running, kicking, changing directions, or standing up/sitting down.

Treatment for osteitis pubis includes stabilization exercises, taking antibiotic medications and rest.  Consult a physician if you think you have this condition as it is very serious and can cause irreparable bone damage if not treated effectively.