Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature

Abstract

Alessio Giai Via,1 Antonio Frizziero,2 Paolo Finotti,2 Francesco Oliva,3 Filippo Randelli,1 Nicola Maffulli4,5 1Department of Orthopaedic Surgery and Traumatology, Hip Surgery Center, IRCCS Policlinico San Donato, Milano, Italy; 2Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy; 3Department of Orthopaedics and Traumatology, Tor Vergata Hospital, University of Rome “Tor Vergata”, Rome, Italy; 4Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy; 5Centre for Sport and Exercise Medicine, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England Abstract: Osteitis pubis is a common cause of chronic groin pain, especially in athletes. Although a precise etiology is not defined, it seems to be related to muscular imbalance and pelvic instability. Diagnosis is based on detailed history, clinical evaluation, and imaging, which are crucial for a correct diagnosis and proper management. Many different therapeutic approaches have been proposed for osteitis pubis; conservative treatment represents the first-line approach and provides good results in most patients, especially if based on an individualized multimodal rehabilitative management. Different surgical options have been also described, but they should be reserved to recalcitrant cases. In this review, a critical analysis of the literature about athletic osteitis pubis is performed, especially focusing on its diagnostic and therapeutic management. Keywords: osteitis pubis, pubalgia, groin pain, rehabilitation, review

Keywords

• Osteitis pubis
• pubalgia
• groin pain
• rehabilitation
• review