2. Self Diagnosis

Amongst the medical community Osteitis Pubis is a poorly understood injury. The first steps on the road to recovery are;

  • Determining if you actually have OP
  • Determining how far (what stage) your OP has progressed

Determining how far your OP has progressed is vital to developing an effective intervention strategy. The stage/progression of your OP will determine the:

  • Type/style of treatment
  • Rehabilitation exercises
  • Period of rest between exercise

This page will demonstrate and provide you with the tools to accurately diagnose whether you have OP and how severe it is.

Click here if you would like to book in for a free, 20 minute Skype consultation to discuss your case specifically. Or continue reading to learn more.

 

Osteitis Pubis Self Diagnosis: a simple guide

There are three main tools used to diagnose Osteitis Pubis.

  1. Radiological Scans: XRays and MRI
  2. Symptoms/case presentation: type and level of pain you feel, on what movements etc.
  3. Orthopaedic tests: A set of movements which test the integrity of the adductors, hip and pelvis.

In late stage OP morphological changes take place in the pubic symphysis (click here for more info…landing page). These changes can be picked up in an Xray or MRI and give a definitive diagnosis of OP. Unfortunately scans at this stage of OP are unnecessary; the pain and dysfunction is so severe that it’s obvious that you have OP.

Diagnosis for OP uses a combination of symptom history and orthopedic tests. These tools establish whether you have OP and what stage it has progressed to.

 

2 Stages of Osteitis Pubis

For simplicity we have broken OP down into two distinct stages. In stage 1 OP, the pain in your adductors (anatomical name for your groin muscles) may have been around for a while. You’ve likely managed it with a combination of conservative treatment, such as ice, heat and massage. But no matter how much you rest or stretch, the tightness, lack of mobility and dull pain in the groin won’t go away.

In stage 2 your symptoms are becoming severe and your stage 1 symptoms are becoming more intense. Your groins are extremely tight all the time, pain comes on immediately during exercise and you need longer periods of rest between exercise to reduce the pain. Alarming symptoms such as numbness and tingling may present.

MRI and Xrays during stage 2 often show dysfunction and changes in the pubic bone and symphysis. Essentially the problem in your adductors has become so serious that its affecting bones.

The checklist below will use the symptoms you have to categorise whether you have stage 1 or 2 OP. If your symptom history is inconclusive, you can perform orthopedic tests to clarify.

Stage 1 symptoms
Stage 2 symptoms
Tightness/sore in adductors: Your adductors feel rigid and tight most of the time.Numbness: in the adductors, hip or pubic area
Dull pain on exerciseWeakness during exercise: a noticeable loss of strength
Feeling of heaviness: your groins feel even when not training.Pain in pubic bone during movement
Rest improves pain: but the minute you train it returns and you need to rest again to recoverMigration: Symptoms begin migrating to the hip flexors, lower back.
Loss of flexibility/mobility: you’ve notice a distinct lack of mobility in the groins.More rest required: Long periods of rest between exercise needed for groin to recover
Slow onset: You don’t feel groin at the beginning of a workout. The pain comes on slowly.Pain immediately upon movement
Pain if you touch pubic bone

 

Interpreting the symptoms of Osteitis Pubis (OP)

  • If you suffer from any of the symptoms in stage 2; do not proceed to orthopedic testing. You have OP. Though you can cure OP by yourself using this guide, I highly recommend you consider engaging SUPT or another health professional to help with the treatment of Stage 2 OP.
  • If you have 3 or more symptoms from the stage 1 checklist you have OP. Perform the Squeeze and Palpation test to confirm. If there is no pain in the Palpation test and minor pain from the squeeze test continue on to the FABERS test.
  • If you have less than 3 symptoms from stage 1 continue to all three orthopedic tests.

Orthopaedic testing: confirming early stage Osteitis Pubis (OP)

If you have 3 or less stage 1 symptoms there is a good chance that you have early onset OP. We can confirm a diagnosis of OP with some orthopedic testing.

The palpation, Squeeze and FABERS test will attempt to elicit/reproduce the symptoms of OP by placing the adductors and pubic symphysis in a compromised mechanical position. In simple terms we put the adductors/pubic symphysis under pressure highlighting any pain or dysfunction present. Reproduction of your symptoms would be a ‘positive’ sign (confirmation) of OP.

Orthopedic tests for Osteitis Pubis; can they make things worse?

Orthopedic tests can aggravate the adductors. This is why we only perform them when we are unsure of an OP diagnosis. In stage 1 your OP has not progressed; brief testing will not cause significant issues. However in stage 2 the adductors may be extremely weak; which is why the symptoms are severe (numbness, tingling, weakness etc.). If you have experienced any stage 2 symptoms you should avoid all orthopedic tests, as they constitute an unnecessary risk to your adductors.

Palpation test

The adductors attach to the pubic bone. In OP the adductors are over contracted; placing excessive pressure at their attachment on the pubic bone and pubic symphysis. Overtime this area of bone will become inflamed and painful. In stage 1 the inflammation can only be felt through manual pressure on the bone. By stage 2 the inflammation increases; simply moving the adductors aggravates the area. The palpation test will help highlight the presence of inflammation.

Squeeze Test

The squeeze test measures the strength, function and integrity of the adductor muscles. If the squeeze test reproduces any stage 1 or 2 symptoms you have OP. The severity of these symptoms will determine whether you are in stage 1 or 2 (refer to the ‘interpreting the symptoms’ section).

FABERS test

I’m diagnosed, now what?

Now you need to learn what causes OP, so you can go about making the best decisions regarding treatment and rehab to overcome your OP. Keep working through the rest of this site, as we explain what causes OP, how to treat and rehab it.

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