Groin pain is one of the most frustrating injuries for athletes and active individuals, particularly in sports that demand rapid cutting, kicking, and directional changes like soccer. Often difficult to pinpoint and slow to resolve, this type of pain can interfere with performance, training, and everyday movement. When rest and standard treatments fail to provide relief, the underlying cause may be more complex than a simple muscle strain. One frequently overlooked source is osteitis pubis—a condition affecting the pelvic joint that plays a critical role in stability and movement. This post breaks down what osteitis pubis is, why it develops, and the most effective options for diagnosis and treatment.
What Exactly Is Osteitis Pubis?
Osteitis pubis is inflammation of the pubic symphysis, the joint at the front of the pelvis where the left and right pubic bones meet. This small but important joint absorbs force every time you run, twist, kick, or change direction. When it becomes irritated or overloaded, it can cause sharp or aching pain that radiates into the groin, lower abdomen, or inner thigh. The findings of osteitis pubis are correlated with advanced imaging.
Why Athletes and Active Adults Are More at Risk for Osteitis Pubis
Sports involving cutting, sprinting, or repetitive kicking place continuous stress on the pelvis and surrounding muscles. Soccer, running, hockey, and rugby athletes frequently develop osteitis pubis due to repeated microtrauma. Over time, this overload sparks inflammation in the pubic joint, leading to stiffness, pain during movement, and reduced performance. Even highly conditioned athletes can develop this condition when training intensity outweighs pelvic stability.
Pelvic Muscle Imbalances Play a Major Role
Pelvic alignment and muscle balance are crucial. When the abdominal muscles, hip adductors, and pelvic stabilizers are not working in harmony, they pull unevenly on the pubic symphysis. This imbalance increases friction and strain at the joint. Weak core control, tight hip muscles, or prior groin injuries can all contribute. Addressing these issues through targeted rehabilitation is key to long-term recovery.
Underlying Hip Problems Can Trigger Pelvic Pain
Many patients are surprised to learn that hip pathology such as femoroacetabular impingement (FAI), hip labral tears, or limited hip mobility can cause compensatory stress on the pelvis. When the hip can’t move efficiently, the pelvis absorbs the extra load, eventually leading to inflammation at the pubic symphysis. A specialist in hip and groin preservation can evaluate both the hip and pelvis to ensure no contributing factor is overlooked.
Getting the Right Diagnosis Matters
Because osteitis pubis overlaps with sports hernias, adductor strains, hip injuries, and pelvic stress fractures, accurate diagnosis is essential. Imaging studies and a detailed clinical exam help clarify the true source of groin pain. Early evaluation can prevent months of frustration and unnecessary treatments.
AUTHOR: Srino Bharam, MD, MBA, is a board-certified, fellowship-trained sports medicine orthopedic surgeon and professor of orthopedic surgery specializing in the treatment of athletic injuries of the hip and groin. Dr. Bharam has over 20 years of experience in treating injuries and conditions of the hip to restore athletes and patients to an active lifestyle.
