OSTEITIS PUBIS (ATHLETIC GROIN) IN ATHLETES
Osteitis Pubis (OP), or in a broader term ‘Athletic Groin’, describes the common overuse injury present in many athletes competing in kicking and running based sports.
OP is the condition that affects the pubic symphysis (the joint between the pubic bones) and is due to repeated trauma over a prolonged period. Symptoms of OP include referred pain to the groin and pain upon palpation of the pubic symphysis.
OP can occur due to instability of the pelvis and the increased shear forces around the pubic symphysis and the tendons attached to it.
OP can be a very debilitating injury in youth and take longer than expected to return to full health. Below you can find items that need to be ticked off in the preparation for the rehabilitation phase.
Firstly, a correct diagnosis for the injury is required. Currently there are 33 different terminologies for athletic groin with ‘OP’ being the most common in Australia. Musculoskeletal deficiencies can often be mis-diagnosed for OP.
A short term and long term rehabilitation plan needs to be set, a reduction in training load is often required at the start to minimise some of the symptoms. However, once this has been achieved, a longer term approach needs to be planned for. Cross-training, gym rehabilitation, physiotherapist input, recovery and movement training all need to be planned.
Structuring your week around your rehabilitation needs are important. Many athletes will forget about their cross-training and focus solely on their gym rehabilitation. Others will spend too long trying to preserve energy systems and not enough time rehabilitating the pelvis and its corresponding areas.
Movement training needs to be incorporated once pain allows, with gait re-education, hip stability and co-ordination the most important factors.
Below you will find exercises which can include gym rehabilitation, cross-training and movement training that you can use in your OP recovery program.
BARBELL NARROW SQUAT
To maintain lower body strength without the shear forces felt at the pubic symphysis, we use a narrow squat. The position of the legs reduces load through the groin/adductors but still provides the athlete with a stable base to lift from.
To develop intrinsic pelvic strength through the stabilising musculature, we incorporate breathing exercises such as the belly bulge. The idea of the exercise is to expand through the Transverse Abdominus (TA) when the athlete inhales. This will provide awareness in the pubic region and is the starting point prior to moving in to more advanced intra-abdominal stabilising exercises.
The sled march provides the athlete with a movement training / gait re-education exercise that also has proprioceptive feedback from the belt. After performing belly bulges, the belt incentivises strong intra-abdominal pressure (IAP) during the march. This helps align the pelvis and provide a stable base for the body to move off.
These are only a few of the many exercises we will program for our athletes. All athletes experiencing OP present differently, so tailoring the exercises, duration, intensity and frequency is an important skill for our coaches.
To watch a demonstration of the exercises we have mentioned above, click HERE.
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