Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ PubalgiaAthletic pubalgiaPelvic sprainOsteitis pubis ++ 848.5 Sprain of pelvic ++ S33.8XXA Sprain of other parts of lumbar spine and pelvis, initial encounter ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation +++ Description ++ Pubalgia-osteitis pubis is a collective term that refers to disorders causing chronic pubic pain. Pubalgia-osteitis pubis includes osteitis pubis and athletic pubalgia, which are overuse conditions involving stress to the pubic symphysis.All conditions result in abnormal stress to the pubic bone, pubic tubercle, or pubic symphysis.Symptoms due to increased mechanical stress in the pubic region due to abnormalities or stress from osseous, ligamentous, or muscular structures. Symptoms typically reduce with light activity but worsen with exertion. +++ Essentials of Diagnosis ++ Diagnosed primarily through signs and symptoms, and exclusion of other pathologies typical to the region.Clustering of special tests/signs and symptoms is most accurate, as there are no confirmatory special tests.Injury typically due to chronic, repetitive stress to the pubic region during exertional sportsOften result of repetitive stress such as kicking, sprinting, or twisting at high speeds during sportsStresses from hip adductor insertion or rectus abdominus precipitate symptoms.Weight-bearing forces with athletic activity result in stress to pubic symphysis.Palpation of pubic tubercles, inferior pubic rami, rectus abdominus and adductor tendons elicit pain.Differential diagnosis from other orthopedic (pubic, spine) or medical (intra-abdominal pathology, hernia) pathologies that may warrant a more immediate surgical or medical intervention is essential. +++ General Considerations ++ Pubalgia-osteitis pubis is collective term and often refers to several possible conditions. Caused by repeated trauma from exertional activities that over-stress the pubic bone or tendons that insert upon it, and shearing of the pubic symphysisDiagnosis often made through exclusion of other pathologies. Full history of symptoms, medical history screening, and differential pelvic/lower abdominal orthopedic and medical screening examination will ensure appropriate diagnosis. +++ Demographics ++ Common in participants in exertional sports or distance running +++ Signs and Symptoms ++ Lower abdominal pain or anterior pelvic pain with exertion, responds to restLower abdominal pain or anterior pelvic pain with sit-ups, kicking, running, sprinting, or squatsTenderness over the pubic tuberclesPossible tenderness over the proximal insertions of the adductor tendons or insertion of the rectus abdominus.Possible pain and ROM limitation with passive hip flexion or abductionPossible weakness of lower abdominals or any components of hip musculature +++ Functional Implications ++ Pain/limitation with runningPain/limitation with squatting into or rising from chairPain/limitation with getting up from floorPain/limitation with sitting up from supine positions +++ Possible Contributing Causes ++ Limited hip ROMIncreased tone or shortening of iliopsoas, rectus abdominus, ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth