Tell me about your experiences with osteitis pubis.
I got hit with it a few weeks ago after I ramped down SBR a lot and was focusing mainly on rock climbing. It started off non-specific groin pain but I went to a doc after I couldn’t run more than 2 miles without pain. It was verified via an MRI that showed “bone marrow edema of the left public bone reflecting osseous stress reaction without definitive stress fracture”. Anyway, my physio has had me on basically zero activity (no climbing, no running, easy cycling) and only allowed me to swim (as long as I didn’t use fins). Because of persistent achiness now he wants me to shut it down completely. No anything. Obviously this is something difficult for someone used to doing something every day.
Just want to hear any tales of how you conquered this pesky condition and any advice.
Tell me about your experiences with osteitis pubis.
I got hit with it a few weeks ago after I ramped down SBR a lot and was focusing mainly on rock climbing. It started off non-specific groin pain but I went to a doc after I couldn’t run more than 2 miles without pain. It was verified via an MRI that showed “bone marrow edema of the left public bone reflecting osseous stress reaction without definitive stress fracture”. Anyway, my physio has had me on basically zero activity (no climbing, no running, easy cycling) and only allowed me to swim (as long as I didn’t use fins). Because of persistent achiness now he wants me to shut it down completely. No anything. Obviously this is something difficult for someone used to doing something every day.
Just want to hear any tales of how you conquered this pesky condition and any advice.
Wow, your story sounds a lot like mine, including the MRI. For me, I could not run even 100ft without that annoying groin pain. Had to stop running and swimming…I tried using pull buoys to support my pelvis, but it still hurt too much, so had to stop it. I could bike as long as it did not cause pain.
Overall, took me 6 months to get over it. One of the ways I could tell if I was getting better or not was doing a forward lunge. That one maneuver would simulate the pain in the groin, and if I felt it then I knew I was not healed yet.
While trying to heal from this, I did a lot of core work, but had to be careful as to not aggravate the groin. This meant no sit ups or crunches for a long time. I did bridges, hip strengthening, etc… Not sure if these were what helped heal me from OP, or just giving it enough rest time.
Not doing the PT/core may not be a big deal now. There’s not a ton of precise info on this problem. Rest may be the best thing for it, at this time.
When I first developed OP, it was quite discouraging to read up on it. Any reports I saw were of people saying they either never got over it or it took them 2+ years to recover. I hope you heal up quicker than I did, so you can do what you enjoy
So I just got my MRI results back and I’m in same boat. As well as a disc issue then
“Dedicated imaging of the pelvis demonstrates bilateral parasymphyseal bone marrow oedema extending into the adjacent superior pubic rami bilaterally and inferior pubic ramus on the LEFT. This is associated with early symphysis pubis osteophyte formation without evidence of associated subchondral bony resorption . There is no evidence of tenoperiosteal avulsion.”
Findings consistent with chronic osteitis pubis.
Now this is 18 months after it started. Basically my back went 2 weeks before IMNZ in 2020, I somehow made the startline, and even more miraculously the finishline but the run was basically a 30km of crippled lurch, and I suspect that was the root cause of the injury. Actually manifested itself for first time in pilates about a month later. I did take 3 months off running, but did carry on with pilates and swimming. Recently I’ve identified that swimming and pilates were actually worse than running for me. So the stuff I’d kept and normally ‘safe’ was actually the stuff that made it worse.
Going from someone that did 3 pilates classes a week at the upper end of intermediate, to where I am now where I needed help to sit up off the MRI table it’s pretty gutting.
So any positive tales? My biggest fear is not about losing form for racing. My big fear is that I train (and as a side product compete) for mental health reasons. Now is not a good time with pressures and stresses at work and losing any chance of a health routine scares the crap out of me.
Was I missing something specific? It seems like an automated summary of all the papers google comes up with. But headline was 3 months off. Potentially less if shockwave therapy added in early phases. And that the hip impingement - FAI - is potentially an underlaying contributory factor, especially as it started on the right side which is where the hip issue has been.
So yes to a period of total rest, but only 2 weeks whilst taking a stack of anti inflammatory pills. And then introduce strengthening from there. Looking at 6-8 weeks before slow reintroduction of running. And whilst no swimming as that seemed to set it off, cycling was given the green(ish) light. If it doesn’t set off the pain (which it’s not up to now) then carry on.
This seems to be a lot less conservative approach to anything else that I’ve seen discussed before. Posting here in case anyone else digs up this thread in the future.
Bad news is the degenerative failure of the L5-S1 disc and slight bulge on the one above. Good news is that’s not (yet) causing me any grief.
I believe my MRI also showed some degenerative disc disease, I was not aware of (no back pain). I figured it was an inadvertent finding and I would simply ignore it since I was not currently having problems.
Like you, swimming really aggravated my OP, so good you are not trying to get back to that yet. I hope the rest, followed by the strengthening works to help get you through this. OP is such an aggravating health issue
I’m at 6 months and this is still kicking my ass but it has improved. Been doing physio exercises 3-4x a week but I do get pretty sore. I’ve been doing steady state bike rides again in the 2hr range but accelerations and hard efforts still bug me so no group rides. I ran a 10 minute mile the other day and was mostly pain free. I never thought I’d be that happy for that kind of trivial achievement. Good luck with your OP and bad discs, that’s a bummer.
Edit to add: I think my OP was caused by an adductor strain I kept pushing. As it’s improved I’ve had crazy tightness and soreness in my psoas muscles. I bought a pso-rite. It’s an overpriced piece of plastic that is amazing for digging into the psoas and lower abs
Great work Jazzy - take the wins where you can and that 10min mile isn’t just a milestone (literally), it’s a step that’s confirming you are on the right path.
Interesting about the Psoas - mine has been really playing up in the last 6 months, and so had the adductors. Got to the point that a little cough would leave me squealing in pain down to my inside knees. And the dry needling into the psoas… lets just say my physio got to hear ALL of the rude words.
Since stopping swimming a few weeks back and stopping pilates then the adductors are a lot better which has then helped the psoas I think.
2 weeks of total couch with 2x800mg ibuprofen a day, that I was glad to stop as by the end my stomach was starting to feel the strain. I’m now 4 weeks into a very very slow rehab programme of controlled movements, not even strengthening really. In the last week I’ve added 45mins of 150w steady zwift, which as comparison was off a ‘normal’ session of 1h45 at 210w or a typical 1hr zwift race at about 285NP.
As it stands then I’m feeling a little sore until lunch after my 5am core and zwift, but walking up stairs and around the place is generally pain free.
Adductors certainly the more obvious issue. They became incredibly tight, and some needling / massage helped, but I’ve started really going to town with the massage gun twice a day and that’s amazed me at how much it’s helped. Not fun, but seems effective.
Specialist yesterday suggested carrying on with the strength build until mid December and not try running until then. I’m also starting back with a weekly 1:1 pilates/physio session from next week. In talkign to a physio friend she checked and showed that I was breathing from my chest not diaghram, and so that was keepign all my pelvis locked. Some gentle mobility exercises and a renewed focus to be belly breathing all the time is also helping I think. Worst thing is getting out the habit of sitting with legs crossed. I know it’s better for me but so hard to break those habits when relaxing.
I’ve learned to ignore my past performance numbers and just accept what is. I’ve been able to start a cycling program again and have been tolerating sweet spot workouts. Even climbing isn’t hurting. I am still mentally scared to run so keep putting it off. I think time is finally adding to the healing. We’re so used to always working out and the more we try to get back to “normal”, the worse it is. At 7 months I finally got to the point where I was hurting or worrying about it all the time. Now I just need to find a way to lose the 20 pounds I gained during this 😅
Feedback yesterday is that it’s not like a muscle strain where if you push back too soon you can tear it before it’s healed, and you’re back to square 1. I was possibly thinking this way, where in reality if you go too far, it’ll get a bit grumbly, so long as you dial back for a day or two and then try again at a slightly lower level then the recovery will continue on the same trajectory.
And I hear you on the 20lbs. Whilst my weight has stayed fairly stable that’s because I’ve swapped from leg and arm muscle to a floatation vest - the scales say no change my shirts and belt says something different. So good to be riding again, and I’ve got back to some better diet habits than the first days of consoling myself with chocolate, whisky and wine. Ironically I’ve swapped my weekends from sitting on sofa binging netflix to home baking. But then I take it all into the office on Monday and that’s meant I’ve been more mentally active, I’m actually not eating all that baking nor shoveling popcorn and pastries, so that’s helped some weight loss.
Only frustration is seeing my ‘target’ events come by and then new targets get set. I’d initially set on a 70.3 in January, and a Marathon in March. Now, I’d be being optimistic for a May half marathon and I’m looking at October 22 marathons…
