Pubic-related groin pain

The 'os pubis' is the pubic bone. Pubic-related groin pain means experiencing groin pain originating from the pubic bone.

This can have several causes, including:

• Stress reaction of the bone: overloading (often in impact sports) can lead to fluid accumulation in the pubic bone.
• Overload of the adductor attachments (= muscles on the inside of the thigh). Overloading of the attachment can also cause some fluid accumulation in the pubic bone.
• Tear of the adductors and/or abdominal muscles (= PLAC injury)

It is also referred to as 'pubalgia'. However, pubalgia means pain in the pubic bone (os pubis) and is not a specific diagnosis. Pubalgia also encompasses other conditions such as overuse of the abdominal muscles, adductor muscles, as well as specifically a tear (PLAC injury).

How does pubic-related groin pain develop?

This problem usually develops gradually and is a typical example of overuse. Whether an injury occurs depends on the load-bearing capacity of the bone: how strong the bone is in relation to the exerted load. If the load is greater than what the bone can handle, the risk of overuse increases.

The body sends a warning signal by producing inflammatory fluid at the site of overuse. This causes pain, which naturally reduces the load. This mechanism allows the bone to recover and adapt better to the load.

It is important to listen to these signals and support the recovery process with appropriate rest and a gradual increase in load.

This typically causes groin pain in the pubic bone area, where the adductors attach. This can radiate to the inside of the thigh. Often, it spreads to the other side.

It is important to distinguish this from an inguinal hernia. This can also cause pain in the pubic bone area, but it typically causes discomfort slightly higher than the groin region. It can, however, radiate to the pubic bone, abdominal muscles, and even the testicle. This often typically causes discomfort when coughing, sneezing, and straining.

Pubic-related groin pain typically causes pain in the pubic bone area during:

• Impact (e.g. running or playing football)
• Sports with explosive movements
• Pushing both straightened legs inwards against each other, especially with extra tension in the abdominal muscles

The treatment of this injury is tailored to the severity of the symptoms. Usually, the approach consists of:

• Relative rest: temporarily avoiding high-impact activities to prevent further overuse.
• Stimulating bone healing: low-impact movements and, if necessary, supplementation with nutritional supplements to support recovery.
• Exercise therapy: targeted exercises to improve the load-bearing capacity of the bone and surrounding structures.
• Possibly an injection: as an additional treatment for persistent symptoms.

Together, we will determine which treatment option best suits your situation and needs, so you can work purposefully towards recovery.