Lower abdominal pain- osteitis pubis?


Ive been injured for about 6 weeks with sore lower abdominals. The pain is caused pretty much only by running and is fine when warm up but by the time ive cooled down after a workout im in agony, then the next day it is fine again until i run. I took 4 weeks off but it didnt do any good. I then went to see the physio and he said id jammed my pubis bone, he unjammed it and told me to rest for 1 week until the pain went. Anyway, the pain seemed to disappear but after the first session back it hurt again 2 or so weeks of rest later and it still hurts after running.

Could this be osteitis pubis? The pain is most apparent when i step down on the outside of my foot and is mainly in the right lower abdominal and , as i said, only after intense running/ ground contact (never during weights- squats OLs etc…). Can anyone suggest what this is/ steps to follow? Ive also had blood and urine tests to see if there is an inflammation in my lower intestine or pubis bone but the results are taking ages.


Hi Scotty, and sorry I’m only getting to reply now.

There are a miriad of issues that may be afflicting you.
Osteitis Pubis is one.

The first thing with all of these things is getting a good therapist to help you recover from this. They need to be skilled at diagnoising the exact injury, because of all the various elements to be considered.

The whole groin area is complicated.
It may be a prolonged groin strain of the gracilias etc. that is only effacted in the ab area, but the most likely injury from your description is osteitis pubis or one of the hernias.

Like I said at the outset a good therapist is needed to diagnose the injury and I am no expert.
Each injury whether a hernia or pubis may need a different imaging process to asses the area, such as ultrasound for hernia or MRI for osteitis pubis, and even at this the injuries are difficult to see.

From the location and what you have said I would imagine it is Ostetis Pubis but it may perhaps be a hernia as well, however a hernia would be expected to appear when lifting or when the TA is under pressure.

There are many other questions to be asked such as how do you react to the squeeze test, how do you feel each morning getting out of bed, any discomfort going to the bathroom, coughing or driving?, what changes have you made to your training program over the past 3 months, what core work are you doing?
But scans would unltaimately help with a better diagnosis.

None of this helps you much, but the best advice I can give is get a good therapist to get it narrowed down with a scan to accurately diagnose and then get a rehab plan and program in place.
Good luck

Thanks for the wise words- im definately going to try to see a specialist in this area and get some kind of scan.

To answer some of your qs- adductor squeeze is fine (no pain whatsoever), no discomfort getting out of bed at all or going to bathroom, coughing or driving.

As for changes in my training- my coach increased the volume of track work radically leading into a championship (dont ask me why) which led to a number of niggles becoming an increasing worry, this includes my hips, lower abs and back and eventually these areas became such a problem that i have ended my outdoor season. Further, as i got into the competition peroid, due to rest issues, i couldnt do weights and cut down on core work and flexibility, by the time of injury i had pretty much ceased all strength and core work with just track work being my priority.

The only real time it gives any pain is after a running workout where alot of foot contacts have taken place. I actually did an extensive tempo session on grass the other day of around 2000m followed by a few sets of ab work to see what effect this had. I found that immediately after the session it was painful to walk and to lift my right knee to a great extent and expected pain for the next few days but i woke up the next morning and the area was pretty much pain free ( a little sore due to the sit ups& knee raises) and better than it has been for a while. Any ideas why this may be?

Thanks for taking time to help out! This injury is so frustrating and just wanna get it fixed before i concentrate on next season!