Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy

• New rehabilitation protocol for management of recurrent chronic OP/PBS.
• Clinical objective markers as guidelines for progression within rehab of LSARGP.
• Functional measures normalised to body mass as prophylactic guidelines.
• Provides exercise progressions within each stage of the nine-point programme.
• Successful conservative management with shorter time frames than previously detailed.

Background/AimThe aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent chronic groin pain and evaluate the evidence of the interventions.MethodsA professional footballer presented with chronic recurrent OP/PBS. The injury was managed successfully with a nine-point programme –1. Acute pharmacological management.2. Tone reduction of over-active structures.3. Improved ROM at hips, pelvis and thorax.4. Adductor strength.5. Functional movement assessment.6. Core stability.7. Lumbo-pelvic control.8. Gym-based strengthening.9. Field-based conditioning/rehabilitation.The evidence for these interventions is reviewed.ResultsThe player returned to full training and match play within 41 and 50 days, respectively, and experienced no recurrence of his symptoms in follow up at 13 months.ConclusionThis case report displays a nine-point conservative management strategy for OP/PBS, with non-time dependent clinical objective markers as the progression criteria in a Premier League football player.