Osteitis pubis in four young football players: A case series demonstrating successful rehabilitation

This case series study reports on successful rehabilitation outcomes and two new possible clinical indicators for return to football following osteitis pubis (OP). Four young football players developed OP acutely within 6 months of a rapid increase in training load after joining a junior elite programme. The clinical outcome measures included strong effort pain-free hip adduction, no tenderness over the pubic symphysis, bone or adductor complex. The functional outcome measure involved a pain-free completion of a running programme based on average distances covered by players in a game. The performance markers used in this case study (20 m shuttle run, 20 m and 5 m sprint tests) are frequently employed in football to measure player performance. All players were commenced on a conservative rehabilitation program involving abdominal and pelvic strengthening exercises in a graduated format and successfully achieved this outcome between 10 and 16 weeks after diagnosis. Rehabilitation included completion of a running programme consisting of durations and elements specific to football. During their rehabilitation a consistent pattern of clinical milestones emerged that coincided with the players’ readiness to return to football. The players were able to perform 5 min of skating on a 3 m slide board and three sets of 12 repetitions of adductor exercises against 6 kg of resistance. No recurrence of injury has been reported at 12 months follow up.