Explainer | Do you have pelvis pain when you run? You might have osteitis pubis, a common overuse injury
- Pain in your pelvis, which can be so bad it even hurts when you sneeze or cough, could be a sign of an overuse injury and a weak core
- There are several simple preventions and treatments for osteitis pubis
A common injury for runners is osteitis pubis, but because it’s in the pelvis and not the knees or ankles, it is ignored or not associated with running at all. So it never gets properly treated or given time to heal.
What is osteitis pubis and what causes it
Osteitis pubis is an inflammation where the left and right pubic bones meet. The bone and the soft tissues become inflamed, causing discomfort or pain.
A number of muscles that are crucial to running meet here, including the lower abdominal muscles and the hip flexors.
It is an overuse injury. If you are running too much, or running with too much intensity, compared with your experience and fitness, it causes inflammation.
Overuse is a term relative to each runner. You can be more susceptible to overuse injuries if you are weak, or stronger on one side than the other, or have old shoes or bad running technique.
Symptoms of osteitis pubis
There can be a dull pain in the centre of your pelvis, even when sitting down. It can be very painful. There are a number of symptoms.
-
Pain at the centre of the pelvis is the most common symptom.
-
For runners, it can be painful to run, or even walk.
-
The pain can feel like it is at the bottom of the abs.
-
When it’s very bad, a cough or sneeze can send a sharp pain through your pelvis.
-
Perhaps there is the feeling of “popping” when you move, or maybe clicking.
-
Lying on your side can cause pain because of the weight on the pelvis.
Osteitis pubis treatment and prevention
There are some easy home treatments – although if it is acute or not healing, seek medical advice:
-
Rest – do not go on a run. If it’s very painful, limit movement. It’s an overuse injury, so now stop using it.
-
Ice – try to reduce the swelling with an ice pack. Or maybe have a cold bath if it’s hard to ice the area.
-
Gradually return to running – if you dive into the deep end again, you will just relapse. So start with walking, then gentle jogging.
-
Anti-inflammatory medicine – it may relieve the pain and reduce the swelling.
Hill repeats and why runners should do them to improve performance
Prevention is better than a cure. These preventive measures will also make you a better runner:
-
Run easy – do not go too far, too hard, too often. Lots of easy sessions will build up your base fitness and give your body time to adjust to the workload, and recover between sessions while still getting fitter.
-
Strength training – a lot of single leg strength training will make you a better runner and prevent many injuries, including osteitis pubis. Lunges, split squats, Bulgarian split squats and single leg Romania dead lifts are all great.
-
Ab training – work on your core. Do planks, and sit-ups and a host of other ab exercises to prevent osteitis pubis.
-
Cross training – keep getting fitter but spread the load over your body by doing other sports like cycling, rowing, hiking and swimming.
-
Less intense – long easy runs are a great way to get fit. Run in zone one or two of your heart rate (that’s up to 70 per cent of your maximum heart rate, which is 220 minus your age). The lower intensity will spare you injuries.
-
Get proper running shoes – going for runs in old, worn-out shoes, or shoes that aren’t designed for running, will add strain to your body and cause injuries.
-
Warm up and cool down – doing both of these properly will help prevent injuries.
