I'm looking for rehabilitation procedures for osteitis pubis. In particular, I'd like to find out permitted exercises / training during the rest phase, and recommended time-frame for including running into the program.
As you probably already know, osteitis pubis is a classification for increased bone density seen at the symphysis pubis. This increased bone density usually is associated with PAIN and /or increased physical activity. We cannot give you an exact protocol without an assessment. However, we strongly recommend consulting and/or performing a comprehensive kinetic chain assessment before your client resumes intense activity. By assessing the articular, neural and myofascial structures (kinetic chain) the practioners will know where to start.
Examples of subjective and objective information that should be assessed: IF your client is experiencing pain the question is at what intensity? What position(s) In what plane(s)? Is the pain sharp, tingling, dull? After a workout? Before? What position aggravates the condition most? How is their gait pattern? Does one foot externally rotate more than the other? How is your clients muscle balance - there is a good chance the adductors, iliopsoas, sartorius, tensor fascia lata and IT Band are of less than optimal length creating not only compensation patterns but also placing tremendous unnecessary force on articular structures.
- Assess all subjective information (what the client tells you)
- Assess posture statically, transitionally and dynamically
- STATIC: Goniometric assessments assessing for individual muscle length.
- TRANSITIONAL: Over Head Squat Profile assessing for dynamic flexibility, neuromuscular efficiency, integrated functional strength.
- TRANSITIONAL: Multi Planar Balance Excursion Test (Journal of Sports Rehab 10(2)93-104, 2001) assessing for dynamic balance, core strength, multi planar dynamic flexibility.
- Dynamic: Shark Skill Test assessing for agility, balance and power.
- Sift through all assessment information and start by designing a low-level stabilization program. Always keep in mind stabilization precedes strength and strength precedes power exercises/activities. Your client will need to systematically progress through a stabilization, strength, and power phase to resume normal activity SAFELY.
Articles posted on this site to help your client’s condition:
- Inner Unit by Paul Chek (Paul lists several stabilization exercises essential for your client in the beginning phase)
- Outer Unit by Paul Chek
- Neurological Rationale for Integrated Training by Rodney Corn
- Glute article by Rodney Corn (very important for runners!)
- Overhead Squat Profile by The NASM Performance Team
- Muscle Balance Assessment by The NASM Performance Team
- And many more