Individualized multi-modal management of osteitis pubis in an Australian Rules footballer

Jarosz, Brett S

doi:10.1016/j.jcm.2010.09.003

Cited by 15 publications

(27 citation statements)

References 34 publications

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“…All programs included a combination of manual therapy, 4-7 strengthening, 4-7 stretching, [4][5][6][7] and sport-specific exercise. [4][5][6][7] One study 7 included aquatic therapy as part of the intervention program.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

“…• All studies 4-7 used return to preinjury sports participation as the primary outcome measure and used several secondary measures such as strength, 4-7 flexibility, [4][5][6][7] pain-free function, 4-7 and provocation. [4][5][6][7] Only 1 study 6 used patient-related outcome measures.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

“…• Three studies [5][6][7] reported a successful return to preinjury activity between 4 and 14 weeks, and 1 study 4 study reported that a patient successfully returned at 30 weeks.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

“…• Two studies 5,6 reported a successful follow-up period of 6 months, and 1 case series 4 reported a successful follow-up period of 18-48 months for all patients.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

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The Effectiveness of Nonoperative Rehabilitation Programs for Athletes Diagnosed With Osteitis Pubis

Cheatham¹,

Kolber²,

Shimamura³

2016

Journal of Sport Rehabilitation

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Clinical Scenario: The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is a pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football. Conservative nonoperative treatment is often prescribed first before surgical intervention. Of particular interest are the outcomes of nonoperative rehabilitation programs and their effectiveness to return athletes to preinjury levels of participation. The most recent systematic review in 2011 examined the spectrum of treatments for osteitis pubis and found only level 4 (case report or case series) evidence with varying approaches to treatment. Due to the amount of time since the last published review, there is a need to critically appraise the recent literature to see if more high-quality research has been published that measured nonoperative interventions for athletes with osteitis pubis. Focused Clinical Question: Is there evidence to suggest that nonoperative rehabilitation programs for osteitis pubis are effective at returning athletes to their preinjury levels of participation? Summary of Key Findings: Four studies met the inclusion criteria. Only level 4 evidence was found. All studies reported using a structured nonoperative rehabilitation program with a successful return to preinjury participation between 4 and 14 wk, except for 1 study reporting a successful return at 30 wk. Successful long-term follow-up was reported at 6-48 mo for all patients. Clinical Bottom Line: There is weak evidence to support the efficacy of nonoperative rehabilitation programs at returning athletes to their preinjury levels of participation. Strength of Recommendation: There is grade D evidence that a nonoperative program for osteitis pubis is effective at helping athletes return to their preinjury level of participation. The Centre of Evidence Based Medicine recommends a grade D for level 4 evidence with consistent findings.

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Section: Focused Clinical Questionmentioning

confidence: 99%

Section: Focused Clinical Questionmentioning

confidence: 99%

“…• Three studies [5][6][7] reported a successful return to preinjury activity between 4 and 14 weeks, and 1 study 4 study reported that a patient successfully returned at 30 weeks.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

“…• Two studies 5,6 reported a successful follow-up period of 6 months, and 1 case series 4 reported a successful follow-up period of 18-48 months for all patients.…”

Section: Focused Clinical Questionmentioning

confidence: 99%

See 2 more Smart Citations

The Effectiveness of Nonoperative Rehabilitation Programs for Athletes Diagnosed With Osteitis Pubis

Cheatham¹,

Kolber²,

Shimamura³

2016

Journal of Sport Rehabilitation

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show abstract

“…Jarosz et al [44] suggests that the implementation of an individualized multimodal management approach consisting of a variety of physical therapy techniques such as spinal manual therapy, proprioceptive neuro muscular facilitation and mechanically assisted adjusting techniques as well as an individually designed progressive rehabilitation program directed specifically toward an athlete's physical health deficit and special needs, may contribute to a more rapid recovery from estates pubis [44] . Land and water based active core muscle streng thening exercises, proprioceptive neuromuscular facilitation techniques and manual therapy are some of the essential components incorporated into multimodal intervention approach with emphasis to water based symphyseal cleft to the adductor tendon origin is another commonly encountered MRI finding in OP [17,33,40] .…”

Section: Stagementioning

confidence: 99%

Osteitis pubis in elite athletes: Diagnostic and therapeutic approach

Angoules

2015

WJO

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Osteitis pubis (OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient. Radiologic examinations such as plain radiographs, magnetic resonance imaging and 3 phase bone isotope scanning may be helpful to differentiate from other clinical entities with similar clinical presentation. Most cases respond well to conservative treatment which includes several physical modalities and especially a progressive rehabilitation programmed individualized to each one of patients diagnosed with OP. Local injection therapies have been also been proposed as a non-operative therapeutic option for the efficient management of these patients. In refractory cases, surgical therapeutic strategies are warranted. These include several open or minimally invasive surgical interventions such as arthroscopic or open symphysis curettage, wedge or total resection of pubic sympysis, polypropylene mesh placement and pubic fusion. In this review a critical analysis of OP in elite athletes is performed with special focus on current concepts of diagnosis and management of this source of athletic groin pain.

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Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study

Schöberl

Prantl

Loose

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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Individualized multi-modal management of osteitis pubis in an Australian Rules footballer

Abstract: This case suggests that the implementation of an individualized multi-modal management approach directed specifically toward an athlete's deficiencies and requirements, may lead to a more rapid recovery from osteitis pubis.

Cited by 15 publications

References 34 publications

The Effectiveness of Nonoperative Rehabilitation Programs for Athletes Diagnosed With Osteitis Pubis

The Effectiveness of Nonoperative Rehabilitation Programs for Athletes Diagnosed With Osteitis Pubis

Osteitis pubis in elite athletes: Diagnostic and therapeutic approach

Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study

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