Osteitis Pubis

[MargOZ]

It seems that this injury has well and truly hit our Club and if Chipper's recovery is anything to go by, it is a serious and debilitating injury. Here's hoping some research goes into curing and preventing it in the future. http://www.realfooty.theage.com.au/news/2002/02/08/FFX1XCEFDXC.html

If anyone wants to know a bit more about this injury, here's some interesting info:

Osteitis Pubis
Solving a Perplexing Problem
Peter C. Vitanzo, Jr, MD; John M. McShane, MD
THE PHYSICIAN AND SPORTSMEDICINE - VOL 29 - NO.7 - JULY 2001

In Brief
Osteitis pubis is a painful condition that affects the pubic symphysis and surrounding tendinous attachments. One common cause stems from unusual biomechanical stress to the pelvis. Patients typically have a variety of vague and nonspecific symptoms, which makes accurate diagnosis of this condition difficult, particularly for clinicians not familiar with the disorder. A systematic approach to evaluating these patients is essential because the differential can be quite large and includes isolated muscle tears, lumbar radiculopathy, and stress fractures. Fortunately, once the diagnosis is confirmed, conservative treatment such as rest and nonsteroidal anti-inflammatory drugs usually leads to a favorable outcome.

Pathogenesis
Osteitis pubis may result from activities that create either acute or continuous shearing forces across the pubic symphysis. Such activities may include twisting, cutting, pivoting on one leg, excessive side-to-side motion, or multidirectional motions with frequent acceleration and deceleration. Men and women may be equally affected, typically during their 20s or 30s. Acute episodes of osteitis pubis can develop as a consequence of forced hip abduction or rotation, kicking, trauma from a fall, or a direct blow.
There is still no consensus about the disorder's exact cause and course. Frequently, the irritating event (particularly in athletes) is repetitive strain or tendinopathy of one or more muscles (especially the adductors) inserting or originating from the pubic rami. Subsequently, shearing forces develop across the pubic symphysis and provoke an inflammatory response. Ultimately, a self-perpetuating cycle of events leads to further worsening of the problem.

Accurate Diagnosis
The diagnosis of osteitis pubis can prove very challenging, even to the most astute clinician. Although the differential diagnosis can be broad, a thorough history and examination, complemented by the appropriate diagnostic studies, can make the task significantly less arduous.

History and presenting complaints
It is important that physicians inquire about the nature of the patient's activity or sport and the motions required. Associated constitutional symptoms as well as any trauma or falls should be noted. Presenting complaints include the insidious development of progressively worsening pain--unilateral or bilateral groin (inguinal), medial thigh, testicular, scrotal, perineal, suprapubic, anterior pubic area, and/or hip--along with restricted motion. Pain is often described as sharp, stabbing, or even burning and is exacerbated by running, pivoting (especially one-legged), twisting, climbing stairs, kicking, sit-ups, leg raises, or Valsalva maneuvers. Patients may have difficulty lying in bed at night. If instability is present, patients may describe an audible or palpable clicking sensation at the symphysis pubis with certain activities (eg, arising from a seated position, turning in bed, or walking on uneven surfaces). Rest usually relieves the symptoms, but not entirely.

Successful Treatment
Various treatment options have been suggested. Initially, the goal is to reduce inflammation and pain by using rest from provocative activities, ice, and physical therapy modalities. Medications may include NSAIDs, but one should not hesitate to use oral corticosteroids if the patient demonstrates intense pain from inflammation. Physical therapy may include therapeutic ultrasound, phonophoresis with hydrocortisone lotion, and electrogalvanic stimulation. Thermally protective compression shorts have also been advocated. If symptoms persist, injected corticosteroids may be considered, but only after infection has been excluded. This step, however, is controversial.
When pain and inflammation are reduced, patients should begin structured physical therapy program that, ultimately, progresses to a graduated exercise program. Eventually, sport-specific activities will be incorporated. In the early stages of this program, pain may actually increase.
Return to preinjury level of functioning may take from 3 to 6 months and occasionally longer. The prognosis of this apparently self-limited condition is very good, with success rates as high as 90% to 95% with the previously noted program. Residual symptoms may occur but do not usually prohibit the patient from participating in activities. Only patients who fail to respond to conservative measures should be considered candidates for surgery.

(full version): http://www.physsportsmed.com/issues/2001/07_01/vitanzo.htm

[MargOZ]

And on a lighter note......

New AFL star on the rise
by STAFF REPORTERS

Osteitis Pubis has firmed as an early favorite to take out this year’s Norwich Rising Star award. The Latin recruit is starting to make an enormous impact at AFL level – an impact that’s all the more remarkable considering he wasn’t even in the game a couple of years back.

Among a quickly growing list of Osteitis Pubis’ achievements has been his demolition job on Roo skipper Wayne Carey last year – not just once, but on several occasions. Over the course of the same season, seven Brisbane players were benched due to the “little mongrel's" determined tagging efforts.

Speaking from his day job at an inner-city physio clinic, Osteitis Pubis told The Bladder he is confident he can continue to do the job. “My all-time hero was Mick Gayfer,” he said. “I like to get in real close and cut off their run at the ball.”

Many have argued that Osteitis Pubis’ tenacious in-and-under style will see him become the next Tony Liberatore.

Experienced football commentator, Bruce McAvaney, thinks we could be witnessing the start of something special. “Osteitis Pubis is a very exciting prospect,” he said. “We haven’t seen anything this big in football since James Hird’s Stress Fracture came runner-up in the final Miss Australia contest.”

The only threat to Osteitis Pubis’ burgeoning career seems to be his murky and mysterious past. Having been born and bred in the delta region of the subcontinent, the enigmatic name of “Osteitis Pubis” was originally rumoured to be an alias of outlaw bookie Mukesh Gupta, as he attempted to infiltrate and bring down another sport.

Having cleared himself of those allegations, Osteitis Pubis then had to hose down speculation that he had fathered an illegitimate child on an airplane. A young and very angry Deepvein Thrombosis is taking court action to try and prove paternity.

However, these are only minor distractions for Osteitis Pubis. For now, he is focusing all his energy on building a long and successful career – by hitting his opponents right where it hurts.

http://www.thebladder.com.au/content/news/displayContent.asp?CID=570&EID=75

[Danzy Rocks!!!]

danny had it

danny.... i will never forget you.