3. Biomechanical Issues

So we know that Osteitis Pubis develops when biomechanical weaknesses in the lower body overload the adductors.

Overused adductors; the true cause of Osteitis Pubis.

The major biomechanical weaknesses that cause Osteitis Pubis are:

  • Hip drop whilst running
  • Over pronation/supination
  • Anterior pelvic tilt
  • Knocked knees/bowed legs

These are not isolated issues; weakness in one area increases the likelihood of having a weakness in another. If you over pronate your tibia will be internally rotated, increasing the likelihood of having knocked knees. Furthermore the arch muscles; which stabilize your foot to prevent over pronation connect in the same muscular/fascial chain to the stabilizing muscles of the pelvis, which help prevent an anterior pelvic tilt.

This is why flat feet are often associated with an Anterior Pelvic tilt; and why OP patients present with varying degrees of the 4 major biomechanical weaknesses.

Click here if you would like to book in for a free, 20 minute Skype consultation to discuss your case.

Individual Muscles aren’t necessarily weak

The first reaction patients have is to want to strength each weak muscle; their gluteus medius for a hip drop, their glut max for an anterior pelvic tilt etc. to fix their biomechanical weaknesses. But there is a major problem with this theory; these muscles aren’t necessarily weak.

When we test the strength of muscles in isolation (1 muscle at a time) OP patients don’t always show strength deficits. In fact most OP patients, being athletes demonstrate strong powerful muscles… when each is tested individually.

However functional, whole body tests (multiple muscles at once) tell a different story. 1 legged squats, lunges, deadlifts, balance work, Osteitis Pubis patients do poorly in. In fact a wide variety of exercises that demand muscular co-ordination and balance challenge OP patients. This is because they struggle activate their muscles/fascia in their correct ‘chains’. Each muscle is strong enough on its own; but they have no idea how to work together.

Osteitis Pubis patients move clunky

When we slow down OP patients during movements they often appear stiff, rigid and well…. Clunky. Their movements are often powerful; a lot of patients are great athletes. But they never move ‘smoothly’. This makes changes in direction particularly difficult; as the more off balance you are the harder you have to contract your muscles to counter balance.

The muscles aren’t communicating and working together, they’re fighting each other. They’re bracing and contracting, doing their best to maintain balance without any help. No muscle more so than the adductors.

A simple test?

Stand on one foot and close your eyes. You should be able to maintain your balance without shaking too much for 20 seconds. This sounds easier than it is. Most OP patients will find themselves touching the ground regularly.

So which Muscular/Fascial systems are faulty?

The million dollar question. There are three specific systems. Click on the links below to find out more about each, or return to the Osteitis Pubis guide landing page to move straight onto the treatment and rehab methods to fix your Osteitis Pubis forever!

The functional chains that fail you:

  • Deep front line and Osteitis Pubis; what happens when the major fascial chain fails
  • Weak core and glutes and Osteitis Pubis
  • Poor balance causing Osteitis Pubis? The invisible cause.

3 functional systems fail in Osteitis Pubis

3 functional fascial, muscular and neural chains are dysfunctional in OP patients. These 3 chains can explain all of the biomechanical issues present in OP; and explain how they are all interconnected. The 3 chains are:

  1. The Deep Front Line: A fascial/muscular chain which includes the muscles of your arch (which affect pronation/supination and bowed/knocked knees), your adductors and your hip flexors (which strongly affect an anterior pelvic tilt) becomes weak and stops functioning effectively.
  2. Weak core and glutes: Your core muscles and gluteus medius are responsible for keeping your pelvis stable. Failure to stabilize the pelvis effectively forces the body to stabilize from the adductors.
  3. Vetibular/Proprioceptive system (balance): Whilst not a muscular system on its own, your balance is vital to the function of every muscle in the body. OP patients present with reduced balanced and body awareness; their movements tend to be clunky and rigid. This clunky, rigid movements create more friction and force through the lower body; putting more load on the already overloaded adductors.

The longer these systems remain weak, the harder the adductors work. Overworked muscles become tired, fatigued and tight. They develop trigger points and refer pain. They jam up joints and restrict mobility.

Click here if you would like to book in for a free, 20 minute Skype consultation to discuss your case.