9. The Role of Treatment

OP is an extremely painful injury. Treatment can go a long way to reducing this pain and improving your ability to get back out on the field. The problem is when treatment becomes a stop gap measure. Most athletes stop training, get treatment to reduce the symptoms till they’re groin feels pain free and then return to training… only for their OP to return with a vengeance.

Knee Pain Remedial Massage

Your adductors are a long group of muscles. The run from the groin/pubic bone all the way down the inside of your leg. The longest attaches on the inside of the shin.

Treatment needs to go beyond symptom recovery; it needs to create biomechanical changes in how the muscles and joints in the body function. If it isn’t treatment can be the equivalent of popping pain medication; good in the short term useless in the long run.


Anterior Pelvic Tilt

When the hip flexors become short, the pelvis tilts anteriorly and the hamstrings become over-lengthened and ‘tight’. This often plays a big role in the development of OP.

Deep Tissue Massage for OP

Osteitis pubis involves inflammation and dysfunction of the adductors and pubic symphysis. If you have it you know exactly how tight, uncomfortable and painful your groins feel. They don’t need to be aggravated any further.

Most conventional treatment or massage involves fast, superficial, painful strokes across the surface of the muscle. The increased blood flow to the adductors often feels good immediately after the treatment, loosening up and improving range of motion. But over the next day the groin often tightens, returning to its original state or feeling even worse. This is because this style of treatment aggravates the adductors, encouraging the body to create more inflammation as the muscle is essentially ‘assaulted’ through treatment.

OP treatment needs to be slow, deliberate and deep. Your adductors will be riddled with trigger points deep under the surface. Treatment has to slowly engage the tissue, encouraging the superficial tissue to relax before deeper trigger points can be attacked with the more deliberate pressure of an elbow.

Treatment beyond the adductors

Obviously your pain is in your adductors. But there must be a reason that your adductors have become so overworked and tight. This is because OP patients always have particular set of biomechanical weaknesses and faults which overload the adductors. Continually treating your groins without considering the rest of the body will get you nowhere.

Matthew Green Myotherapy Massage

Your Adductors share a connection to your medial hamstring. With OP, your adductors and hamstring tissue essentially become ‘stuck’ to each other.

The majority of OP patients have dysfunctional glutes, hamstrings and hip flexors. Essentially the hip and pelvis stop moving and the adductors suffer the effects of this. Treatment needs to address the hip flexors, especially around the front of the hip and the gluteal muscles in the back of the hip. Once the hip can move freely than pressure can be reduced from the adductors and they can start healing themselves.

If you are going to try to fix OP with treatment, you’re going to need a therapist that understands the whole picture. Isolated treatment of the groin is unlikely to yield great results.