A strange pain

[saathi]

I'm training for a marathon in late October (Detroit Free Press).

I've been training for five weeks, following a training chart downloaded from Runner's World. On Sundays I do my long runs--yesterday it was 15 miles. I finished the run in decent shape.

After the run, I developed a sharp pain in my lower abdomen, right above the coccyx or pubic bone. That is, if I press on the painful area, I can feel my pubic bone directly below.

I feel a shooting pain in this area whenever I get up--from a chair or out of bed. It makes me think hernia, but I'm not sure.

I've never had this before and I've been doing races on and off for 15 years. Any ideas?

saathi

[liza larence]

Pubodynia is often found in late pregnancy, when the stress of the infant pressing on the pubic symphysis causes pain there. That area is actually a fibrous joint, and separates slightly with pregnancy widening the pelvis. That can be excruciatingly painful. I suppose it can also be caused by the stress of high impact, sustained exercise...male or female, we both have the same (well, very similar) pelvic bone anatomy and we both have pubic symphyses.
I injected this area on a very pregnant hispanic lady a few months ago, the first I ever did...with bupivicaine and depo medrol. It was a painful shot, and I had to make sure I didnt poke her bladder, but her pain immediately resolved.
Hope that was of help....

[saathi]

Thank you so much for your response. I have a couple follow-up questions.

1) If I've been running for a long-time (though typically not 15 milers), is this an unusual development?

2) Is it possible to develop a hernia in this area? I was helping with a move a couple weeks ago and I worried that I might've overdone it.

Thanks again for your informative and helpful answer.

saathi

[liza larence]

I would say it is unusual, but not preposterous!
Usually hernias are in the groin area (in the anterior crease where the thigh meets the trunk) or umbilical (a bubble in the belly-button area)...sometimes if you have had a previous abdominal surgery, a hernia will develop along the scar...creating a painful bulge. Your problem doesnt sound like a hernia...ESPECIALLY if your mons pubis (pubic bone) is exquisitely tender.

[stephenlavin]

ok saathi ....I', assuming you are a woman ..what you have described to me sounds something like ostheitis pubis ...This is an inflamation of the pubic bone Sharp pain right on the centre of the pubic bone ..it can also lead to severe pain in both groin areas ..I had an operation on my conjoin tendon and had an adductor tenotomy to solve the problem ..if you look it up on the net it sounds awful ....I would advise you not to believe all you read on the net.

Couple o questions ..
1. Does it hurt when you sneeze
2.Is it painful while running
3 Did you recieve any direct hit to the area or has it just developed
4 Is the pain focused only on the pubic bone or does it spread anywhere
5 If the pain is muscular then it is not ostheitis pubis


Dont get me wrong and i could be totally wrong but it sounds an awful lot like ostheitis pubis. It is more common in men than women because we have generally a weaker core area because of the conjoin tendons

[liza larence]

Same thing...the DIAGNOSIS is ostheitis pubis, (osth:bone, and itis:inflammation ) the SYMPTOM is pubodynia...(pubo:pubic, and dynia:pain.)
Corticosteroid injections as I stated above can help or resolve it, but not always...especially when you continue the activity causing the problem in the first place...sorry my dear Saathi...hope you get over it! Question: Are you female? Are you pregnant? .....oh, and reps to stephenlavin above

[saathi]

Finally getting back to your helpful responses... I am not a woman and, therefore, I was not pregnant. I'm a man, 37, in good health. I workout at least five times a week, combining cardio with weights.

I'm still feeling that discomfort though I've realized a new tendency--it hurts especially after sports with a lot of lateral movement (basketball, soccer).

Stephenlavin, it does not hurt while I run but afterwards after my body has cooled down and been resting a few hours.

Thanks for all your help. I may just go to the doctor.

saathi

[blast7]

Originally Posted by saathi

Finally getting back to your helpful responses... I am not a woman and, therefore, I was not pregnant. I'm a man, 37, in good health. I workout at least five times a week, combining cardio with weights.

I'm still feeling that discomfort though I've realized a new tendency--it hurts especially after sports with a lot of lateral movement (basketball, soccer).

Stephenlavin, it does not hurt while I run but afterwards after my body has cooled down and been resting a few hours.

Thanks for all your help. I may just go to the doctor.

saathi

It very much sounds like osteitis pubis. Common for athletes who participate in soccer, running, basketball and baseball. Basically it invovles an imbalance in the muscles of you leg that connect to your pelvis and the muscles of your abdomen. Typically the hip adductors (insdie thigh muscles) are tight and the abdominals are weak so the pelvis is undergoing uncontrolled motion and these shearing forces lead to inflammation of the pubic symphysis (directly in the middle of your pelvis right above your penis. If you complain of pain to the side of this you could potentially have an athlete's hernia rather than osteitis pubis. Interestingly an athlete's hernia is caused by the same muscular imbalances. I recommend consulting a physical therapist as they can direct you in general exercise/stretches and then progress to functional dynamic exercise related to your sport to get you back into pain free motion. Hope this helps.