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Running Doc: Recovering from Osteitis Pubis


Dear Running Doc:

I am a 38-year-old woman who has been running since I was 12 years old. I run high mileage, have good running shoes and expect to finish 5 marathons a year. Recently, without any direct trauma, I developed pain at the symphysis pubis. I feel it when I stretch, when I run, and when I stand. When you palpate it, it hurts more. My doctor examined me, did an x-ray and an MRI and said I have Osteitis Pubis. He said I may be able to run for 9 months until this heals, or I can have surgery. Do I have any other options, I can’t wait 9 months to run?

Sharon A., Great Neck, NY

Thanks for the question Sharon. Osteitis Pubis (OP) is most common in women in their mid-30’s and men in their mid-40’s to 50’s. The good news is as women age, if it is healed, the risk decreases.

OP starts as an inflammatory process at the pubic symphysis with the pelvic bones come together. Because of tight muscles attaching to this area and to the constant pounding due to running, the area becomes inflamed. The inflammation can spread into the interior of the bone (inferior and superior pubic ramus). The inflammation in the bone can cause stress fractures. Topol et al in Argentina has published his experience that most patients took 11 months to be pain free.

Tips from the Running Doc. (Corey Sipkin/New York Daily News)

Until recently there was no specific treatment for OP. Doctors would treat the pain and inflammation with ice, stretching and strengthening. Sometimes prednisone shots were used but it made the bone softer and increased the length of recovery. Resection via surgery scraps out the infection but again has a long recovery.

Luckily, Topol has shown that regenerative injection therapy (PRP) will generate new tissue and cut healing time down to less than a month. What wonderful news for my patients! I have done 8 cases since November and all are back to running pain free within a month. It may take a couple of weeks of injections (depending upon your healing process) and how far the inflammation has spread before you see the results.

I hope this helps Sharon. No one wants to stop running for long periods of time. Now with this new treatment you don’t have to be.

Enjoy the Ride!


Lewis G. Maharam, MD, FACSM is one of the world’s most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc’s Guide to Healthy Running and past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at