title: Osteitis pubis: can early return to elite competition be contemplated?
abstract: OBJECTIVE
  In elite athletes, osteitis pubis is a common painful degenerative process of the pubic symphysis and surrounding soft tissues and tendons. We report the diagnostic pathway and the rehabilitation protocol of six elite athletes with osteitis pubis in three different sports, and compare protocol stages and time to return to competition.
  
  
  METHODS
  6 athletes (2 soccer, 2 basketball, 2 rugby players) were diagnosed with osteitis pubis stage III and IV according to Rodriguez classification using standard clinical and imaging criteria. After performing a baseline lumbo-pelvic assessment, the rehabilitation protocol described by Verrall was adapted to each individual athlete.
  
  
  RESULTS
  The length of time for each stage of the protocol was as follows; Stage 1 (rest from sport) was 26 +/- 5 days, Stage 2 (to achieve pain free running), 18 +/- 5 days, Stage 3 (squad training) 63 +/- 7, Stage 4 (return to competition) 86 +/- 15. Soccer players took longer to return to competition than basketball and rugby players. No recurrences were reported at 2 year follow-up.
  
  
  CONCLUSIONS
  The protocol presented ensures a safe return to elite athletes. The time from diagnosis to full recovery is longer in football players, and seems to increase with age.
authors.affiliation: F.C. Barcelona Medical Department. Barcelona. Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Jardí
authors.affiliation: F.C. Barcelona Medical Department. Barcelona. Spain.
authors.forename: Gil
authors.initials: G
authors.lastname: Rodas
authors.affiliation: Centre de Diagnòstic per Imatge de Tarragona. Tarragona. Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Pedret
authors.affiliation: F.C. Barcelona Medical Department. Barcelona. Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Til
authors.affiliation: Sydney School of Medicine. University of Notre Dame. Sydney. Australia.
authors.forename: Manuel
authors.initials: M
authors.lastname: Cusí
authors.affiliation: National Track & Field Centre, Sports Medicine Clinic of S.E.G.A.S., Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Malliaropoulos
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
authors.affiliation: Centre Lead and Professor of Sports and Exercise Medicine Consultant Trauma and Orthopaedic Surgeon Centre for Sports and Exercise Medicine Barts and The London School of Medicine and Dentistry Mile End Hospital.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
keywords: Lumbo-pelvic stabilization; Osteitis pubis; Rehabilitation; sport