Why rest is the worst thing for Osteitis Pubis

Refresh your understanding:

op-development-diagram

  • Osteitis Pubis is caused by overworking and overusing your adductors. This chronic overuse leads to their degeneration, which we call Osteitis Pubis.
  • Biomechanics(the ways you move) are at the heart of Osteitis Pubis. You have developed a pattern of moving your body (your own biomechanics) that overload and overuse your adductors giving you your very own OP  mechanics.
  • Fixing OP will involve altering/correcting your ‘OP mechanics’ so you can stop overloading your adductors and give them a chance to heal.

 

Rest often escalates OP!

This is a typical story we hear from clients.  Perhaps it will sound familiar.

A patient visits the doctor with this chronic, nagging groin/abdominal pain that won’t go away. The doctor diagnoses OP, perhaps on the spot or with a scan. The prescription is some pain killers (or perhaps even a cortisone or PRP injection), a trip to the physio for some exercises (squats, clams, bridges, stretches, adductor strengthening, easy or painful exercises) and most importantly anywhere between 2 – 8 weeks of complete rest.

The news is a blow; you don’t want to take 2 months off. But you talk yourself into it. At least you know what the problem is and after two months you can get stuck straight back in, this time without this niggling injury holding you back.

Except this doesn’t happen. Sure when you first return your groins feel better and you think it’s over. But as you get back into full training that pain starts creeping back and you’re ready to cry.

You keep pushing, hoping that  rest and recovery did fix it, but no. This time the pain is worse than before. Instead of remaining in just your adductors it has started migrating to your abdomen or it’s coming on at the start of training, instead of just the next day. Somehow your OP is actually worse than before. It has progressed to Stage 2 or 3 and you are have run out of ideas.

You see every chiro, osteo or physio you can find. But nothing works properly.

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Why rest doesn’t work

For traumatic tissue injuries like muscle or ligament tears rest and a slow return to activity is the right move. It gives your acute trauma time to heal.

But OP is not an acute injury, OP is a chronic injury. It’s the accumulation of hundreds of little traumas caused by your poor OP mechanics. Rest, handout sheet stretches and rehab you don’t really understand or complete doesn’t work. That recovery plan will not work because it does not change your biomechanics.

As soon as you return to training you will  start accumulating more trauma until your adductors start breaking down again.

muscle-atrophy

Except this time you’re starting from a weaker position. You’ve rested and your whole body has grown lazier. Without the load of your training your core, glutes and arches have grown even weaker, leaving more work/load for your adductors.

OP often hits a critical point after a return from rest, progressing from a nagging injury to a severe one. Rest weakened your body, leaving you vulnerable to your OP progressing from Stage 1 to Stage 2 or possibly Stage 3.

How to use rest correctly

Rest is an extremely important part of the rehab protocol, specifically taking a break from activities which flair up your OP. But this doesn’t mean you take it easy.

You need to be laser focused, rehabbing hard during your time away. You need to be putting in the time, sweat, blood and tears into remoulding those biomechanical pathways that caused your OP.

When you return to activity you need to be a new animal, a new machine with mechanics that don’t overload your adductors. You need to be strong and well trained so your body is completely invulnerable to the injury. You need to be sure that you’ve completely eradicated those OP mechanics.

Return with poor mechanics and you will just start the cycle again, except this time weaker and vulnerable to a more severe form of OP

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