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3.5 Causes of OP: Dysfunctional pelvic floor and Sacroilliac Joint
3.6 Causes of OP: Dysfunctional oblique chains
3.7 Causes of OP: The balance and coordination system

Osteitis Pubis (OP) is the most misunderstood musculo-skeletal condition of modern medicine. Lasting anywhere from 8 weeks to 2 years, OP has a poor track record for treatment and recovery outcomes. To put things in perspective, most ACL repair patients are back running within 6 months. Most OP cases last between 7 to 10 months.

This shouldn’t be the case.

Osteitis Pubis can be fixed. With the right information and the right approach recovery can be counted in weeks rather than in months.


Osteitis Pubis is a rare condition. Most health professionals achieve poor or inconsistent patient outcomes over the longer term because they have relatively little practical experience with the condition.


We have treated hundreds of OP patients, both in our Port Melbourne clinic and across the world over Skype. Let’s be honest from the outset; there is no magic treatment. OP is a chronic pain condition and fixing it takes hard work.

However, with the right work recovery time is usually 8 to 14 weeks.

Motivated, thoughtful, ‘body aware’ patients have recovered in as little as 5 weeks. The key to this faster recovery was focus and education.  The patient took full advantage of the video reviews, instructional videos and session recordings we provided during the treatment process. They got the most out of every rehab exercise and every appointment. They became their own ‘OP experts’ and fast tracked their own recovery. This is the key to fixing OP. It's not about a magical treatment strategy, it's about you learning exactly what you need to do to fix yourself.

There is no instant cure. People get this condition because they move badly, overload and wear down their joints/tissues. Most people understand this but struggle to know how to correct their movement. No body is perfect or symmetrical. Our bodies develop in a lopsided way, uniquely responding to the demands of our environment. Sometimes this encourages us to develop ‘bad’ movement habits that work well for a time, but put a strain on our bodies in the end.

The OP clinic possesses every tool you need to ‘re-balance’ your body movement and fix your OP. If you’re willing to do the work you can fix your OP permanently.



We know you’ve been through the ringer, that you’ve seen a lot of physios, chiros, doctors and specialists and you’ve been disappointed countless times.

The OP Clinic specializes in OP. There is an endless amount of misinformation out there. You could spend half your life scouring the internet trying to find the ‘answer’ to OP. It’s our hope that as you read this website you will begin to appreciate that we offer real solutions. We have the answers, so instead of spending your time looking for answers, you can get started on applying solutions.

You see OP is caused by a bunch of bad habits working together. We understand these causes of OP and how they work together. Our treatment and rehab protocol takes you through every step of your recovery. From self-treatment to core activation, glute weakness, pelvic floor release, SIJ dysfunction, arch activation (ie address pronation) we have every step of your recovery covered.

Because every one of these issues play a vital role in why you have developed OP, you won’t fully recover from OP until every one of these issues is addressed and corrected.

Our 10 Stage Rehab and Treatment Protocol addresses and corrects every issue, fixing your OP permanently.


While seeing therapists, physios, osteos, specialists and even surgeons, they might have scanned your pubic bone, said something complicated like ‘CAM impingement’, ‘sclerosis’ or ‘irreversible degeneration’. They might even recommend surgery.

But before you let someone cut you open let me ask you one question, have they actually explained to you:

  • What exactly OP is

  • Why you have it, but your teammate in the exact same position is fine

  • What the biomechanical weaknesses are that cause OP

  • Whether it matters if your pubic bone is showing arthrosis/degeneration

How can someone fix OP when they don’t really know what it is?

Continue reading. We will answer every question you have about OP. From how useful scans are, to the biomechanical causes, role of self treatment and how you go about fixing it, OP will be explained and ‘demystified’.

Most OP patients fail in their rehab because they are not really clear on what they need to do. Patients perform generic physio rehab plans wondering, ‘Is this working? Am I doing this right?’

That’s not how the OP clinic works. You are always put in the best position to succeed. From appointment session recordings, to instructional videos and technique review videos you are given every tool, every piece of information to fix your OP.

You don’t have to be technically minded and you don’t have to have a strong understanding of anatomy. By the end of the 10 Stage Rehab and Treatment Protocol you will understand your body, and exactly what you need to do to fix it!


In technical terms, Osteitis Pubis (OP) describes a pattern of tissue damage, chronic dysfunction of the adductors (groin muscles), pubic bone and pubic symphysis caused by repetitive trauma or excessive stress across the pubic joint.

Patients usually experience groin pain that gradually develops over time. Symptoms worsen, with pain migrating to the pubic bone, hip flexors and lower back. Exercise such as running, kicking, changes in direction and explosive movements usually makes the pain worse. Fully developed cases may be sensitive to all weight bearing movements and even coughing or sneezing.


Osteitis Pubis usually starts with just a dull ache in your groins at the end of a long training session or the day after. Then you start to feel it at the start of training. Once you warm up its fine, but it takes longer and longer to warm up. You start feeling it when you roll over in bed, and when you wake up in the morning. As the condition progresses it is not too long until the pain stops going away at all. Your groin can then feel so tight that you start feeling pain in your pubic bone. Then you seem to be losing power in your legs so getting out of the car or moving your groceries seems like a heavy gym workout.


OP can be broken into three stages based on the progression of symptoms. Above is a broad description moving from early symptoms (stage 1) all the way through to end stage (stage 3) OP. It is a slippery slope. But no matter what stage you’re in there is only one truth, ignoring the problem is not working.


OP can be broken into 3 distinct stages:

  1. Early Onset OP

  2. Fully Developed OP

  3. End Stage OP.

Stage 1: Early Onset OP is when you first start noticing symptoms. At this stage there may be confusion as to whether you have an adductor strain or are developing OP. Pain is usually isolated to the adductor muscle group. The patient usually continues chosen activities but does not feel at 100%. Scans are unlikely to show degenerative changes in the pubic symphysis/adductor tendons, although there maybe a small abdominal separation (sports hernia) present.

Stage 2: Fully Developed OP is when OP starts affecting performance. Pain and stiffness becomes more constant and most people have to stop exercising. Symptoms often spread, including pain, discomfort and stiffness in the lower back, hip flexors, lower abdomen and knees. Scans may show mild degeneration of the pubic symphysis (the way it grows together) and tendinopathy (problems with the tendon) of the adductor or hip flexor attachments.

Stage 3: End Stage OP is rare but extremely painful. Low level pain in the pubic bone is present constantly. Scans will show degeneration and damage to the pubic symphysis, abdominal insertion and hip flexors. Significant stiffness and pain is present on most movements after rest.


To your left you will see a navigation bar with all the topics/pages listed for this guide to OP in order. Each page includes a summary of important information you should understand before reading that page.

Skip ahead to topics you’re interested in or read in order, but always check the summary at the top before reading the main content of a page.

If you’re ready to start the 10 stage OP Rehab and Treatment Protocol you can book your free 20 minute Skype introduction with the links below. Otherwise keep reading and equipping yourself with knowledge!

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