Our Best 8 Exercises for Osteitis Pubis
Osteitis pubis is one of the most frustrating injuries an athlete can face. The groin pain is debilitating, recovery feels slow, and without the right rehabilitation approach, the condition has a stubborn tendency to return. The good news is that physiotherapy-led exercise is the most effective treatment available and when done correctly, the results are excellent.
At Physio Pro, we work with AFL players, soccer athletes, runners, and everyday active people across Perth to rehabilitate osteitis pubis using structured, evidence-based exercise programs. Below, we share the eight exercises our physiotherapists use most frequently in clinic and as part of home programs.
Important disclaimer: These exercises are intended as general guidance only. Osteitis pubis varies in severity and stage, and not every exercise is appropriate for every person at every point in their recovery. We strongly recommend a professional assessment before commencing any rehabilitation program. If any exercise causes pain, stop immediately and consult your physiotherapist.
Quick Summary
| # | Exercise | Stage | Target Area | Sets x Reps |
|---|---|---|---|---|
| 1 | Pelvic Tilts | Early (Weeks 1–3) | Deep abdominals, pelvic floor | 3 x 10–15 |
| 2 | Side-Lying Hip Abduction | Early (Weeks 1–3) | Gluteus medius, hip stability | 3 x 15 each side |
| 3 | Isometric Adductor Squeeze | Early–Mid (Weeks 2–5) | Adductors, pubic symphysis | 3 x 10–15 |
| 4 | Dead Bug | Mid (Weeks 3–6) | Core, lumbopelvic stability | 3 x 8–10 each side |
| 5 | Glute Bridge | Mid (Weeks 4–8) | Gluteus maximus, pelvis | 3 x 12–15 |
| 6 | Side-Lying Adductor Raise | Mid–Late (Weeks 5–10) | Adductors (dynamic) | 3 x 12–15 each side |
| 7 | Copenhagen Adductor Plank | Late (Weeks 8–16) | Adductors, core stability | 3 x 8–12 sec holds |
| 8 | Single-Leg Romanian Deadlift | Late (Weeks 10–16+) | Glutes, hamstrings, pelvic control | 3 x 8–10 each side |
Why Exercise is the Cornerstone of Osteitis Pubis Recovery
Osteitis pubis develops when the pubic symphysis is subjected to repetitive stress that exceeds the tissue’s capacity to recover. The underlying drivers are almost always the same: weakness in the adductors (groin muscles), poor core and lumbopelvic stability, and insufficient hip strength. Exercise rehabilitation targets all three of these areas simultaneously, which is why it consistently outperforms passive treatments alone.
The exercises below are ordered from early-stage to more advanced, reflecting the progressive nature of a well-designed osteitis pubis rehabilitation program.
8 Best Exercises for Osteitis Pubis
Pelvic Tilts
Stage: Early — Weeks 1–3
Pelvic tilts are one of the safest and most effective early-stage exercises for osteitis pubis. They gently activate the deep abdominal and pelvic floor muscles without placing load through the pubic symphysis, making them ideal when pain levels are still elevated.
How to perform:
- Lie on your back with your knees bent and feet flat on the floor
- Gently flatten your lower back against the floor by tightening your abdominals
- Hold for 5 seconds, then release and allow a small arch to return
- Repeat 10–15 times
Why it helps: Activates the transversus abdominis and pelvic floor — the deepest stabilising muscles of the pelvis — which are often inhibited in osteitis pubis.
Sets/Reps: 3 sets of 10–15 repetitions, once daily
Side-Lying Hip Abduction
Stage: Early — Weeks 1–3
This exercise strengthens the gluteus medius — the muscle on the side of the hip responsible for controlling pelvic stability during walking, running, and single-leg activities. Weakness here is a common but frequently overlooked contributor to osteitis pubis.
How to perform:
- Lie on your side with your legs stacked and your body in a straight line
- Keeping your top leg straight and your toes pointing forward, slowly raise it to approximately 30–40 degrees
- Lower with control and repeat
- Perform on both sides
Why it helps: Strengthens the glute med to improve pelvic control and reduce asymmetrical loading through the pubic symphysis during everyday activities.
Sets/Reps: 3 sets of 15 repetitions each side
Isometric Adductor Squeeze
Stage: Early to Mid — Weeks 2–5
Isometric (static) adductor loading is one of the earliest forms of groin strengthening tolerated in osteitis pubis rehabilitation. It loads the adductor muscles without producing the shear forces at the pubic symphysis that dynamic movements can create.
How to perform:
- Lie on your back with your knees bent and feet flat on the floor
- Place a rolled towel, pillow, or small ball between your knees
- Gently squeeze the object between your knees and hold for 5–10 seconds
- Release slowly and repeat
- The squeeze should be pain-free — start gently and gradually increase pressure over time
Why it helps: Begins loading the adductor tendons and the pubic symphysis in a controlled, low-stress manner, stimulating tissue healing and preventing muscle atrophy.
Sets/Reps: 3 sets of 10–15 repetitions
Dead Bug
Stage: Mid — Weeks 3–6
The dead bug is one of the most effective core stability exercises available and a staple of osteitis pubis rehabilitation. It trains the deep abdominals and hip flexors to work together while keeping the lumbar spine neutral — directly addressing the lumbopelvic control deficits that contribute to osteitis pubis.
How to perform:
- Lie on your back with your arms pointing straight toward the ceiling and your hips and knees bent to 90 degrees (tabletop position)
- Slowly lower your right arm above your head while simultaneously straightening your left leg toward the floor
- Keep your lower back pressed firmly against the floor throughout
- Return to the starting position with control and repeat on the opposite side
Why it helps: Challenges the deep abdominal wall and lumbopelvic stability under load without placing stress on the pubic symphysis.
Sets/Reps: 3 sets of 8–10 repetitions each side
Glute Bridge
Stage: Mid — Weeks 4–8
The glute bridge strengthens the gluteus maximus — the primary hip extensor and one of the largest contributors to pelvic stability. Strong glutes reduce the compensatory load placed on the adductors and pubic symphysis during running and kicking.
How to perform:
- Lie on your back with your knees bent and feet flat on the floor, hip-width apart
- Press through your heels to lift your hips off the floor until your body forms a straight line from shoulders to knees
- Squeeze your glutes at the top and hold for 2–3 seconds
- Lower with control and repeat
- Progress to single-leg glute bridges once the double-leg version is pain-free and comfortable
Why it helps: Builds gluteal strength to improve pelvic control, reduce anterior pelvic tilt, and decrease stress on the pubic symphysis during dynamic activities.
Sets/Reps: 3 sets of 12–15 repetitions
Side-Lying Adductor Raise
Stage: Mid to Late — Weeks 5–10
Once isometric adductor work has been well tolerated, dynamic adductor loading can be introduced. The side-lying adductor raise is a straightforward progression that directly targets the groin muscles through a full range of movement.
How to perform:
- Lie on your side with your bottom leg straight and your top leg bent with the foot resting on the floor in front of you
- Slowly raise your bottom (straight) leg off the floor to approximately 20–30 degrees
- Lower with control and repeat
- Perform on both sides
Why it helps: Directly strengthens the adductor muscles through dynamic loading, building the groin strength essential for kicking, sprinting, and change-of-direction movements.
Sets/Reps: 3 sets of 12–15 repetitions each side
Copenhagen Adductor Plank
Stage: Late — Weeks 8–16
The Copenhagen Adductor Plank is considered the gold-standard exercise for adductor strengthening in osteitis pubis rehabilitation. Research in elite football populations has demonstrated its effectiveness not only in rehabilitation but also in injury prevention. It is a challenging exercise and should only be introduced once earlier stages have been well tolerated.
How to perform:
- Set up in a side-lying position with your top foot resting on a bench or chair at approximately knee height
- Push through your top foot to lift your hips off the floor, forming a straight line from head to toe
- Hold for the required time, maintaining core engagement throughout
- Lower with control and repeat on the other side
- Beginners can start with the bottom knee on the floor as a regression
Why it helps: Produces high levels of adductor muscle activation while simultaneously challenging lumbopelvic stability — making it the most sport-relevant adductor exercise available.
Sets/Reps: 3 sets of 8–12 second holds each side, progressing to longer holds and more dynamic variations over time
Single-Leg Romanian Deadlift
Stage: Late — Weeks 10–16+
The single-leg Romanian deadlift (RDL) is an advanced exercise that challenges the entire posterior chain — glutes, hamstrings, and lower back — while demanding significant lumbopelvic control on a single leg. It closely replicates the demands of kicking, running, and landing mechanics.
How to perform:
- Stand on one leg with a slight bend in the knee
- Hinge at the hip, sending your free leg behind you as your torso lowers toward the floor
- Keep your back straight and hips level throughout — avoid rotating the pelvis
- Lower until you feel a stretch in the standing leg hamstring, then drive through the heel to return to upright
- A light dumbbell in the opposite hand can be added as a progression
Why it helps: Develops the posterior chain strength and single-leg lumbopelvic control required for full return to running, kicking, and sport-specific movements.
Sets/Reps: 3 sets of 8–10 repetitions each side
How to Progress These Exercises Safely
The key principle in osteitis pubis rehabilitation is progressive loading — gradually increasing the demand on the pubic symphysis and surrounding structures over time. A general guide for safe progression:
- Only advance to the next exercise when the current exercise is completely pain-free
- Expect mild muscle fatigue during and after exercise — this is normal
- Do not continue if you experience pain at the pubic symphysis or in the groin during an exercise
- Monitor your symptoms the following day — a small increase in soreness that resolves within 24 hours is generally acceptable; pain that persists longer than 24 hours indicates the load was too high
- Never skip the early stages in favour of advanced exercises, even if pain levels are low
When to See a Physiotherapist
While these exercises provide a strong foundation, osteitis pubis rehabilitation is not a one-size-fits-all process. The specific exercises, sets, repetitions, and progressions that are right for you depend on your severity, stage, sport, and movement patterns. Attempting to self-manage a significant or long-standing case without professional guidance is one of the leading causes of prolonged recovery and recurrence.
If your groin pain has persisted for more than one to two weeks, keeps returning with exercise, or is affecting your ability to train and compete, book an assessment with one of Physio Pro’s experienced physiotherapists. We will provide an accurate diagnosis, identify the specific factors contributing to your condition, and build a personalised rehabilitation program to get you back to full fitness as quickly as possible.
Osteitis Pubis Treatment In Perth
Physio Pro has clinics in Floreat and Como, and our team has extensive experience managing osteitis pubis in athletes at all levels of competition. Book today to get started.
