Pubis (Pubic Bone): Anatomy, Function, and Treatment

The pubis is one of the three main bones that make up the pelvis. It's also called the pubic bone or the pelvic girdle.

The pelvis is a structure located between the abdomen and thighs. The pubis is the most forward-facing bone of the pelvic bones. The ilium, ischium, and pubis form the deep, cup-shaped structure of the pelvic girdle.

The main function of the pubis is to protect the urinary organs and the internal sex organs. The pubis has a different form and function in people born female compared to people born male.

This article will cover the anatomy and function of the pubis, including how the bone is different in males in females. You will also learn about conditions that can affect the pubis and how they are treated.

Pubis Anatomy

The pubis is located at the front of the body just below the abdomen. There are two halves to the pubis. Each half has three sections:

• Pubic body: This is the largest portion of the pubis. The body forms the wide, strong, middle, and flat part of the pubic bone.
• Superior pubic ramus: This is one of two sections of bone that branch off the pubic body. The superior pubic ramus is the upper section that connects to both the wing-shaped ilium and the upper portion of the L-shaped ischium.
• Inferior pubic ramus: This is the lower section of bone that branches off the public body. The inferior pubic ramus connects to the lower portion of the L-shaped ischium.

The right and left halves of the pubis are connected by cartilage called the pubic symphysis. In most adults, the pubic symphysis is not completely rigid and can move by around 2 millimeters.

Variations in Pubis Structure and Function

The general structure of the pelvis differs between biological sexes:

• The female pelvis is thin and light, while the male pelvis is thick and dense to support a heavier body build.
• The female pelvis is wide and shallow, while the male pelvis is more heart-shaped and narrow.

The variations in the structure of the pelvis are necessary because there are differences in the urinary and sexual organs of each biological sex. They also vary in terms of function.

With the pubis, one difference between the sexes is in the pubic symphysis:

• In males, the pubic symphysis is where the suspensory ligament of the penis is attached to the pelvis.
• In females, the pubic symphysis is situated close to the clitoris and can expand to allow for childbirth.

In the female sex, there can also be anatomical variations in the structure of the pelvis, some of which are more accommodating to childbirth than others.

Variations in the female pelvic structure are classified as:

• Gynecoid: This is the most common type of pelvis. It is more round in shape, shallow, and open. These features make it very accommodating to childbirth.
• Android: This type looks more like a male pelvis. It is not as accommodating for vaginal childbirth but is usually fine for a Cesarean section (C-section) delivery.
• Anthropoid: This type of pelvis is narrow and deep. It's shaped a bit like an egg. Vaginal birth is possible with this pelvis type, but it may take longer than it would in someone with a gynaecoid pelvis.
• Platypelloid: This type is also known as a flat pelvis. It's the least common pelvis type. This variation of the pelvis is wide but shallow, making it hard for a baby to pass through the birth canal. Pregnant people with a platypelloid pelvis often need to have a C-section.

Functions of the Pubis

The main function of the pubis is to support and protect the urinary and sexual organs, including the bladder, uterus (womb), ovaries, prostate gland, and testes (testicles).

The pubis joins the rear bones of the pelvic girdle, providing a stable junction between the trunk and the legs. Together, the bones of the pelvic have three jobs:

• To support and balance the trunk
• To enable movement by transferring body weight to the lower limbs
• To facilitate childbirth

The pubic symphysis can also be a "shock absorber" when a person is walking or jumping.

The pubis is also the attachment point for the tissue that connects bone to bone (ligaments) and the tissue that connects muscle to bone (tendons), including:

• The tendons that connect the muscles of the abdomen to those of the pelvis (inguinal falx)
• The ligament that attaches the base of the penis to the pelvis (suspensory ligament)

Conditions Affecting the Pubis

There are several conditions that can affect the pubis. Each one requires a different treatment and rehabilitation plan.

Pelvic Fractures

As with any bone, the pubic bone can be fractured. Pelvic fractures are most often caused by a high-impact event like a car accident or falling from a great height.

When a person breaks their pubic bone, they cannot walk, sit, or move without pain. If the pubis is fractured, the bone must be immobilized to allow for complete healing.

However, the pubic bone is hard to immobilize. Therefore, complete bed rest for several weeks is usually required. This includes avoiding unnecessary movements of the upper body and lower limbs.

Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve (naproxen) or Advil (ibuprofen) can be used to relieve pain and inflammation. Some people need stronger prescription opioid drugs to control pain from a broken pelvis.

Once a pelvic fracture is mostly healed, crutches or other assistive devices can be used as part of the rehabilitation process.

A physical therapist can create a rehabilitation plan for someone healing from a pubic fracture. The plan will often involve manual (hands-on) therapy to improve muscle flexibility and increase mobility in the hips, spine, and pelvis. Exercises involving the hips and core muscles are often done after a pelvic fracture.

Osteitis Pubis

The pubis can also be affected by a condition called osteitis pubis. This condition occurs when there is inflammation of the pubic symphysis and other tissues attached to the pubis.

Osteitis pubis is mainly caused by repetitive stress. It tends to affect athletes and other people who are very physically active, including soccer players and long-distance runners. It can also occur after childbirth or pelvic surgery.

The symptoms of osteitis pubis include pain in the groin or lower abdomen. There can also be pain and tenderness when pressure is put on the pubic bone. The condition can be easily mistaken for menstrual cramps or a pulled muscle.

Osteitis pubis is treated with rest. In addition to OTC NSAIDs, applying ice several times daily for 10 to 15 minutes can help ease inflammation and pain.

The recovery for osteitis pubis mainly involves exercises to strengthen the muscles supporting the pubis, including core muscle training of the traverse abdominal muscles (which wrap horizontally across the belly like a belt) and abductor muscle exercises that target the inner thighs.

Summary

The pubis is one of three major bones of the pelvis. It connects the upper wing-shaped bone (ilium) to the lower L-shape bone (ischium) to form the pelvic girdle. There is a right and left pubic bone separated by a piece of cartilage called the pubic symphysis.

The primary function of the pubis is to support and protect the urinary and internal sexual organs.

The pubis can be broken. Athletes can develop a condition called osteitis pubis in which the pubic bone becomes inflamed from repetitive stress. Both conditions are treated with rest and benefit from rehabilitation with a physical therapist.