Sporting activities that typically place large adverse torsional and/or shear loads across the symphysis (. ‘cutting’ and kicking in football, Fig 8) predispose to early degeneration with an associated loss of articular disc thickness and resilience, . elite footballers, even in early adult life, often show features of premature osteoarthrosis . An unstable symphysis further predisposes to a wide range of secondary mechanical effects, including: (a) pubic bone stress, manifesting variously as ‘osteitis’, stress fracture, or pubic apophysitis; (b) ‘tendonitis’ with or without complicating tendon tears involving any or all of the structures attaching at the pubic plate; (c) conjoint tendon dysfunction causing insufficiency of the posterior inguinal wall; and (d) a range of other features of pelvic instability more generally, . sacro-iliac joint strain, ITB & gluteal tendinopathy, dynamic stretch-related irritation of various nerves that exit the pelvis (. pudendal, lateral femoral cutaneous, sciatic). Although sacroiliac joint symptoms are generally not a striking feature of the condition, many patients will admit to low-grade pain or discomfort in the sacroiliac region if specifically asked.