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Understanding Athletic Pubalgia (Sports Hernia)


man pointing to pubic symphysis on skeleton

Athletic pubalgia, also known as sports hernia, is a common yet often misunderstood condition that can affect athletes and active individuals. In this blog post, we'll delve into what athletic pubalgia is, why it happens, its symptoms, typical populations affected, and how physical therapy can play a crucial role in its treatment and management.


What is Athletic Pubalgia?


Athletic pubalgia refers to a painful condition that involves the soft tissues of the groin and lower abdominal region. Contrary to its name, it is not a true hernia but rather a complex injury involving the muscles, tendons, and ligaments of the pelvic and abdominal region. It commonly occurs in athletes who participate in sports that involve repetitive twisting, turning, and sudden changes in direction, such as soccer, hockey, and football.


Causes and Symptoms:


Athletic pubalgia typically results from repetitive stress or overuse of the muscles and tendons in the groin and lower abdominal area. Common causes include sudden acceleration or deceleration, excessive twisting or turning motions, and poor biomechanics. Symptoms of athletic pubalgia may include:


1. Groin pain, particularly with activities such as running, jumping, or kicking.

2. Pain or tenderness in the lower abdomen or pelvic region.

3. Difficulty with activities that require core stability, such as squatting or lifting.

4. Pain that worsens with coughing, sneezing, or straining.


Typical Populations Affected:


While athletic pubalgia is most commonly seen in athletes, particularly those involved in high-impact or contact sports, it can also occur in individuals who engage in repetitive activities that place strain on the pelvic and abdominal muscles. This includes activities such as dancing, martial arts, and manual labor.


Physical Therapy as Treatment:


Physical therapy plays a crucial role in the treatment and management of athletic pubalgia. A skilled therapist can assess the underlying biomechanical issues contributing to the condition and develop a comprehensive treatment plan to address them. Typical treatments may include:


1. Manual Therapy: Hands-on techniques such as soft tissue mobilization, joint mobilization, and myofascial release to alleviate muscle tightness and improve mobility.


2. Strengthening Exercises: Targeted exercises to strengthen the muscles of the core, hips, and pelvis to improve stability and support.


3. Neuromuscular Retraining: Techniques to improve movement patterns and biomechanics to reduce strain on the affected muscles and prevent recurrence.


4. Activity Modification: Guidance on modifying activities or sports-specific movements to avoid exacerbating symptoms and promote healing.


5. Return to Sport Training: Gradual progression of activity and sport-specific training to safely return to full participation.


Athletic pubalgia can be a frustrating and debilitating condition, but with the right treatment and management strategies, individuals can find relief and return to their active lifestyles. If you're experiencing symptoms of athletic pubalgia, don't hesitate to seek guidance from a qualified physical therapist. Together, you can develop a personalized treatment plan to address the underlying issues and get back to doing what you love.


References:

- Emery, C. A., Meeuwisse, W. H., & Powell, J. W. (2005). Groin and abdominal strain injuries in the National Hockey League. Clinical Journal of Sport Medicine, 15(2), 103–106. https://doi.org/10.1097/01.jsm.0000158243.71323.7f

- Hölmich, P., Uhrskou, P., Ulnits, L., Kanstrup, I. L., Nielsen, M. B., Bjerg, A. M., & Krogsgaard, K. (1999). Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: Randomised trial. Lancet, 353(9151), 439–443. https://doi.org/10.1016/s0140-6736(98)03340-6

- Tyler, T. F., Nicholas, S. J., Campbell, R. J., & McHugh, M. P. (2001). The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. The American Journal of Sports Medicine, 29(2), 124–128. https://doi.org/10.1177/03635465010290020201

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