Updated: 10/6/2016

Athletic Pubalgia & Adductor strain

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https://upload.orthobullets.com/topic/3092/images/sports hernia.jpg
Introduction
Presentation
  • Symptoms
    • lower abdominal pain and inguinal pain at extremes of exertion
  • Physical exam
    • inspection
      • tenderness to adductor longus
    • provocative tests
      • pain with valsalva and situps
Imaging
  • Obtain radiographs, MRI, and bone scan to rule out other cause of symptoms
Differential
  • Must be differentiated from subtle true inguinal hernia
Treatment
  • Nonoperative
    • rest and physical therapy for 6-8 weeks
      • indications
        •  first line of treatment
  • Operative
    • pelvic floor repair (hernia operation) vs. adductor / rectus recession
      • indications
        • after extensive nonoperative treatment fails
    • decompression of the genital branch of the genitofemoral nerve
      • indications
        • after extensive nonoperative treatment fails
 

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Questions (2)
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(OBQ05.19) Sports that rely heavily on which of the following movements are felt to contribute to the overuse syndrome known as athletic pubalgia? Tested Concept

QID: 56
1

Hip extension and abduction

51%

(961/1896)

2

Hip extension and adduction

12%

(224/1896)

3

Hip flexion and abduction

12%

(232/1896)

4

Hip flexion and adduction

23%

(440/1896)

5

Lumbar hyperextension

2%

(33/1896)

L 4 D

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