summary Athletic Pubalgia is a clinical entity characterized by anterior pelvic/groin pain, commonly referred to as "sports hernia," thought to occur as a result of an adductor muscle strain due to direct trauma or overuse microtrauma. Diagnosis is made clinically by tenderness over the adductor longus and groin pain that worsens with sitting up or valsalva maneuvers. Treatment is nonoperative with rest and physical therapy. Epidemiology Demographics males > females common in hockey players and soccer players Anatomic location muscles of abdominal wall or adductor longus Etiology Pathophysiology mechanism of injury may be caused by acute trauma or microtrauma caused by overuse thought to be caused by abdominal hyperextension and thigh abduction specific injury to the common aponeurosis between the rectus abdominis and adductor longus is thought to be source of pain 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
QUESTIONS 1 of 2 1 2 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ05.19) Sports that rely heavily on which of the following movements are felt to contribute to the overuse syndrome known as athletic pubalgia? QID: 56 Type & Select Correct Answer 1 Hip extension and abduction 50% (1149/2287) 2 Hip extension and adduction 12% (264/2287) 3 Hip flexion and abduction 13% (288/2287) 4 Hip flexion and adduction 23% (531/2287) 5 Lumbar hyperextension 2% (45/2287) L 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic
All Videos (4) Podcasts (1) 2018 Baseball Sports Medicine: Game-Changing Concepts Surgical Treatment of Athletic Pubalgia - Mark Zoland, MD (BSM 2018, #41) Knee & Sports - Athletic Pubalgia & Adductor strain A 12/21/2018 2597 views 4.8 (5) Login to View Community Videos Login to View Community Videos 2017 Chicago Sports Medicine Symposium: World Series of Surgery Physical Therapy for Pelvic/ Sacrum/ Lumbar Dysfunction - Catherine Stegemann, PT (CSMS #95, 2017) Catherine Stegemann Knee & Sports - Athletic Pubalgia & Adductor strain E 11/17/2017 308 views 5.0 (1) Login to View Community Videos Login to View Community Videos 2017 Chicago Sports Medicine Symposium: World Series of Surgery Pelvic and Sacral Dysfunction - Josh Harris, MD (CSMS #94, 2017) Joshua Harris Knee & Sports - Athletic Pubalgia & Adductor strain B 11/17/2017 292 views 3.8 (4) Knee & Sports | Athletic Pubalgia & Adductor strain Knee & Sports - Athletic Pubalgia & Adductor strain Listen Now 6:1 min 6/24/2022 112 plays 3.0 (2) See More See Less