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Review Question - QID 56

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QID 56 (Type "56" in App Search)
Sports that rely heavily on which of the following movements are felt to contribute to the overuse syndrome known as athletic pubalgia?

Hip extension and abduction

51%

1321/2602

Hip extension and adduction

11%

298/2602

Hip flexion and abduction

12%

320/2602

Hip flexion and adduction

23%

604/2602

Lumbar hyperextension

2%

48/2602

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Athletica pubalgia (sports hernia) is theorized to be an overuse syndrome typically seen in high level athletes. It is theorized that emphasis on lower extremity strengthening (especially adductors) with minimal emphasis on rectus strengthening leads to muscle imbalance. Extension-abduction of the leg with eccentric contraction of the adductors leads to high shear stress on the rectus and may lead to tears of the transversalis fascia, rectus muscle, and/ or adductor magnus origin. While these may be detected on MRI, the diagnosis remains largely clinical. Non-operative treatment is attempted for 6-8 weeks, prior to considering surgery. Hernia repairs with mesh, rectus abdominus reattachment, and adductor release are all possible surgeries for this problem depending on the specific site of injury.

Taylor et al found inguinal hernias and microscopic tears or avulsions of the internal oblique muscle seen at surgery in athletes with groin pain.

Farber describes sports hernia as groin pain in the athlete without imaging abnormalities and tends to not improve without hernia-type surgery.

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