Athletic Pubalgia: Causes, Symptoms and Treatment

06 October, 2020
Pubalgia isn't just a simple injury, but rather a syndrome with different symptoms, generally characterized by pain in the groin area. Here we'll tell you how it can originate, what the symptoms are and how it can be treated.

Defining athletic pubalgia can be a little difficult because it doesn’t just have one name or diagnosis. For some, it’s just groin pain. But other specialists consider that there are specific causes and characteristics of the problem, such as in certain sports, for example.

Speaking of specifics, we can say that it’s a medical condition that includes different kinds of pain, all originating from the pubic joint, or the joint where the pelvis bones come into contact. Upwards of this joint, the limits are the straight muscles of the abdomen, and below it, it can reach down to the adductor muscles in the hips and thighs.

Causes of athletic pubalgia

Athletic pubalgia has gained a lot of attention in sports recently because it keeps coming up on the news. In general, soccer players are those who most commonly suffer from it. This can be due to excessive training, or extreme physical effort in a game.

In any case, apart from the more direct causes, we’ll look at below, some people are more prone to suffering from pubalgia than others. This can be due to their anatomical makeup, related diseases, or poor training techniques. These are some of the risk factors of athletic pubalgia. Another can be using footwear that isn’t right for you or for your sport.

Now, here are some of the most direct causes of athletic pubalgia. The following are the most important:

  • Repetitive traumas: these are small injuries that accumulate in the pubic joint over time. These accumulate when the athlete makes the same movements all the time with the same amount of force.
  • Adductor sprains: the thigh muscles are injured relatively frequently in sports that especially involve the legs. These injuries can become chronic and lead to pubalgia.
  • Overuse: this includes training sessions that go over the top and games that the athlete plays while injured. Playing for a prolonged time in a game due to a lack of replacements can also contribute. In these situations, the pubic area is overused beyond the natural limits and is injured.
An athlete being treated on the field for hip pain

Symptoms and signs

The best-known symptom of athletic pubalgia is groin pain. The word itself means ‘pain in the groin’. As we mentioned above, this pain isn’t necessarily limited to the front of the pelvis area. Rather, it can reach to higher up, and right down to the thigh muscles.

The pain may appear immediately as inflammation in the area, or it may be sporadic, going several days without pain. It doesn’t always appear exactly in the groin, but can reach upwards and downwards. One common characteristic is that the athlete usually has to stop playing immediately.

When a doctor checks out the athlete’s injury, the pain can intensify as they press on the spot. If the thigh muscles are inflamed, it’ll hurt more to move the legs. If the sore spot is more in the abdomen area, changing their position between sitting and standing will increase the pain.

There is only one sure way of making an accurate diagnosis without errors. As detailed in the Argentinean Magazine of Radiology, the current trend is to request numerous scans to rule out other injuries. However, the scans will usually show a diagnosis of pubalgia without other complications.

An MRI of the pubic joint, for instance, can indicate if the joint itself is inflamed, or where the exact problem is.

Different scans are often requested to determine the extent of the injury

Treatment for athletic pubalgia

Once a medic has diagnosed pubalgia, they’ll proceed to form a plan for its treatment. There are basically four options available: medication, physiotherapy, infiltration, and surgery. Let’s take a closer look at each one:

  • Anti-inflammatory medication: if the pain isn’t severe, pubalgia can be treated with a combination of rest and basic analgesic medication. Non-steroid anti-inflammatories are a good option since they’re generally less risky than other medication. These medications can also be used for longer time periods than cortisols.
  • Physiotherapy: there are many and varied options for treatment using kinesiology techniques. The medic and the physiotherapist should decide on the best option for the patient. They’ll adapt the sessions to the patient’s athletic needs since it’s quite different returning to one sport or to another.
  • Infiltration: this means applying a special medication directly into the affected joint or tissue. An anti-inflammatory is almost always injected into the spot to relieve the pain. With athletic pubalgia treatments, injections of TGF-B (an anti-inflammatory protein) are in use, which activates and accelerates the healing process.
  • Surgery: this option will depend on each different injury. A hernia is treated in one way with a procedure called laparoscopy. If the ligaments are damaged or if the nerves that send the pain signals are injured, the procedures will be different.

Knowing about athletic pubalgia can help you treat it sooner

Medical knowledge about the causes and treatments for pubalgia is constantly improving. Sports medicine has made great leaps in identifying and classifying different injuries. This means that more types of injuries are receiving their own names and specific treatments by qualified therapists.

If you’re an athlete with pain in your groin, consult a medic as soon as possible. Early diagnosis and help to control the pain will save you time down the track so you can get back to training sooner. Your medic can also develop a strategy to quickly identify the underlying cause of the pain and therefore reduce the negative consequences.

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