Concept and Risk Factors of DOP or Pubalgia
In the following article, we’ll analyze a subject as interesting as it’s complex, and on which much remains to be investigated. The purpose is to show the relevant information found in the scientific literature about one of the injuries that occur within the scope of physical activity and high-performance sport: pubalgia.
The main objective of this article is to clarify and unify basic criteria that help athletes and physical trainers to know what dynamic osteopathy of the pubis—DOP—is as an injury. Also to understand its most important risk factors.
What is DOP or Pubalgia?
In order to understand DOP, pubalgia, or groin pain, we must know the anatomical structures involved in this pathology, in addition to the parts that make up the pelvic region.
The pelvic girdle is the lower anatomical region of the torso; it’s the base that supports the spine and transfers the weight of the body to the lower limbs. This structure supports and offers protection to the noble elements of the abdominal and pelvic cavity. Also, it’s the insertion point for the muscles that mobilize the lower limbs and torso.
It’s made up of the coxal bones that, when united in the anterior part, form the symphysis of the pubis; from the back, they articulate with the sacrum. Located in the pelvis where the abdominal muscles and the muscles that form the thigh region begin. These are the main culprits for such an injury to occur.
What do we understand by DOP or pubalgia?
Pubalgia is a pain in the inguinal and pubic areas that can radiate to both the adductor regions and the lower abdominal area. For many specialists, this injury should be seen as a consequence of the functional instability of the pelvis.
Therefore, we understand DOP as an injury to the insertion of the abdominal rectum in the pubic symphysis. It’s characterized by distension in the adductor muscles and in the abdominal rectum.
In addition, it’s defined as an inflammatory and painful condition of the pubic symphysis and the surrounding muscular fascia. It’s usually due to repetitive trauma or excessive stress on the fascia itself and the osteoligamentous junction.
Why does DOP occur?
DOP occurs due to the weakness of the posterior inguinal wall added to the antagonistic and constant action of the abdominal muscle group that’s inserted in the pubis and the adductor muscle group that originated in this same area.
This imbalance between the adductor and abdominal muscles generates pelvic instability. Also, it causes a shearing and friction effect of the pubic symphysis.
Risk factors for pubalgia
In order to develop preventive programs, it’s essential to know and identify the risk factors related to the appearance of pubalgia. These can be classified into two categories:
Intrinsic or personal factors
This has to do with the biological and psychosocial characteristics that predispose the subject to injury, such as:
- Muscular imbalances: abductors, abdominals, or retroversors.
- Postural changes: pelvic hyperanteversion, sacral horizontalization, dorsal kyphosis, lumbar lordosis, or lower limb asymmetries.
- History of previous injury: articular, sacral-iliac, coxo-femoral, dorso-lumbar, or lumbo-sacral alterations.
Extrinsic or environmental factors
These factors refer to the external circumstances of the subject that influence the appearance of the injury. The most common are:
- The practiced sport.
- Insufficient physical preparation or, on the contrary, a very intense one.
- Flattering material.
- Nutrition and hydration.
- Insufficient or incomplete recovery.
- Inadequate or insufficient prior treatment.
- Environmental conditions. Climate, temperature, humidity.
With the evaluation of these factors, a specialist can design a preventive program for a person with a certain predisposition to suffer form pubalgia. In this way, one can avoid unnecessary pain as well as lengthy suspensions from sports participation.
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Santilli, O. L., Nardelli, N., Santilli, H. A., & Tripoloni, D. E. (2015). Sports hernias: experience in a sports medicine center.
- Garvey, J. F. W., & Hazard, H. (2014). Sports hernia or groin disruption injury? Chronic athletic groin pain: a retrospective study of 100 patients with long-term follow-up. Hernia.
- Castro G, Rojas E, Serrato M. (2009). Osteopatía Dinàmica del Pubis, Un reto para el medico del deporte.
- Caudill, P., Nyland, J., Smith, C., Yerasimides, J., & Lach, J. (2008). Sports hernias: a systematic literature review. British Journal of Sports Medicine.
- Mandelbaum, B. y Mora, E. (2005). Osteitis pubis. Oper Tech Sport Med.
