Houston Methodist. Leading Medicine

Hip FAQ

Question:

I'm not recovering from a groin injury like I expected. My soccer coach sent me to a sports medicine physician who thinks I might have something called athletic pubalgia. The next step is some other tests like MRIs and maybe a bone scan to find out for sure. If they do find that I have this pubalgia business, what does that mean for me getting back into the game?

Answer:

Athletic pubalgia is a common cause of groin pain in athletes. Soccer and hockey players seem to be at greatest risk but any athlete can be affected. Males are affected most often. It's a rare injury in women. This condition involves injury to the abdominal muscles, especially the rectus abdominis where it attaches to the pubic bone. In many cases, the adductor longus muscle is also injured. When contracting, the adductor muscles move the leg toward the body. This muscle also attaches to the pelvis so any injury of the adductors can cause groin pain and pelvic instability. The connective tissue over the affected abdominal muscles called the fascia can weaken and tear. This leads to an inguinal hernia as part of the problem. With an inguinal hernia, a portion of the bowel slips through the tear and can get pinched or compressed. Hernias of this type can be serious problems. Surgery is usually required for hernias or other causes of athletic pubalgia. Conservative (nonoperative) care can be tried first, but symptoms often persist when abdominal wall weakness or tears are present. The diagnostic imaging studies that are planned for you will help determine the exact cause, location, and severity of your problem. Treatment is the next step but the exact plan of care won't be clear until all the test results are in. Timothy F. Tyler, MS, PT, ATC, et al. Groin Injuries in Sports Medicine. In Sports Health. May/June 2010. Vol. 2. No. 3. Pp. 231-236.

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