Athletic pubalgia - Definition and surgical treatment
ABSTRACT Athletic pubalgia, or "sports hernia," affects people actively engaged in sports. Previously described in high-performance athletes, it can occur in recreational athletes. It presents with inguinal pain exacerbated with physical activity. Examination reveals absence of a hernia with pubic point tenderness accentuated by resisted adduction of the hip. Diagnosis is by history and physical findings. Treatment with an internal oblique flap reinforced with mesh alleviates symptoms.
A retrospective review from December 1998 to November 2004 for patients with athletic pubalgia who underwent operative repair was performed. Descriptive variables included age, gender, laterality, sport, time to presentation, outcome, anatomy, and length of follow-up.
Twelve patients, 1 female, with median age 25 years were evaluated. Activities included running (33%), basketball (25%), soccer (17%), football (17%), and baseball (8%). The majority were recreational athletes (50%). Median time to presentation was 9 months, with a median 4 months of follow-up. The most common intraoperative findings were nonspecific attenuation of the inguinal floor and cord lipomas. All underwent open inguinal repair, with 9 being reinforced with mesh. Four had adductor tenotomy. Results were 83.3% excellent and 16.7% satisfactory. All returned to sports.
Diagnosis of athletic pubalgia can be elusive, but is established by history and physical examination. It can be found in recreational athletes. An open approach using mesh relieves the pain and restores activity.
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ABSTRACT: Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology.
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ABSTRACT: Although athletic injuries at the hip occur less commonly than injuries in the extremities, groin pain is an insidious condition in athletes with significant morbidity, which leads to time away from training and competition, and may result in a career ending event. The anatomy and biomechanics of hip and pelvis are among the most complex and controversial in the musculoskeletal system. Groin pain may result from an acute or chronic repetitive trauma and also from systemic diseases. The differential diagnosis of hip pain is broad and includes bone injuries, intra- and extra-articular pathologies, neuropathies and also visceral diseases. All these make an accurate diagnosis and well-organized treatment plan critical. The different available imaging modalities are effective useful when selected on the basis of a through history and physical examination, thus facilitating the treatment. This article briefly summarizes the different hip and groin conditions affecting athletic patients and highlights specifically bone injuries that determines anterior pelvic painMedicina dello sport; rivista di fisiopatologia dello sport 03/2014; 67(1):1-26. · 0.13 Impact Factor