The Athletic Hip Series-Athletic Pubalgia
By: Maggie Gebhardt PT, DPT, OCS
Adjunct Clinical Professor- Mercer University, Division of Physical Therapy
Athletic Pubalgia is more commonly known as a Sports Hernia. People with a Sports Hernia will initially complain of groin pain that spreads to the inner thigh as the condition progresses. With the possible involvement of the genitor-femoral nerve, it can also present with numbness or other nerve-related symptoms in the thigh, the scrotum in males, and the pubis in females. Most often the pain is aggravated by extreme and repetitive twisting, turning, or extending the affected hip and primarily affects football, hockey, tennis and soccer players.
This diagnosis can be a frustrating one for the patient and clinician alike due to the fact that it is a tear in the lower abdominal (most commonly oblique muscle’s) fascial connection and therefore does not present with a palpable bulge. Oftentimes patients are told they have a groin strain and that it should heal with rest and anti-inflammatories. This course usually helps temporarily, but a true hernia will re-aggravate with resumption of activity. Once diagnosed, the condition can be treated conservatively with therapy or surgically. It is not until recently the surgery was considered a viable option by the English Hernia Society and that a better diagnosis would be to label the condition as an “Inguinal Disruption.”
Therapy focuses on equalizing the forces between the abdomen, hips, and pelvis to minimize stress across the affected area and facilitate the healing process. Usually it is a longer recovery process and can be frustrating for the athlete with a small timeframe to return to sport. The ultimate goal is to correct the lumbo-pelvic and lower extremity mechanics to return the patient to their sport of choice without risk of further injury or re-aggravation. As always, it is important for the medical team to work collaboratively so that there is optimal return to sport with minimal lost time or dysfunction.
A PT with good discernment for hip pathology should be able to point you in the right direction and set you on the path to recovery!
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