Pubalgia: hernia of the athlete or groin pain

Pubalgia

Pubalgia - also known as athletic pubalgia or herniation of the athlete, or, more commonly, groin - pain is a lesion of the inguino-pubic region that usually arise when performing sports activities on a daily basis. The pain is usually a symptom of a dynamic osteopathy of pubis or a pubic enthesitis, and radiates to areas close to the groin or lower abdomen.
There are three types of pubalgia depending where the injury is located

• Pubalgia signup: Occurs when the previous rectus muscles of the abdomen is swollen and cause pain because of a problem in the abdominal muscles.
• Low Pubalgia: Damage is located at level of muscles adductors of which there are three types: major, medium and minor. This lesion is usually affect medium adductor.
• Mixed Pubalgia: Occurs when both muscle groups are connected.

An example of athletes who suffer this injury so common and annoying are footballers, since generally they suffer a great workload regularly in this area and do not have the time necessary for a correct recovery due to the large number of parties that play weekly.

Causes of pubalgia

Among the causes that give rise to a pubalgia are overexertion in the abdomen and adductor or beating the ball when centers or door shooting, these gestures can cause an imbalance between these muscles or overload in them resulting in pubalgia.
And, as mentioned above, the dispute of a too high number of matches or training without the needed rest may involve an injury of this type. Also, change frequent playing surfaces (move from soft to hard or vice versa) or a bad physical preparation can cause this problem.
Finally, a sharp fall on the feet (such as making a leap to be unbalanced in the air) or the realization of defective or forced technical gestures could eventually lead to a pubalgia.

Symptoms of pubalgia

It's a picture characterized by pain in the symphysis, inguinal region and lower part of the abdomen. As days pass and the injury evolves, pain tends to be sharper, being located in the inclusion of adductor and radiates to the muscle on the same side or even the testis in males.
Pubalgia may become a permanent pain that affects daily life, preventing routine movements as simple as crossing your legs, sit, walk or stand.
There are four degrees in the evolution of a pubalgia:

• At first the pain appears after perform a workout, do intense physical workouts, sports or play a game.
• In a second phase of the injury, the pain manifests itself during training or the party itself.
• In the penultimate stage, we see how pain arises just start a sports activity and prevents their implementation.
• The last stage shows pain even at rest.

Treatment of a pubalgia

The best thing to combat a pubalgia is rest, although this can be complemented with physiotherapy and osteopathy if we need to shorten the time of the injury. Different drugs may also be prescribed to provide momentary relief for the pain in the legs.
Most specialists also recommend the incorporation of special warm-up routines aimed at improving the irrigation of the affected areas and avoid the potential problem of chronic pubalgia, which usually occurs quite frequently in retired football players.
Thus, it is important to make some practices:

• Isometric work adductors, abductors, straight anterior abdomen and oblique.
• Elongation by eccentric positions of hamstrings, adductors, abdominal and psoas.
• Use techniques of electrotherapy (magnetotherapy, laser...).
• Massage therapy (a technique integrated into the physical therapy that employs different types of therapeutic massage) in adductor and abdominal.
• Deep transverse massage or Cyriax in adductor and abdominal: this technique is applied by means of a digital transverse friction caused by mobilization at a frequency determined in order to produce an analgesic effect and the reorganization of collagen fibers.
• Apply cold after a session of physiotherapy.

At the time in which to achieve an improvement of the lesion, it is recommended to begin a program of rehabilitation exercises in the area. In this way and in a gradual manner, you can restart sport practice, that Yes, avoiding as far as possible and always the sudden changes of direction.
If this lesion to become chronic and only in the case that the conservative treatment fails, arises the surgical option in the context of sports medicine. With intervention, specialists will match the forces of the rectum anterior of the abdomen and the adductors to relieve excess pressure exerted on pubic these muscles.

Prevention of pubalgia

Of course, as in any other type of injury, the aim is to prevent them with a good warm-up and avoiding those movements or poorly executed gestures that can lead to injury. Although this is not always easy to get.
To prevent pubalgia we must pay attention to a series of exercises such as:

• Strengthen stabilizer muscles of the hip.
• Dosage of workloads. When notice discomfort, if possible try to rest.
• Use of isometric work in adductors, abductors, oblique and upright in the abdomen.
• Work of muscle potentiation of abductors, adductors and abdominal.

Article contributed for educational purposes