Pubalgia: what it is and what symptoms it manifests itself with

By Cristiano Antonino Last updated Jun 16, 2023

In medicine, the term pubalgia refers to a painful syndrome of the pelvic girdle, which falls under ‘overload pathologies’, i.e. all those pathologies caused as a result of repeated overloading of a certain body district

It is a muscular pain – more or less intense depending on the degree of severity of the injury – that affects the muscles of the lower and frontal area of the abdomen, the pubic area and the inner thigh.

Generally, pubalgia, whatever its nature, manifests itself with pain – more or less intense – in the hip, groin, joints and lower abdominal muscles.

Pubalgia: what causes it and who suffers from it

Pubalgia affects, in particular, sportsmen and women who, as they carry out continuous, high-intensity activities, are prone to intense and continuous use of the lower limbs.

The sports most at risk for the development of this pathology are football, tennis, fencing, handball, dancing, horse riding and all sports with a comparable muscular effort.

This pathology also affects another category, different from the first: pregnant women.

During the gestation period, especially during the last few months, it is not uncommon to develop this fatigue syndrome as the foetus, now of considerable size and weight, overloads the muscles of the lower abdomen.

Different forms of pubalgia

The aetiology of pubalgia is very varied.

Nevertheless, it is possible to group the causes of pubalgia into three macro-categories.

Insertional Tendinopathy

Insertional tendinopathy or rectus adductor syndrome – the most common form of pubalgia – occurs due to repeated microtrauma to the thigh adductor and abdominal muscles.

The critical point at which the subject will experience a greater sensation of pain is, in this case, the pubic sphincis.

Symphyseal syndrome

Symphyseal syndrome refers to the partial failure of the sphincis pubis, a fibro-cartilaginous joint that is located in the centre of the pelvis and which, due to its elasticity, allows the foetus to pass freely during the final stage of delivery.

When this is subjected to excessive pressure during gestation, it can be subject to relaxation, which can cause pain, especially during walking.

Rectus femoris sheath syndrome

The term ‘rectus femoris sheath syndrome’ or ‘rectus abdominis perforating nerve syndrome in football players’ refers to an abnormal elongation of the perforating nerve sheath, which can become inflamed, giving rise to painful symptoms.

Pubalgia: how to treat inflammation

Whatever the cause of this overload condition, the patient diagnosed with pubalgia must necessarily take a period of rest in order to prevent the inflammation from becoming chronic.

Only then can he or she undergo medical treatment with anti-inflammatory or corticosteroids, accompanied – if necessary – by physiotherapy with targeted stretching, lengthening, pelvic rebalancing and proprioception exercises.

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