HomeBlogProper diagnosis and management of athletic pubalgia
Proper diagnosis and management of athletic pubalgia
August 14, 2023
Each year, between 10 and 13 percent of reported sports-related injuries involve groin pain. Some of these people will be diagnosed with athletic pubalgia, which is also known as a sports hernia. These are injuries that may happen to continue participating in his or her chosen sport.
Other conditions that cause groin pain
When a patient reports groin pain, doctors should first check for other conditions that can cause the pain. There are a number of differential diagnoses, including:
Strained or pulled muscles
Muscle bruises
A ruptured tendon
Bursitis
Pubic instability
Referred pain from the lumbar spine or sacroiliac joint
There are several other possible causes of pain in the groin. The differential diagnoses should be eliminated as causing the pain first.
Diagnosis of athletic pubalgia
People who are suffering from athletic pubalgia often report pain in their groins and lower abdomens that may radiate down to play despite the pain.
When a sports hernia is suspected, a docto confirm the diagnosis.
Management of sports hernias
Sports hernias will generally need to finish out the season.
After surgery, rehabilitation will involve several things. Athletes will be able to their sports at about six weeks after their surgeries.
Groin pain is a fairly common type of injury experienced by people who play certain sports. When a sports hernia is suspected, it is important that it is properly diagnosed and treated so that it doesn’t prevent the person from being able to his or her sport.
About the Author
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating the full thickness tear and already occurring muscle atrophy due to misdiagnosis and not referring the patient to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed to be a complete tear with muscle contraction under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris with large hematoma (blood)
Separation of muscle ends due to tear elicited on dynamic sonography examination
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