“Pubalgia” or groin pain
What is pubalgia?
Groin pain, commonly called “pubalgia”, corresponds to a lesional etiology where the patient suffers from pain in the groin or pubic area. Its causes are very diverse, so it is imperative to perform a comprehensive diagnosis looking for the factors that may be causing the injury.
Why can groin pain occur?
According to the expert consensus conducted in Doha in 2014, the most common causes in athletes are three:
- Groin pain related to adductor musculature, iliopsoas, inguinal canal and tendinopathies of the pubis.
- Hip-related pain.
- Another very wide range of causes may include orthopedic, neurological, rheumatological, urological, gastrointestinal, dermatological, oncological, etc. problems.
Therefore, due to the complexity and multiple factors of the injury, it is vital to make a broad anamnesis where other pathologies that may require different intervention can be ruled out.
Focusing on the more purely mechanical aspect, from my point of view and without falling into simplistic correlations, one of the possible causes of this injury is a decompensation or maladaptation of the entire pelvic girdle, including the gluteal musculature, abdominal, diaphragm, pelvic floor and of course adductor. In addition, whenever there is pain, neuromotor coordination is altered, so it is necessary to “reprogram” the muscles through therapeutic exercise.
How to treat pubalgia?
For all these reasons and due to the idiosyncrasy of the injury itself, its approach must be multimodal and multifactorial, being able to integrate the different therapies found in the clinic. The key is to integrate the benefits offered by manual therapy with invasive techniques, to allow the patient a correct progression to physical activity through therapeutic exercise.
Among the techniques available:
- Invasive physiotherapy: management with neuromodulation will allow us to regulate pain by treating the nerves that may be “altering” the signal to these muscles (especially the iliohypogastric, ilioinguinal, obturator and femoral nerves). In addition, in cases with tendon involvement or muscle ruptures, EPI (percutaneous intratissue electrolysis) offers a plus to improve the quality of the injured tissue through the application of a galvanic current.
- Osteopathy and manual therapy: will allow us to know the compensations and osteoarticular imbalances that are occurring in the patient’s body in order to normalize the different tensions that may be reaching the groin area.
- Therapeutic exercise: an indispensable basis for optimal recovery as well as avoiding injuries. In the clinic we use the REDCORD technology or pilates machine to adapt and supervise the exercises to the patient.