Pubalgia and Groin Pain in Athletes

Groin pain (pubalgia) is a vague term that has been used to describe a constellation of symptoms in a broad anatomical region, including the lower abdominal wall and hip adductor musculature. Recent medical literature utilizes the term “core muscle injury” (CMI) to characterize a patient’s symptomatology. CMI is a chronic overuse injury seen in athletes involved in sudden changes in direction, kicking, and core torsion. Higher-risk individuals typically note weaker posterior abdominal/hip adductor musculature or a high level of athletic competition. There are a variety of physical exam maneuvers, in addition to real-time sonography, that can aid in the diagnosis. Conservative measures involve rest, anti-inflammatory medications, physical therapy, and percutaneous procedures. These should be pursued in all patients prior to surgical intervention. Return to play can take weeks to months depending on which anatomic structures are involved and where the individual is within the spectrum of CMI.