Pubalgia is a painful condition around the pubic bone (the front part of the pelvis) typically resulting from overuse, strain, or repetitive microtrauma of the groin and abdominal muscles. It is common in athletes, especially those involved in sports with rapid directional changes, kicking, or sprinting, such as soccer, hockey, or basketball, but it can affect non-athletes as well when there are underlying biomechanical or postural factors. The term is often used to describe pain in the pubic region that involves structures such as the rectus abdominis tendon, adductor muscles, and nearby supporting ligaments. Key points about pubalgia (what it is, symptoms, causes, and typical approach to care):
- What it is
- Pubalgia refers to pain in the groin/pubic area associated with stress or strain on the muscles and tendons around the pubic bone. It can involve the tendons of the adductors, the rectus abdominis, or related structures. Note that “pubalgia” is a broad, non-specific term and many other conditions can cause pubic-area pain, such as hip joint issues or inguinal hernias.
- Symptoms
- Dull or sharp pain localized to the pubic/groin region, often aggravated by running, cutting, kicking, changing direction, or curling movements.
- Pain may radiate toward the lower abdomen or inner thigh.
- Stiffness or weakness in the groin area, particularly during sport activities.
- Causes and risk factors
- Repetitive overuse and microtrauma from sports with rapid sprinting, twisting, and kicking.
- Biomechanical issues such as poor posture, core weakness, or problems with hip mechanics.
- Acute groin or pelvic injuries, prior lower abdominal surgeries, or changes in training load without adequate recovery.
- Other conditions can mimic pubalgia, including hip osteoarthritis, abdominal or inguinal pathology, or hernias.
- Diagnosis
- Evaluation typically includes a thorough history and physical exam focusing on the groin, abdomen, and hip; sometimes imaging (ultrasound, MRI) is used to assess tendons, muscles, and the pubic symphysis and to rule out other causes. Because groin pain has a broad differential, accurate diagnosis often requires expert clinical assessment.
- Treatment and management
- Initial management usually involves rest or modification of activity to reduce aggravating movements, combined with targeted rehabilitation focusing on gradual strengthening of the core and groin muscles, hip stability, and flexibility.
- Physical therapy often emphasizes gradual load progression, eccentric strengthening of adductors, and functional sport-specific drills.
- Pain management may include nonsteroidal anti-inflammatory drugs (NSAIDs) for short periods, but these do not address underlying problems.
- In cases where conservative therapy fails or when there is an identifiable hernia or other structural issue, surgical options may be considered to address the specific pathology (e.g., repair of tendon injuries or rib/osteitis-related problems, depending on the exact diagnosis).
- Return-to-sport decisions are individualized and typically guided by symptom resolution and progressive functional testing.
- Important caveats
- Because pubalgia is a symptom complex with a broad differential, proper diagnosis is essential before committing to a treatment plan. Other conditions (hip joint problems, abdominal wall issues, hernias) may require different management. If pain is persistent, worsening, or associated with systemic symptoms, seek medical evaluation promptly.
If you’d like, I can tailor this to a specific sport or provide a simple step- by-step rehab outline, including example exercises and progression criteria.
