The pubalgia is a pain of the inguino-pubic area (groin and pubis) which takes various forms. To distinguish them is essential to treat them well.
It is mainly in the sports environment that we meet the most people suffering from pubalgia. Footballers are the most exposed, but this pain exists in other sports, such as rugby, athletics or tennis. Men are also the most affected, but the prevalence of pubalgia is increasing among women.
What is the Pubalgia ?
mainly due to overwork, it is an inflammation of the practically immobile joint in front of the pelvis, the pubic symphysis. It manifests as pain in the lower abdomen, groin and pubic area, united or bilateral. The irradiation of these pains is done to the abdominal muscles, the perineum, or the testicles.
If its appearance can be brutal, it is generally progressive with at the beginning a simple discomfort. The pain occurs during forced physical exercises, such as a quick start, a change of support or a violent strike during a soccer shot.
At first, the pubalgia goes "hot" then returns "cold". But in the absence of treatment, it becomes more and more frequent, even almost permanent and above all more painful. It can be accentuated by coughing, weight lifting efforts or sudden movements when the patient leans over the bust.
The three forms of pubalgia :
Adductor pubalgia: the tendon form It is the most common form of pubalgia.
It begins after a movement of the thigh apart while the muscle is contracted and the heating has not been sufficient. In 7 out of 10 cases, footballers are affected. The pain can appear at the level of the insertion of the tendon on the bone, one speaks about insertion tendinitis, of the tendon itself, it is true tendinitis, or of the tendon-muscle junction, it is then a musculo-tendon tear.
Parietal pubalgia: the musculo-tendinous form
This form of pubalgia is due to a weakness of the abdominal wall in the groin. The imbalance that exists between the abdominals, which are too weak, and the adductors, which are too powerful, then causes shear in the pubis, at the crossroads between these two muscles.
The pain can be localized in the middle of the pubis, it is then a tendinitis of insertion of the rectus (abdominal muscles), or in the groin, from where it can radiate towards the abdominals or towards the perineum and testicles.
Pubic arthropathy: joint shape
It is the third form of pubalgia. At the beginning, the pain is located in the groin but lower abdominal pain coexists. They appear gradually during a sporting activity, during changes of direction, acceleration, jumps and especially more and more precociously during the effort. It reveals a sharp pain on palpation of the pubic symphysis.
The diagnosis of pubalgia:
The pubalgia is often easy to diagnose since the sportsman complains of a progressive pain occurring after the practice of the sports activity and localized in the lower abdomen, the pubis, or even the adductors.
The diagnosis is based on the patient's interrogation, in particular on his sporting practice, a change in the type of terrain, unsuitable shoes for example, and on a clinical examination which aims to locate the painful area. In general, the doctor looks for possible imbalances in the pelvis, the existence of one leg shorter than the other, too much lumbar arch or even too stiff and over-trained muscles, all risk factors for pubalgia .
It can use imagery, in particular MRI in cases of suspected pubic arthropathy and adductor tendinopathy, ultrasound to confirm parietal pubalgia or radiography of the pelvis from the front, standing, feet naked and resting on one foot. Regarding the differential diagnosis, it can be hip pathology, fatigue fracture, intervertebral disturbance or even chronic inflammatory rheumatic pathologies, neurological pathologies, or acute inflammatory pathologies.
How to prevent pubalgia ?
2 times a year go to a kinesiologist physiotherapist to realign the postures (pelvis positions elasticity of the joints…)
Attention, only force the obliques and the lumbar area and especially not to strengthen the right of the abdominals which is already to tense and painful
The 8 daily stretches to perform
Wear the bsb
During the sporting activity: you don't have to tighten it, but as soon as you feel that it is pulling, you put yourself in safety so as not to trigger injuries and help the pubic symphysis to absorb tension and waves chocs .
The role of each strap in the treatment of pain: :
The upper strap tightens the 2 iliac crests and the sacroiliac It absorbs the downward vertical shock wave from the trunk and upper limbs. It decreases the mechanical pressure of the pubic symphysis by reducing its shearing and torsion.
It is fundamental to the effectiveness of BSB, which is why it must always be tightened, whether for preventive or curative purposes.
The 2 lower straps tighten the insertion of the adductor tendons and the hip. They absorb the vertical shock wave rising from the lower limbs and therefore relieve the tension absorbed by the pubic symphysis.