The groin

Edited by Dr. Luca Franzon

The term pubalgia refers to a painful syndrome characterized by pain in the groin and / or pubic area and / or on the inner face of the thighs.

Its etiology is so vast that according to Jarvinen it is possible to identify as many as 72 causes of groin pain. Currently it is classified in three different categories which are:

INSERTIONAL TENDINOPATHY = groin pain is caused by repeated microtrauma to the adductor muscles of the thigh and abdominal muscles. The critical point of these muscle insertions is the pubic symphysis which represents the area where the ascending and descending forces of the involved muscles are discharged.

SYPHISIARIA SYNDROME = caused by microtrauma induced by the adductor muscles which, acting in an unbalanced and lengthening way between the two limbs, create a sort of collapse at the level of the symphysis. This situation leads to an imbalance in the stability and equilibrium of the pelvis. This is a situation that arises especially in the age of development during which the symphysis is already in itself weaker.

SYNDROME OF THE SHEATH OF THE ABDOMINAL RECTUM OR PERFORATING NERVE OF THE ABDOMINAL RECTUM OF THE PLAYER = groin pain is caused by the act of kicking during which there is a strong tension in the abdominal muscles. This tension sometimes creates a fissuring of the superficial fascia with consequent stretching and compression of the perforating nerve which then gives rise to the pain syndrome.

Initially the pain is located in the pubic area, then it radiates in the antero-medial aspect of the thigh and sometimes also in the retropubic area associated with bladder tenesmus (sensation of incomplete bladder emptying so much that you have to go almost continuously to urinate even if the bladder is completely empty )
It can present with an initial symptomatology with pain especially upon awakening and when physical activity begins. Both of these symptoms disappear with movement demonstrating the presence of a slight inflammation. In the most severe cases the pain is continuous and burdensome and sharpens in sudden movements. Upon clinical examination, the adductor muscles are contracted and the pressure in the pubis is more or less painful.

, malocclusion and posture. The presence of any pre-contacts creates muscular tensions which, through the temporomandibular joint, are transmitted to the articular muscle system in the neck and cervical tract with subsequent repercussions on the entire postural system.
As fitness instructors it is right to know that even pregnant women can sometimes suffer from groin pain due to the laxity of the pubic symphysis due to the marked release of the relaxin hormone, which makes the joints looser.

In conclusion, it can be said that groin pain is a "well-known pathological entity, it requires an early diagnosis that will allow us to give an adequate and effective treatment. Beyond all those that may be medical or kinesiological therapies in this type of pathology with a very vast etiology, it is necessary to be able to understand what is the cause or the triggering causes and try to eliminate them.
As in all pathologies it would be useful to try to prevent them instead of treating them. The various prevention programs, applied with rigor, must make it possible in the years to come to avoid this pathology of overmenage.

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