Stina Lilje1*, Jón Karlsson2 and Hamid Behzadmehr3
1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
2Sahlgrenska University Hospital, Göteborg, Sweden
3Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
The incidence of athletic groin pain is 3%-25% of all sports-related injuries. A complex anatomy, overlapping diagnoses, heterogenous terminology, and lack of clinical guidelines complicate the treatment.
The 22-year old male football player described in this study had suffered from groin pain for almost a year. Per oral analgesics had no effect, plain radiography was negative, and physical therapy according to the diagnosis “adductor tendinitis” did not improve his condition. Movement restriction test of the adductor muscles was negative, why treatment was focused on the focal pain area; the symphysis pubis. Manual mobilization of the right pubic bone yielded a distinct and stable improvement in pain and physical function, which leaded the working diagnosis. After four treatments the patient’s night pain and ability to run, climb stairs, and play football were restored, his locking/clicking sensations and medication ceased, and he was able to return to football. At follow-up 8 years later, he was still symptom-free.
The etiology and symptoms of the common diagnosis ‘adductor tendinitis’ and dysfunctions of the pubic bones are similar, yet the lack of clarity around the diagnosis adductor tendinitis -thus the basis for treatment - has been highlighted in earlier research. According to a thorough literature search “symphysis pubis dysfunction” guided the care of the patient. The present study suggests that the described manual diagnostic and treatment approach may provide quick, significant and nonexpensive benefits for certain patients with groin pain.
Level of Evidence: Level IV.
Athletic groin pain; Orthopedic outpatient; Muscle energy technique
Lilje S, Karlsson J, Behzadmehr H. Pain Relief after Mobilization of the Symphysis Pubis in a 22-Year Old Male Football Player with Remaining Groin Pain after Conventional Care. Sports Med Rehabil J. 2018; 3(2): 1035.