The Role of Femoroacetabular Impingement in the Etiology of Athletic Pubalgia and Sports Hernias

Abstract

Groin injuries in athletes are a common problem, especially in athletes participating in sports requiring significant cutting, twisting, and kicking. Two of the most common causes of groin pain in athletes are femoroacetabular impingement (FAI) and athletic pubalgia. FAI is the impingement of the femoral neck on the acetabular rim due to abnormal bone morphology. Athletic pubalgia is a constellation of injuries to the soft tissues surrounding the pelvis caused by repetitive injury. The most commonly injured structures in athletic pubalgia are the insertions of the rectus abdominis and adductor muscles. FAI may be the first step in a cascade of events that lead to athletic pubalgia. FAI leads to biomechanical changes including decreased hip range of motion, and athletes compensate for this loss of motion by increasing movement in the pelvis. This increased motion of the pelvis can lead to imbalance and injury of the muscles surrounding the pubic bones. Tearing of the insertion of the rectus abdominis and other muscles of the pelvis may lead to the pain associated with athletic pubalgia.