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Pubic symphysis in Male Athletes | Caring Medical Sports



Ross.Hauser.MDRoss Hauser MD

This article will deal with the treatment of injury to the pubic symphysis in male athletes, for treatment in women please see our companion article: Symphysis Pubis Dysfunction Treatment in Women. Pubic symphysis injury is very treatable with Prolotherapy, see below.

The pubic symphysis is a fibrocartilaginous (cartilage like) disc that, like any other discs in the body, can be damaged. In union with the sacroiliac joints the symphysis pubis forms a stable pelvic girdle.

pubic symphysis injuryBecause the pubic symphysis and the sacroiliac joint are the only two joints connecting the two halves of the pelvis, an injury to one can affect the other. Thus, anyone sustaining injury to a sacroiliac joint should also have the pubic symphysis examined. This may help alleviate chronic low back pain in some athletes.

The pubic symphysis role in muscle strength

The pubic symphysis plays a role very similar to that of the sacroiliac joint by enhancing overall pelvic mobility. It also is the site of attachment of the powerful adductor muscles, which move the leg inward, and the abdominal muscles whose strength helps keep force off of the lower back and discs.

pelvic.floor

Pubic symphysis dysfunction or injury is often overlooked and blamed on the more “glamorous,” abdominal muscles and adductor muscles which attach in this area. When there is pain attributable to this area, the diagnosis is called “abdominal muscle pull” or “adductor tendonitis.”


How the Pubic symphysis injured


The pubic symphysis joint may be stressed whenever the leg is pulled out from underneath . On overextended strike in soccer players can also cause injury.  Swimmers who swim the breast stroke often suffer groin pain from a pubic symphysis injury.

The pubic symphysis widens slightly whenever the legs are stretched far apart, and therefore activities requiring this type of movement have a higher risk of causing injury to the pubic symphysis. This widening leads to misalignment and instability of the symphysis pubis joint.

An injury to the pubic symphysis can cause severe groin pain.  In the case of pain in the pubic symphysis, the cause is pubic symphysis diathesis or laxity, that is a weakening of the supportive structures causing excessive movement and instability.


public symphysis

Symptoms of pubic symphysis pain in men

Pain and tenderness is localized over the pubic symphysis and radiates outward to the upper thighs and perineum (the area between the anus and the scrotum). Pubic symphysis pain may be mild or severe, and can develop into a chronic condition. It can be a burning, shooting, grinding or stabbing pain. Pain is experienced while performing such activities as running, doing sit-ups and squatting. In more severe cases, the pain affects activities of daily living and causes the sufferer to walk with a waddling gait, as pain is experienced while walking, climbing stairs, coughing, and sneezing. The person also experiences exquisite tenderness to touch in the pubic symphysis area.


Pubic Symphysis Pain Treatment with Prolotherapy


Prolotherapy for pubic symphysis injury and instability are injections into the fibro-osseous junction of the superior pubic symphysis ligament and injections into the pubic symphysis itself.

Prolotherapy is extremely effective in strengthening the pubic symphysis and relieving chronic groin pain in this area. Prolotherapy solutions injected into the affected ligaments, tendons, and/or joints causes a local inflammation in the injected area. The mild, localized inflammation boosts blood supply and regenerative cells to the weakened area. This results in the deposition of new collagen, the material that the symphysis pubis is made of. The new collagen tightens the weakened, unstable joint and makes it stronger.

As mentioned above, the pubic symphysis is the front joint of the pelvic bone and the sacroiliac joint is in the back. The doctor should check for sacroiliac joint instability and treat it at the same time.

pubic tubercle

The pubic tubercle

In patients with groin pain due to abdominal wall abnormalities, one finds a history of inguinal pain that worsens with strenuous activity, especially activity stressing the abdominal muscles, such as sit-ups.

On physical examination there is tenderness of the pubic tubercle and a positive jump sign is elicited. In this instance, Prolotherapy to the muscle attachments onto the pubic symphysis is often curative.

All of the other muscle attachments to the groin area, including the rectus femoris, gracilis, rectus abdominis, and adductor group, can all be treated with Prolotherapy if there is tenderness and reproduction of the man’s pain upon palpation of the area where the muscle attaches to the bone. If a positive jump sign is elicited, the diagnosis is made and Prolotherapy is given.


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