Symphysis syndrome in athletes: surgical treatment for chronic lower abdominal, groin, and adductor pain in athletes

Clin J Sport Med. 2003 Sep;13(5):278-84. doi: 10.1097/00042752-200309000-00002.


Objective: To investigate the results of surgical treatment on athletes presenting with chronic symphysis syndrome (lower abdominal, groin, and adductor pain).

Design: Retrospective nonrandomized study.

Setting: Swiss Olympic Medical Center associated with Institute of Sports Sciences.

Patients: Twenty-four athletes who were treated for chronic symphysis syndrome, a combination of abdominal, groin, and adductor pain, were evaluated for an average of 6.6 years after surgery. All athletes were males, with a mean age of 25.8 years. The average duration of chronic symptoms was 17 months.

Interventions: Of patients, 20 underwent spreading of the lateral border of the sheath of the rectus abdominis muscle together with an epimysial adductor release, and 4 had only the reconstruction of the rectus abdominis muscle.

Main outcome measures: Subjective (questionnaire) and objective (clinical examination) follow-up data using point scores were obtained at a mean of 6.6 years posttreatment.

Results: The mean point score in the subjective overall rating was 10.2 (maximum 12) and in the objective rating was 12.0 (maximum 13). Of athletes, 21 were very content, 2 were content, and 1 was not content. Full sports activity was noted in 23 of 24 athletes.

Conclusions: Surgical treatment of chronic symphysis syndrome is successful and can salvage the career of athletes.

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / surgery*
  • Adult
  • Athletic Injuries / complications
  • Athletic Injuries / diagnosis
  • Athletic Injuries / rehabilitation
  • Athletic Injuries / surgery*
  • Chronic Disease
  • Follow-Up Studies
  • Groin / surgery*
  • Humans
  • Male
  • Muscle, Skeletal / surgery*
  • Outcome and Process Assessment, Health Care
  • Patient Satisfaction
  • Physical Examination
  • Pubic Symphysis / surgery*
  • Recovery of Function
  • Rectus Abdominis / surgery
  • Retrospective Studies
  • Sports Medicine / methods
  • Sprains and Strains / complications
  • Sprains and Strains / diagnosis
  • Syndrome
  • Treatment Outcome