A suggested model for physical examination and conservative treatment of athletic pubalgia

Phys Ther Sport. 2013 Feb;14(1):3-16. doi: 10.1016/j.ptsp.2012.04.002. Epub 2012 May 8.


Background: Athletic pubalgia (AP) is a chronic debilitating syndrome that affects many athletes. As a syndrome, AP is difficult to diagnose both with clinical examination and imaging. AP is also a challenge for conservative intervention with randomized controlled trials showing mixed success rates. In other syndromes where clinical diagnosis and conservative treatment have been less than clear, a paradigm has been suggested as a framework for clinical decision making.

Objectives: To propose a new clinical diagnostic and treatment paradigm for the conservative management of AP.

Design: Relevant studies were viewed with regard to diagnosis and intervention and where a gap in evidence existed, clinical expertise was used to fill that gap and duly noted.

Results: A new paradigm is proposed to assist with clinical diagnosis and non-surgical intervention in patients suffering with AP. The level of evidence supporting this paradigm, according to the SORT taxonomy, is primarily level 2B.

Conclusions: Further testing is warranted but following the suggested paradigm should lead to a clearer diagnosis of AP and allow more meaningful research into homogeneous patient populations within the AP diagnostic cluster. Strength-of-Recommendation Taxonomy (SORT): 2B.

Publication types

  • Review

MeSH terms

  • Athletes*
  • Athletic Injuries* / complications
  • Athletic Injuries* / diagnosis
  • Athletic Injuries* / therapy
  • Diagnosis, Differential
  • Humans
  • Pelvic Pain* / diagnosis
  • Pelvic Pain* / etiology
  • Pelvic Pain* / therapy
  • Physical Examination / methods*
  • Physical Therapy Modalities*