Abdominal-adductor syndrome is a fairly common condition that usually occurs in athletes. It is often referred to in the literature as an athlete’s hernia, and the main characteristic of the condition is pain in the groin and pubic symphysis.
The anatomy of the area is what allows the appearance of this syndrome, since in the area where the abdominal muscles are located, the adductors arise. Therefore, an injury to the abdominals can directly affect the adductors and vice versa.
There are several opinions on the mechanism of the syndrome, but the one that prevails is that the abdominal-adductor syndrome is due to repeated loading of the symphysis pubis. The constant stress of the adductor during sports activities leads to its weakening, causing instability that leads the muscles of the area (abdominal and adductor) to more intense contractions, making them more prone to injury. In many cases, injury occurs to the denervation of the transversus abdominis muscle, while in cases with chronic pelvic instability compression of the neural structures in the area by adjacent tissues is likely to occur.
Abdominal-adductor syndrome can occur either after an acute injury or after a period of time. In most cases the onset of symptoms is slow, starting as a mild discomfort that gradually worsens over time. However, severe pain can also occur after some sporting activity and the intensity of this may even be the main reason for stopping the specific sporting activity. The area where the pain occurs is in the groin, near the adductor protuberance or the apophysis of the rectus abdominis (or both places at the same time), usually on one of the two sides, while more rarely bilaterally. Symptoms of the syndrome usually include a feeling of heaviness in the abdominal and adductor muscles.
Sports activities that involve high-speed movements, but also twisting and bending of the trunk can cause exacerbation and worsening of symptoms. However, these symptoms can be triggered even by coughing or sneezing.
The physical therapy approach has as its main goal the strengthening of the muscles in the area, so that better muscle coordination and restoration of instability can occur, with the therapeutic plan including the use of technical mobilizations (Manual Therapy), but also special rehabilitation & strengthening exercises (therapeutic exercise) .
