INTERNATIONAL JOURNAL OF ATHLETIC THERAPY & TRAINING MARCH 2013 13
Chronic groin pain can be a symptom of
a complex condition that may be provoked
by musculoskeletal disruption.
1
Without
early detection and accurate diagnosis, the
condition may be aggravated and prolonged.
Chronic groin pain typically is experienced by
athletes who participate in sports that require
running and repetitive cutting maneuvers,
with most occurrences reported in soccer.
1-6
Management of chronic
groin pain can be chal-
lenging due to dif-
ficulty in identifying
the cause of the symp-
toms. Muscle strain,
athletic pubalgia, peri-
ostitis, osteoarthritis,
cartilage injury, stress
fracture, pubic symphy-
sitis, nerve entrapment,
and pathologies in the
genitourinary system
may all produce chronic
groin pain.
1-7
The mor-
bidity from injuries
associated with chronic
groin pain may last from 2.5 to 48 months.
6
Once the main pathology causing the pain
is identified by clinical assessment or diag-
nostic imaging (MRI, computed tomography,
bone scintigraphy), treatment options can
be considered.
1-7
Verrall et al.
7
reported that
Pubic Stress Fracture in a Collegiate
Lacrosse Player
CASE REVIEW
YuriHosokawa•UniversityofArkansasandGretchenD.Oliver,PhD,FACSM,ATC•
AuburnUniversity
pubic bone edema is one of the main causes
ofchronicgroinpain.Pubicboneedemais
produced by a stress fracture that results
from repetitive stress. The inflammatory
response seen in the bone marrow is a sign
of stress fracture. The purpose of this report
is to present a case of a pubic stress fracture
in a female collegiate lacrosse player and
the conservative rehabilitation program that
was successful in restoring normal function.
Case History
A 21-year-old female collegiate lacrosse
athlete (height = 164 cm, weight = 52 kg)
whoparticipatedinEasternJapanDivision
I reported occasional right hip discomfort
duringactivity.Shehadnoprevioushistory
of groin injury. Following promotion to a
varsity level of competition, her training regi-
men intensified, and right hip pain became
persistent. Clinical evaluation performed by
an athletic trainer (AT) revealed moderate
hamstring tightness and tenderness near
the ischial tuberosity and the pubic ramus.
Because the condition did not impede
participation in practice activities, she was
instructed to perform stretching exercises
toaddresshamstringtightness.AnATmoni-
tored the athlete for any changes in symp-
toms while she continued to participate in
lacrosse without restrictions.
© 2013 Human Kinetics - IJATT 18(2), pp. 13-16
Pubic stress fracture is manageable with
early detection and conservative rehabilita-
tion; return to full participation can be
achieved.
Magnetic resonance imaging is an effective
tool in detecting the bone edema as a result
of the stress fracture.
Athletes with pubis stress fracture may
return to full participation without recurrent
symptoms after a conservative rehabilita-
tion.
Key Points Key Points