Struggles with Chronic Athletic Pubalgia: Seeking Insights After Multiple Failures
Greetings everyone, I'll keep my story brief. In 2022, during my triathlon training, I encountered a troublesome incident while engaging in an abdominal workout. My partner was assisting by holding my legs while I caught a 5-pound ball thrown to me as I moved backward, only to lift it back to him. The next morning, I awoke to a searing pain in my abdominal region, specifically the rectus abdominis, which extended from my pubic area up to my lower ribs and even radiated to my testicles. Over-the-counter ibuprofen provided little to no relief. It wasn't until the third or fourth day that I managed to get out of bed and sought emergency medical attention. They conducted a CT scan and inquired whether I was a professional athlete. When I responded with a negative, the radiologist commented that I should be fine. After about six to eight weeks, the discomfort in my abdominal area began to subside slightly. Lacking health insurance, I resorted to seeking help from orthopedic specialists at my own expense. One of them diagnosed me with "athletic pubalgia." The following two and a half years turned into a costly endeavor as I transitioned through various insurance plans—from a high-tier PPO to a basic HMO—while consulting numerous specialists and undergoing five or six MRIs without any concrete conclusions about my condition. Persistent pain in my lower groin eventually led to losing my job and discontinuing my health coverage. Fortunately, I managed to secure medical insurance, and in April 2025, I underwent another MRI, which revealed a "partial avulsion of the rectus abdominis/adductor longus common aponeurosis." I was then directed to consult orthopedic specialists at two different locations. The first facility informed me that they didn’t handle this type of injury and recommended physical therapy instead. After one session with a PT expert, it was concluded that my core and leg muscles were sufficiently strong, thus indicating that PT wouldn’t be beneficial. This led me to a different sports orthopedic specialist, who arranged for yet another MRI. Hours after the procedure, I was summoned back to repeat the exam, which followed a standard hip/pelvic protocol; yet, the report confirmed that everything was "intact." Subsequently, I was referred to a pain management clinic where a steroid and anesthetic injection was administered in the affected area as indicated by the MRI results. This provided significant pain relief the following morning, but its effectiveness lasted just two and a half weeks. Following this, I underwent a PRP injection into the same region. While I experienced heightened pain for five days post-injection, there was a modicum of improvement after ten to twelve days. However, my rehabilitation stretching exercises led to a regression in my condition. Despite having requested to my primary physician on two occasions to repeat the MRI with the correct protocol, she decided against it. Just last week, I reached out once more to express all my symptoms and the ongoing complications post-PRP, asking for another MRI and requesting assistance in finding a surgeon to evaluate my case to determine if I should continue with conservative management or not. I received a reply stating that performing another MRI would not alter the treatment plan. What advice does anyone have for me at this stage? Thank you for your time. Please take care and stay healthy.
Answers (1)
2/3/2026, 5:30:58 PM
OpenHealth AI
I'm really sorry to hear about the challenges you've faced with your injury and the frustration of navigating through various treatments and consultations. It sounds like a complex issue that has significantly impacted your life. Let’s focus on some actionable steps you can take moving forward.
Summary of Key Points
You've been diagnosed with athletic pubalgia and have undergone multiple treatments, including imaging, injections, and physical therapy. Despite some temporary relief, you’re still experiencing significant pain and dysfunction. You're seeking further evaluation and possibly surgical options.
Explanation
Athletic pubalgia, often referred to as a sports hernia, is characterized by pain in the lower abdominal and groin areas due to strain or injury involving the muscles and tendons. Management can be challenging, particularly when conservative treatments do not yield lasting results. Your frustration is understandable, especially given the multiple consultations and the impact on your daily life.
Next Steps
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Seek a Second Opinion:
- Consider reaching out to a specialist who focuses on sports medicine or pelvic orthopedic conditions. Ensure they have experience with surgical interventions for athletic pubalgia.
- Look for a clinic or hospital with a comprehensive program for sports injuries, as they may provide specialized assessments and tailored treatment plans.
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Request a Functional MRI:
- While your current physician may be hesitant to conduct another MRI, you could express your desire for a second opinion specifically emphasizing that insights from updated imaging might guide decisions regarding surgical vs. conservative management. A functional MRI or an ultrasound guided assessment could provide additional insights into your ongoing pain.
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Evaluate Pain Management Options:
- Since you've experienced some relief from steroid injections, consider discussing alternative pain management options with a pain specialist, such as nerve blocks or alternative medication regimes that could interact differently with your pain.
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Explore Comprehensive Rehabilitation Programs:
- Instead of standard physical therapy, look for rehabilitation programs that specialize in pelvic and abdominal injuries. Programs that include both manual therapy and personalized exercise regimens might better suit your condition.
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Inquire about Surgical Consultation:
- If conservative treatments have proven ineffective over time, advocate for a referral to a surgeon who specializes in athletic pubalgia. This could allow for an exploration of surgical options or a clearer understanding of potential risks and benefits.
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Manage Your Symptoms Holistically:
- Focus on symptom management through lifestyle adjustments that may include gentle stretching (as tolerated), strengthening exercises that do not exacerbate your pain, and possibly integrating mind-body practices like yoga or meditation to help manage pain perception.
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Establish a Support System:
- Engage with support groups either online or in person for individuals dealing with chronic pain or athletic injuries. Sharing experiences and strategies with others can be empowering and provide emotional support.
Conclusion
Your record of pain management efforts is commendable, and it's vital to continue advocating for your health. Following these recommended steps may help you move closer to finding a solution that alleviates your pain and restores your quality of life. Please take care of yourself, and know that you are not alone in this journey.
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