Core Muscle Injury: Evaluation and Treatment in the Athlete.

Area of Science:

• Sports medicine
• Orthopedic surgery
• Sports physical therapy

Background:

• Core muscle injury, encompassing athletic pubalgia and sports hernia, is characterized by groin pain at the pubic attachment of abdominal muscles.
• Diagnosing chronic groin pain is complex due to overlapping symptoms with hip and thigh pathologies.
• Increased interest in core muscle injury stems from its challenging diagnosis and impact on athletes.

Approach:

• Comprehensive literature review and analysis of clinical experience.
• Evaluation of pathoanatomic features, history, physical examination, and imaging modalities.
• Comparison of established treatment algorithms with expert clinical insights.

Key Points:

• Core muscle injury diagnosis requires high clinical suspicion, especially with pain near the inguinal ligament and rectus abdominis insertion.
• Adductor longus tendinopathy frequently coexists and requires investigation.
• Dynamic ultrasonography is increasingly utilized, while MRI may underestimate injury extent.
• Functional rehabilitation is often effective; surgical repair is considered for persistent symptoms after nonoperative treatment.

Conclusions:

• Core muscle injury is a clinical diagnosis in athletes with inguinal region pain, often accompanied by adductor pathology.
• Early recognition and appropriate management, including rehabilitation or surgery, are crucial for athlete recovery.
• The Doha agreement (2015) has facilitated consensus on terminology and treatment algorithms for core muscle injury.