Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with insidious onset of localized pubic symphysis pain, exacerbated by weight-bearing activities, running, or sudden changes in direction. Reports associated adductor muscle tightness and occasional radiation of pain to the inguinal region or lower abdomen. No history of acute trauma, fever, or systemic symptoms. Pain is described as a dull ache, worsening with sit-ups or coughing.
Clinical Examination Findings
Physical examination reveals localized tenderness upon palpation of the pubic symphysis. Positive "squeeze test" (pain elicited by adduction against resistance). Gait analysis demonstrates an antalgic component. Range of motion of the hip is generally preserved but may be limited by pain at the extremes of abduction. No evidence of inguinal hernia or lymphadenopathy. Neurological examination of the lower extremities is intact.
Treatment Protocol
Initial management includes relative rest, cessation of aggravating activities, and activity modification. Prescribed NSAIDs for inflammation control. Referral to physical therapy focusing on core stabilization, pelvic floor strengthening, and adductor muscle stretching. Consider corticosteroid injection if symptoms are refractory to conservative management. Gradual return to sport protocol initiated upon resolution of acute symptoms.