Figure description: The upward and oblique pull of the abdominal muscles on the pubis fights against the downward and lateral pull of the adductors on the inferior pubis. This imbalance of forces can lead to injury.
PE: Evaluation of other GU/GYN/other intra-abdominal pathology comes first.
Clinician may note tenderness of the pubic ramus and medial inguinal floor.
Pain is more severe with resisted hip adduction and with resisted sit-up.
Combining these maneuvers (resisted situp while adducting hips) recreates the pathophysiology described above and is a good exam maneuver.
References
Sports hernia: the experience of Baylor University Medical Center at Dallas
