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Patient:  33-year-old female athlete, track and field

Symptoms:  The patient noticed gradual onset of severe pain bilaterally for approximately one year.  Pain was with sneezing and worse with running, biking, and going up stairs.  Pain was experienced after activities, not during. She also had pain with sitting for long periods. She complained of tenderness on the pubic bone.  The pain did not improve with rest.   Acupuncture and physical therapy provided little relief. 

Diagnosis: Physical examination revealed not only a core muscle injury, but suggested a hip injury as well.  Dr. Meyers ordered an MR arthrogram which showed a labral tear with impingement.  MRI of the pelvis showed a rectus abdominis adductor aponeurotic plate disruption at midline going bilaterally with bilateral adductor tendinosis and marked osteitis pubis. The patient had a core muscle injury and a hip injury. 

Treatment & Rehabilitation:  After consultation with a hip specialist, surgery for the hip was performed first followed three weeks later by surgery for her core muscle injury.  The patient rehabbed the hip and groin together.  She did experience occasional flare-ups of osteitis pubis postoperatively for the first couple of months, but still participated at a high level in her sport.  She is currently one year post surgery, pain-free, and ranked highly in her field.