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Patient:  48-year-old male, runner

 Symptoms:  Onset of pain was gradual.  The patient reported pain with coughing, sneezing, running, turning over in bed, and engaging the abdominal musculature in any type of activity.  Right side was worse than the left side, but he definitely felt pain on both sides.  Pain was with activity only and rest relieved the pain.  Conservative therapy, including physical therapy, anti-inflammatories, steroid injection, and massage, did not help the pain.  The patient also was diagnosed with a labral tear by MR and physical examination, but it was not symptomatic. 

Diagnosis:  Bilateral baseball pitcher hockey goalie syndrome, osteitis pubis, left labral tear.  MRI showed a near complete detached tear of the right rectus abdominis that extended into the right adductor longus.  There was a small detached tear of the left rectus abdominis with osteitis pubis.

Treatment & Rehabilitation:   After consultation with the hip specialist, it was decided to have the rectus abdominis surgery done first to offload the forces on the hip. If the patient persisted with pain after surgery, then he would have the hip addressed.  The patient underwent bilateral rectus abdominis repairs and baseball pitcher hockey goalie releases.  He was back to running half marathons in eight weeks after surgery.  Two years later, the patient is experiencing no pain in the groin or hip area.