Pubalgia en el deportista: enfoque fisioterapeútico

Abstract

La osteítis del pubis, entesitis pubiana, osteopatía dinámica del pubis o pubalgia, como más comúnmente se conoce a esta patología, es una de las lesiones más comunes entre los deportistas, la misma presenta una clínica que incluye síntomas objetivos (por ejemplo dolor a la palpación y al estiramiento) como así también síntomas subjetivos (como por ejemplo la sensación de dolor que puede ir de una simple molestia hasta tornarse insoportable provocando impotencia funcional inclusive para la realización de las AVD).Osteitis of the pubis, pubic entesitis, dynamic osteopathy of the pubis or pubalgia, as this pathology is more commonly known, is one of the most common injuries among athletes, it presents a clinic that includes objective symptoms (for example, pain at the palpation and stretching) as well as subjective symptoms (such as the sensation of pain that can go from a simple discomfort to becoming unbearable causing functional impotence even for the realization of the ADL). It is a difficult lesion to treat and its recovery can take several weeks, months and there is even the possibility of reaching a surgical treatment due to the ineffectiveness of conservative treatment.The pubalgia is related to a diffuse pain at the pubic crossroads level as an expression of symptoms at pubic level with irradiation towards adductors, abdominals and crural arches. Only one third of those affected refer to a sudden onset pain, while the rest, the vast majority, emphasizes a chronic pain.Although their signs and symptoms are sometimes clear, their diagnosis is not always so simple, which is why there are often inaccurate diagnoses that cause inappropriate treatment.The rehabilitation is carried out with a gradual and constant progression. The next step is taken if the bearing objectives are met. The time in each level depends on the athlete's ability to perform the exercises and not the time elapsed since the injury. The supervision of the rehabilitation is constant to continuously adapt the workload to the symptomatology.Eliminate or reduce pain. This is the basis of the treatment. Pain is the only indicator to quantify the progress of rehabilitation. If the pain does not decrease, confidence in the therapy will be lost. The roads are many and varied, which shows the difficulty of the task.