A suggested model for physical examination and conservative treatment of athletic pubalgia

BackgroundAthletic pubalgia (AP) is a chronic debilitating syndrome that affects many athletes. As a syndrome, AP is difficult to diagnose both with clinical examination and imaging. AP is also a challenge for conservative intervention with randomized controlled trials showing mixed success rates. In other syndromes where clinical diagnosis and conservative treatment have been less than clear, a paradigm has been suggested as a framework for clinical decision making.ObjectivesTo propose a new clinical diagnostic and treatment paradigm for the conservative management of AP.DesignRelevant studies were viewed with regard to diagnosis and intervention and where a gap in evidence existed, clinical expertise was used to fill that gap and duly noted.ResultsA new paradigm is proposed to assist with clinical diagnosis and non-surgical intervention in patients suffering with AP. The level of evidence supporting this paradigm, according to the SORT taxonomy, is primarily level 2B.ConclusionsFurther testing is warranted but following the suggested paradigm should lead to a clearer diagnosis of AP and allow more meaningful research into homogeneous patient populations within the AP diagnostic cluster.Strength-of-Recommendation Taxonomy (SORT): 2B