ETIOLOGY OF PUBALGIA IN RUNNERS

When you are running, it is possible that you have pain or overload in the groins. It may be caused by many reasons, so, above all, we advise a good biomechanical study of the race in case you will have this kind of upsets, in order to know the exact cause. Some runners have this upset in the groins which hamper them to run the kilometers they can endure on a cardiac level, and they give up their training before they wish, due to this pain. The worry increases when the upset remains day after day. Before everything, we would like to calm down those runners who have this kind of upsets. The upsets or lesions must not be persistent and hamper you running. Therefore, although you need for the recovery some rest or to decrease the volume or intensity of training, this does not mean a considerable loss of your performance, especially for those who are focused on a specific competitive aim, like half a marathon or a planned marathon on their calendar. The first thing that you have to ask yourself is how you are training, how your charge is, your volume, intensity, experience, strength training, mobility, etc. One of the most important things we consider, is this training of strength, flexibility, mobility you are in parallel carrying out in your trainings. It is very usual that those runners who have running as a main sport, they have left any other type of skill, like strength, mobility or flexibility, increasing the risk of lesions. So, first, ask yourself what kind of work are you carrying out, apart from the running trainings. If you do a good training of your body for running with training, mobility and flexibility sessions, and you have this kind of lesions, it is possible that you are one of those sportsmen/sportswomen with a biomechanical problem which can have the origin in different causes according to your body, mobility, strength, etc. For all this, we state that preparing the body for running is indispensable. Therefore, we are going to mention the different causes which can cause this upset in the groins and why. The causes may be from the lack of training with strength work, mobility and articular flexibility, shoes, pathological problems, muscular shortenings, little or a lack of assimilation or the load and volume of running training, technique or the terrain, among the more usual. As you can see, some of them are intrinsic to the sportsman/sportswoman and others are extrinsic. Consequently, the first to be checked are the intrinsic ones, being advisable a good biomechanical study which can check if it is due by a lack of work or strength asymmetry between muscles from right and left side, articular mobility/flexibility by some kind of muscular shortening or pathological problems. Once these factors have been analyzed, we will be able to understand if the problem is due by an intrinsic cause or if we have to analyze extrinsic factors, like shoes, volume/intensity of training, terrain, technique, etc. It is generally, a multifactorial cause, that is to say, it is due to several causes, but there will always be one which will affect more than the other. The pain which is produced in the inguinal zone, has a biomechanical consequence and, therefore, a biomechanical failure is being produced which is going to be related a lot with the articular mobility in hip, the muscular ability of internal and external rotators of the hip, the running technique and other factors which make it worse. Due to different reasons and depending on the sportsman/sportswoman, it is generating a biomechanical problem in the hip and, as a result, the musculature is suffering. Generally, the biomechanical problem in hips which is causing pain/upset or even a lesion, it is mainly affected when the person has a low strength training and shortening of the mobility of internal rotation in hips. Therefore, in the support of the weight in the contact, there is an overload in this zone that is pushing it to the limit of the mobility on internal rotation of hip when it is reduced and, in addition to a possible low muscular control or low strength, entails that throughout there will be muscular overload. The limitation of the mobility of internal rotation of hip can be osseous or muscular. When is osseous, it also has a lot to do with the position of the pelvis, usually more in retroversion which implies that hips rotate some grades less, compared to a pelvis more in an anteversion position. When it is due to muscular shortenings they also have a bearing on this position of the pelvis more in retroversion or shortening of internal rotators of hips which they use to overload when the joint reaches the limit on impacts. If we add to these intrinsic factors, pathological problems, inappropriate shoes, a poor technique, etc., problems can be an obstacle for running. The only way to know which the exact cause is, generally some of the mentioned before, is to carry out a complete biomechanical study which can determine which of these factors cause the upset. The treatment can relieve for a short time, but the upset or lesion will continue to appear with time, because the factors which cause it have not been trained.