This narrative review by Lynch, Bedi, and Larson examines the diagnosis and management of athletic hip injuries — specifically the 'sports hip triad' of adductor strains, osteitis pubis, and athletic pubalgia — and their relationship to femoroacetabular impingement (FAI). It addresses why these conditions are frequently missed or mismanaged and how to approach them systematically.
When an athlete with groin or lower abdominal pain fails isolated surgical treatment — whether for athletic pubalgia or FAI — suspect the other diagnosis is also present; addressing only one pathology when both exist returns fewer than half of athletes to sport, while treating both restores play in nearly 9 of 10.
Use the four-layer framework to avoid anchoring on a single pain generator in what is almost always a multi-source problem.
This narrative review by Lynch, Bedi, and Larson examines the diagnosis and management of athletic hip injuries — specifically the 'sports hip triad' of adductor strains, osteitis pubis, and athletic pubalgia — and their relationship to femoroacetabular impingement (FAI). It addresses why these conditions are frequently missed or mismanaged and how to approach them systematically.
When an athlete with groin or lower abdominal pain fails isolated surgical treatment — whether for athletic pubalgia or FAI — suspect the other diagnosis is also present; addressing only one pathology when both exist returns fewer than half of athletes to sport, while treating both restores play in nearly 9 of 10.
Use the four-layer framework to avoid anchoring on a single pain generator in what is almost always a multi-source problem.