The rectus-adductor pain syndrome, commonly referred to as pubalgia, is a frequent condition in competitive swimming due to repetitive movements and the significant strain placed on the pelvis and lower limb muscles. It is characterized by pain in the groin and pubic area, often worsened by physical activity.
The incidence is higher among breaststroke swimmers because of the specific leg movements essential for propulsion and glide. The circular and pushing motion of the legs required in breaststroke leads to strong activation of the adductor muscles, which are responsible for bringing the legs closer to the midline of the body.
Other potential causes that should be assessed during the physiatric medical examination include: excessive development of some muscles (such as the adductors) compared to others (abdominals, obliques), postural alterations such as hyperlordosis, scoliosis, or leg length discrepancies, which can contribute to the onset of rectus-adductor syndrome.
Pain should not be underestimated because, over time, it can significantly limit the ability to swim and train. However, attention must be paid: pain in the pubic area is not always caused by a muscular problem.
The forced hip opening and closing movements in breaststroke may lead to excessive compression of the hip joint (hip coxo-femoral articulation). In competitive swimmers, this pressure can cause the so-called femoroacetabular impingement syndrome, which manifests with pain and reduced hip mobility and requires specific therapeutic interventions.
The therapeutic strategy must always start from a correct diagnosis.
It is necessary to identify the predisposing factors that contribute to the onset of symptoms and correct them with a multimodal rehabilitative approach, which must always involve the coach.
Dott. Luca Tomaello
