**9. Pubic adductor strain**

(a) (b)

**Figure 13.** a) Ask the patient to rise the leg straighten against resistance; b) Take the leg straighten to an abduction

An initial recommendation is for rest to allow time for the symptoms to be minimized. Treatment is based on a good diagnosis and since here we encounter the convergence of various etiologies of pain, any misdiagnosis could lead to chronic pain that can result in

Lumbar sprains are the most common causes of low back pain. A low back muscle strain occurs when the muscle fibers are abnormally stretched or torn. The injury can occur because of overuse, improper use, or trauma. It is classified as "acute" if it has been present for days to

Almost all of these low back injuries are due to injuries of the muscle. Certain risk factors, such as excessive lower back curvature, forward-tilted pelvis, weak back and/or abdominal muscles,

The symptoms are: Pain around the low back and upper buttocks, Low back muscle spasm, Pain associated with activities, and generally relieved with rest spasms in the lower back that

Trauma of great force can injure the tendons and muscles in the lower back. Pushing and

The diagnosis of lumbar strain is based on the history of injury, but in the physical examination we palpate all the back of the patient facing down, to locate the pain (fig.14 a). We also ask him to try to rise the head while we are holding the ankles(fig. 14 b) and another maneuver is ask

weeks. If the strain lasts longer than 3 months, it is referred to as "chronic".

pulling sports, such as weight lifting or football, can lead to a lumbar strain.

and tight hamstrings, can increase the risk for this injury.

result in more severe pain and lower back feels sore to the touch

him to rise the leg with the knee straighten,on at the time, (fig. 14 c).

position till the pain is triggered; c) Ask the patient to move the leg inward (adduction) against resistance

limitation of the athlete´s sports performance

**8. Lumbar strains**

146 Muscle Injuries in Sport Medicine

)

(c)

The pubic adductor strain is a very common pathology in runners. Attached to the pubis are three muscle that converge: the adductor magnus, minimus and longus.

This injury usually occurs suddenly after having made a sharp sprint or change of direction and speed. When this injury happens, the athlete suddenly suspends the exercise and seeks medical help.

In the physical examination, pain is referred to a specific area of the adductor region to the inner and upper part of the leg. Palpation of the area may reveal edema, increased temperature, and in some cases a visible bruise (figure 15).

**Figure 15.** Palpate all over inguinal area searching for pain over the pubic bone

In carrying out exploratory maneuvers, a patient is unable to laterally raise the leg without pain and may require help to perform this movement.

With the athlete lying supine, ask him to to flex the knee and hip to 45° and then ask him to let the leg drop outward to the point of pain., If the injury is minor, the examiner may need to apply some resistance to provoke pain (figure 16a,16b).

**Figure 16.** a) With the knee flex at 45° and lying over the lateral side ask the patient to rise it against resistance; b) With the knee flex at 45° ask the patient don´t let you push it out

movement and measure the hip and knee angles. Repeat the test with the uninvolved leg and determine the difference in the measurements. Treatment should be instituted immediately to

Overview of Different Location of Muscle Strain

http://dx.doi.org/10.5772/56622

149

**Figure 18.** With the injured leg hanging from the lateral of the examination table flex the knee and measure the an‐

gle at which the pain is triggered and you can compared it to the contralateral side

prohibit the injury from complicating and increasing the pain as time passes.

**Figure 17.** A visible bruise is often seen
