Core Muscle Injury: Evaluation and Management

Abstract

Core muscle injury is a condition of the lower abdominal and inguinal region caused by weakness or tearing of the rectus abdominis insertion to the superior pubic ramus. Generally, the core muscle injury patient will have either pinpoint or generalized pain in the area of the distal rectus abdominis, at its insertion upon the pubis. MRI utilizing the axial oblique plane is key to identifying pathology at the aponeurosis of the adductor longus and rectus abdominis. Initial conservative treatment includes relative rest and physical therapy. Surgical treatment focuses on the insertion of the rectus abdominis to the pubis, along with stabilization of the interface between the rectus and conjoined tendon, with reinforcement of the posterior wall of the inguinal canal if indicated. Treatment options for adductor pathology include nonoperative management, such as injections, along with operative adductor tendon lengthening.