Basically, pubalgia can be due to three mechanisms:

• Impairment of the pubic joint.

The pubis usually refers to the pelvic bone that is located in front of the bladder and above the genitals. In reality, it is the junction of two bony branches, left and right, which meet, in the middle, by a joint called the pubic symphysis and which is hardly mobile. In this place, can develop a joint and bone pathology, called pubic osteoarthropathy, and which resembles osteoarthritis.

• A muscular origin.

Two muscles can be involved in pubalgia: the abdominal muscles and the adductor muscles.

The former are made up of different muscle groups such as the rectus muscles which start from the ribs to reach the pelvis (the famous chocolate bars), but also the obliques and transverse ones, which are located laterally; the relative weakness of the latter can be at the origin of a pubalgia.

The adductor muscles are located on the inner side of the thighs and are inserted into the pelvis: their function is to allow movement of the lower limb from the outside to the inside. In some sports, they are particularly stressed and can then induce pubalgia.

• Abdominal wall failure.

The entanglement of muscle groups in the lower abdomen does not create a homogeneous wall. There are thus certain more fragile zones likely to open and allow the exteriorization of the contents of the abdomen (hernia). This is particularly the case of the inguinal region (also called the groin or hollow between the thigh and the pubis) which can be the site of a hernia of the abdominal contents, called inguinal hernia. In pubalgia, it is this same mechanism that can be in play, although there is, most often, no real hernia, but just an “opening” of this region.