The superior pubic ligament is a transverse fibrous band running along the superior surface of the pubic symphysis between the pubic tubercles, blending with the fibrocartilaginous disc and the periosteum of the adjacent pubic bones. It is thinner than the arcuate pubic ligament but completes the superior boundary of the symphyseal complex.
Resists upward displacement of one pubic body relative to the other, reinforces the superior joint capsule of the pubic symphysis, and acts as an attachment point for the inguinal ligament medially.
The superior pubic ligament is disrupted in pelvic ring injuries involving the symphysis and is implicated in athletic pubalgia (sports hernia) where excessive shear at the symphysis overloads the anterior fibrocartilaginous disc and surrounding ligaments. Ossification of the superior pubic ligament occurs as part of degenerative enthesopathy visible on pelvic radiographs. The adductor longus and rectus abdominis both attach near the superior pubic ligament at the pubic crest, contributing to the tug-of-war mechanical environment that predisposes the region to groin pain in athletes.
Repetitive shear at the pubic symphysis in kicking and cutting athletes disrupts the fibrocartilaginous disc and surrounding ligaments including the superior pubic ligament, producing chronic groin pain that reproduces with Valsalva, sit-ups, and kicking, managed with physiotherapy or surgical repair.
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