Home › Body Atlas › Tendons › Rectus Abdominis Pubic Insertion

Rectus Abdominis Pubic Insertion

insertio distalis musculi recti abdominis

The rectus abdominis inserts distally via its tendinous lower end onto the pubic symphysis (anterior surface) and the pubic crest, with fibres crossing the midline to the contralateral pubic tubercle and interdigitating with the contralateral adductor longus origin. This crossed insertion creates the shared enthesis between the rectus abdominis and the adductor longus — the 'pubic plate' — which is the primary site of pathology in athletic pubalgia and osteitis pubis.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The rectus abdominis distal insertion is central to the pathology of athletic pubalgia (sports hernia): tearing of the posterior inguinal wall at the conjoint tendon or the rectus abdominis insertion produces chronic groin pain in kicking athletes. Osteitis pubis is inflammation at the pubic symphysis from the shear stress between the two rectus abdominis-adductor insertions. Repair techniques include rectus abdominis reinsertion and posterior inguinal wall repair. The crossed nature of the rectus-adductor enthesis means that one-sided sport (dominant leg kicking) produces asymmetric loading contributing to injury.

Pathology

Common Injuries & Conditions

Athletic Pubalgia from Rectus Abdominis Pubic Insertion Tear

Repetitive kicking and trunk rotation in footballers tears the rectus abdominis at its pubic insertion producing chronic inguinal-adductor groin pain that is reproduced by resisted sit-up; MRI demonstrates the rectus abdominis pubic plate injury and adductor longus origin abnormality; physiotherapy is first-line with surgical rectus reinsertion for refractory cases.