The differential diagnosis of pelvic pain and possible injury in the f
emale athlete is quite broad and must include gastrointestinal and gen
itourinary aetiologies, as well as musculoskeletal injuries. These con
siderations reflect the anatomical complexity of the female pelvis. Th
e pelvic bones house the lower gastrointestinal and genitourinary visc
era and transmit stress from the lower extremities to the upper body.
The innervation of the pelvic structures also complicates evaluation a
nd diagnosis when somatic and visceral afferent information affects th
e athlete's interpretation of pain. An algorithmic approach can facili
tate evaluation and rehabilitation of pelvic injuries in the female at
hlete in the context of previously described mechanisms of musculoskel
etal injury.