Long-standing pubic-related groin pain in professional academy soccer players: a prospective cohort study on possible risk factors, rehabilitation and return to play

Helge Eberbach,Schmal Hagen,Lisa Bode,Gerrit Bode,Valentin Bohsung,Ferdinand Kloos,Markus Wenning,Magnus Leible,David Fürst-Meroth

doi:10.1186/s12891-021-04837-x

Helge Eberbach, Schmal Hagen + Show 7 more

Open Access

https://doi.org/10.1186/s12891-021-04837-x

Copy DOI

Abstract

BackgroundDespite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain.MethodsMale soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club’s youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play.ResultsA total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players.ConclusionsLong-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence.Trial registrationThe trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021.

Highlights

Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare
The aim of this study was to evaluate the effect of age, player position and Functional movement score (FMS) for long-standing pubic-related groin pain in players in a professional youth soccer academy, implement a standardized nonsurgical therapeutic regimen and prospectively evaluate the outcome
During the study period, a total of 14 out of 189 soccer players showed clinical and radiological signs consistent with long-standing pubicrelated groin pain and required specific treatment based on the rehabilitation scheme

Summary

Introduction

Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. Long-standing pubic-related groin pain is an entity characterized with typical clinical history, physical findings and imaging morphology [10,11,12]. It is a noninfectious, inflammatory, chronic injury involving the symphysis, pubic rami and the surrounding soft tissue resulting from chronic overuse [10, 13, 14]. It affects high-level athletes, in particular those who participate in sports that involve kicking, turning, twisting, cutting, pivoting, sprinting, rapidly accelerating and decelerating [8]

Objectives

Methods

Results

Conclusion