Related Groin Pain Research Articles

Effect of Low Intensity Modified Hölmich Protocol on Long-Standing Adductor Longus Related Groin Pain

Aim: To evaluate the effect of low intensity Modified Hölmich Protocol (MHP) for long-standing groin pain on pain, and return to sport. Place and duration: Tehran University of Medical Sciences and Lebanese football club clinic from March 2021 till September 2021. Methods: Ten male soccer (age= 24±4.8 yrs.) with adductor longus related groin pain underwent 10-weeks of Low intensity MHP. Results: All outcome measures, except SEBT, improved significantly(p<0.05) in all participants at week 10 as in pain, BKFO, and return-to-sport, muscle strength. Conclusions: Ten-week of low intensity Modified Hölmich Protocol were sufficient to induce significant improvements in all clinical measures with all participants in our study. Keywords: Modified Hölmich Protocol, Long-standing Groin pain, Low Intensity.

Arthroscopically assisted minimally invasive symphysioplasty for the treatment of pubic related groin pain

Therapy of pubic related groin pain via minimally invasive symphysioplasty. Therapy of refractory pubic related groin pain based on osteitis pubis. Groin pain from causes other than pubic related groin pain. After aminimally invasive approach, an incision in the anterior capsule is made while protecting the dorsal capsule parts and the arcuate pubic ligament. The symphysis end plates are remodeled arthroscopically assisted using asurgical burr. The newly created pubic symphysis joint is filled with autogenous fibrin to support the formation of anew discus interpubicus. Partial weight-bearing for 4weeks with 20 kg using crutches is recommended. During the first 4weeks the range of motion should be restricted. Since2010, 10athletes (7men, 3women; average age 34.1 ± 7.8 (23-47) years) have undergone arthroscopically assisted minimally invasive symphysioplasty and treatment of femoroacetabular impingement syndrome. The average follow-up time was 5.1 (2-9) years. All patients returned to their sport level. The mean preoperative Nonarthritic Hip Score (NAHS) of 64.4 ± 15.1 (32.1-86.5) points improved to amean postoperative NAHS of 91.4 ± 9.8 (62.4-98.75) points (p < 0.0001). The average patient satisfaction (scale0 to10; 10highest satisfaction) was 9.8 ± 0.4 (9-10).

Muscle Energy Technique, Stretching and Strengthening on Hip Rotation Range and Kick Distance in Football Players with Adductor Related Groin Pain

Background: Football is a commonly played team sport, and kicking is the primary skill needed. The incidence of adductor strain is high in football players, and thus their kick distance is affected due to groin pain. This indicates the importance of stretching and strengthening exercises as a necessary therapeutic technique to treat these sportspeople.Objective: To compare the effectiveness of muscle energy techniques (MET), stretching and strengthening exercises on hip rotation, and kick distance.Design: Randomized Control Trial.Methods: Forty football players suffering from groin pain due to adductor strain were selected from five professional soccer clubs in Jazan, Saudi Arabia, and randomized into two equal groups. Affected hip joint rotation [Internal + External Rotation] range, instep kick, and sidekick distances were measured and documented as baseline values. In addition, group A received MET, stretching, and strengthening exercises, whereas group B received only stretching and strengthening exercises for six weeks. Post-test values of the outcome measures were recorded at the end of the intervention.Results: Statistical comparison of the results between the groups showed that the MET group had significant improvement than the strengthening and stretching group in the hip rotation range (p&lt;0.005), but the difference was not significant for both in-step kick and front kick distance (p&lt;0.0001).Conclusion: Thus, adding MET to the routine strengthening and stretching exercise regimen can be clinically beneficial in treating groin pain among football players.

ADDÜKTÖR KASLAR İLE İLİŞKİLİ KASIK AĞRISI OLAN ADÖLESAN SPORCULARDA ADDÜKTÖR SIKIŞTIRMA KUVVETİ VE FONKSİYONEL SEVİYE

Purpose: The aim of the present study was to compare adductor squeeze strength and functional levels of adolescent athletes having adductor related groin pain (ARGP) with asymptomatic controls.&#x0D; Methods: A total of 52 adolescent athletes (26 in ARGP group; 26 in healthy control group) were included in the study. Visual Analog Scale was used for pain levels. Stabilizer was used to evaluate the adductor squeeze strength. Hip Outcome Score (HOS) was used to determine functional levels. &#x0D; Results: Demographic characteristics were similar between groups (p&gt; 0.05). Adductor squeeze strength were lower in ARGP group when compared to controls (p

Interest of the botulinum toxin in adductor related groin pain

Groin pain in athletes is a common problem. The use of botulinum toxin (BTX) has shown good results in neuromuscular diseases and more recently in pathologies such as epicondylitis. The aim was to assess the effectiveness and side effects of the BTX injections in adductor related groin pain, which resists to rehabilitation and/or surgery. A pilot study with one year follow-up. Between March 2014 and April 2016 we systematically registered patients who received BTX injections in adductor muscles under both control by ultrasound and electrostimulation. We carried out a follow-up at 1, 3, 6 and 12 months on pain intensity, HAGOS scores, professional disability, and side effect recording. Thirty patients, 83% males and 17% females have been included. Adductor tenotomy was recorded in 14 patients before the injection. Pain intensity decreased significantly (D0: 65 ± 16 mm; D30 31 ± 23; D90 28 ± 23; D180 33 ± 28; D36531 ± 30; P < 0.05). HAGOS score showed significant improvements on all sub-scales [symptoms, pain, physical function in daily living, in spot and recreation, participation on physical activities and hip or groin related quality of life ( P < 0.05)]. The intensity professional disabilities decreased significantly at D30, 90, 180 and D365 ( P < 0.05). Three patients failed to be relieved and all of them had a previous adductor tenotomy. Five patients had a recurrence during the follow-up and 3 of them had a previous adductor tenotomy too. This present study suggests that BTX is an effective treatment for the adductor related groin pain with no side effect and a low rate of recurrence.

Hip-related pain and femoroacetabular impingement syndrome: How common is it? How does it impact on biomechanics? How does it affect muscle function?

Joshua Heerey (La Trobe University, Melbourne) presented at the #SportSuisse2018 his work “What is the prevalence and relationship of bony morphology and features associated with early hip osteoarthritis in sub-elite footballers with and without hip and groin pain”, and won the JOSPT award for the best poster in Bern: congratulations! The aims of this study were to describe the prevalence of bony morphology in football players with and without hip related groin pain, and to determine the association between pain and bony morphology in these athletes (soccer and Australian football players; subelite level; mean age: 26 years old, 80% men; 187 symptomatic and 55 asymptomatic). All subjects underwent specific x-rays exams (supine AP pelvis, Dunn 45°) and filled the International Hip Outcome Tool (IHOT-33). The results showed that in sub-elite football players: /3 of all hips have cam morphology independent of pain (pincer morphology and acetabular dysplasia were rarely seen in this cohort), and that hip related groin pain is not associated with bony morphology. This strengthen again the importance of to use other clinical entities (as described by Per Holmich) and to carefully/critically consider and evaluate the intra-articular pathologies in sub-elite football players with long standing hip and groin pain.

The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions.

Does Bony Hip Morphology Affect the Outcome of Treatment for Patients with Adductor - Related Groin Pain? Long Term Results of a Randomized Controlled Trial

Does Bony Hip Morphology Affect the Outcome of Treatment for Patients with Adductor - Related Groin Pain? Long Term Results of a Randomized Controlled Trial

INVITED

Injuries of the groin have a substantial impact in sport, particularly in the popular Australian sports of Australian football, rugby union, rugby league and soccer. The diagnosis and management of groin injuries present a difficult problem for sports medicine practitioners. Historically, pathology in this area has been given a generic term such as adductor related groin pain or osteitis pubis, while the current literature is limited by the lack of a clinical framework to assist diagnosis. Geographical biases with diagnosis also exist that suggests a lack of agreement between clinicians around the world.

Risk factors in the development of exercise related groin pain: A systematic review

Introduction: Groin pain is a commonly diagnosed injury in a number of sports and often progresses into a chronic condition that has traditionally been difficult to manage and rehabilitate. Managing athletes and preventing initial injury is an important measure to limit the impact of any injury. In an attempt to identify those more susceptible to groin pain a number of studies have investigated the risk factors related to the development of groin pain. A number of systematic reviews have been conducted in this area, however some methodological issues and the period of time since the last review warranted an updated systematic review into the risk factors relating to the development of groin pain.

Adductor longus mechanics during the maximal effort soccer kick

Groin pain is a common cause of athletic disability and often involves the adductor longus. A common complaint of patients with groin problems is pain while preparing to kick the ball. The purpose of this study was to examine muscle length and activation of the adductor longus while kicking a soccer ball. Three-dimensional joint positions and muscle activation were obtained from 15 National Collegiate Athletic Association (NCAA) Division 1 male soccer players during maximal effort kicks. Musculoskeletal modeling techniques incorporating joint position and muscle attachments were used to estimate adductor longus length from the beginning of the kicking leg's swing phase until ball strike. The maximum rate of stretch of the adductor longus (22.3 ± 5.3 cm/s) and maximum hip extension (23.3 ± 8.8°) occurred near 40% of swing phase. Activation of the adductor longus occurred between 10% and 50% of the swing phase. Adductor longus maximum length occurred at 65% of the swing phase. Maximum hip abduction (25.3 ± 5.4°) occurred at 80% of swing phase. The adductor longus appears to be at risk of strain injury during its transition from hip extension to hip flexion. This knowledge could be applied to muscle injury prevention and rehabilitation programs to aid with treatment of adductor longus related groin pain.

Normative values of hip strength in adult male association football players assessed by handheld dynamometry

Chronic groin pain is a common problem in association football players. Normative values for the strength of hip muscles, measured in an accurate and accessible manner, are needed to gauge strength and inform return to play decisions in this group. The purpose of this study was to define normative values of hip muscle strength using handheld dynamometry. A series of reliable clinical tests that are commonly used when making return to sport decisions in athletes with chronic adductor related groin pain have been selected. One hundred and twenty adult male association football players, free from injury, were recruited. Isometric strength of the hip flexors and adductor muscles was measured using a handheld dynamometer. Mean age was 24.9 years (SD 5.9). Eighty participants (67%) had experienced groin pain in the past. Mean strength for dominant leg hip flexion was 47.3 kg (95% confidence interval 45.6–49.0), non-dominant leg hip flexion was 42.5 kg (41.1–43.9), adduction at 0° hip flexion was 35.6 kg (34.1–37.1), adduction at 45° was 32.0 kg (30.9–33.1), and adduction at 90° was 25.5 kg (24.4–26.5). This study establishes reference ranges and predictive equations for maximal isometric contraction strength of the hip muscles in non-injured adult male association football players. This information will assist assessment and management of an athlete's return to play following injury.

Ergebnisse der Hüftarthroskopie bei sportabhängigen Leistenschmerzen

The study analyses the intraoperative findings and the clinical results of hip arthroscopy in sports related groin pain. Between june 1998 and october 2002 we performed hip arthroscopy in 30 athletes (12 female, 18 male) with a history of sports related groin pain. Their average age was 36 (20 to 68) years. All patients had a clinical follow-up- examination at an average of 20 (12 to 48) months postoperative. The result was rated using the Larson-Score. We found a lesion of the acetabular labrum and performed a partial resection at 17 patients (57 %) (synovitis: n = 28 [93 %] loose bodies: n = 6 [20 %] torn ligamentum teres: n = 4 [13 %], others: n = 2 [6 %]). 11 patients (37 %) had a cartilage degeneration grade II in the Outerbridge classification (III degrees : n = 9 [30 %], I degrees : n = 4 [13 %], 0 degrees : n = 6 [20 %]). Preoperative 14 patients (47 %) complained severe groin pain (moderate: n = 14 [47 %], slight: n = 2 [6 %]) against only 3 patients (10 %) with severe groin pain at the follow-up examination (moderate: n = 11 [37 %], slight: n = 16 [53 %]). Following hip arthroscopy 28 patients (94 %) returned to full sports activity. The Larson-Score was increased significantly (p < 0.05) rating 43 (10 to 64) points preoperative to 59 (28 to 80) points at the follow-up. We found that persistent sports related groin pain was frequently caused by an intraarticular hip disorder. Following hip arthroscopy pain could be reduced in most patients as a return to full sports activity.

154 A study of risk factors for chronic exercise -related groin pain in elite Australian football players

154 A study of risk factors for chronic exercise -related groin pain in elite Australian football players

Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study

Background: Groin pain is a diagnostic and therapeutic challenge to sports medicine. The literature provides no consensus on definitions of or diagnostic criteria for groin pain in athletes. To compare...