Academic literature on the topic 'Groin injury or groin pain'

Bakgrund: Ljumskskador, ljumsk- och höftsmärta hos fotbollsspelare har oftast samband med minskat rörelseomfång i höfter, svaghet i bål och höftmuskulatur. Risk för ljumsksmärta ökar hos idrottare som inte tränar skadepreventivt. Syfte: Att undersöka om ett preventionsprogram med sex övningar för styrka och rörlighet kan minska förekomsten av ljumsksmärta hos herrfotbollsspelare. Material och metod: En kvantitativ experimentell fallstudie med kontrollgrupp, som utfördes med 14 herrfotbollslag (7 lag interventionsgrupp, 7 lag kontrollgrupp). I studien deltog 514 manliga fotbollspelare i åldern mellan 15-47 år. Resultat: I interventionsgruppen som genomförde ett preventionsprogram var antalet spelare med ljumsksmärta oförändrat, medan antalet deltagare med ljumsksmärta i kontrollgruppen ökade. Konklusion: Ett preventionsprogram med övningar för styrka och rörlighet kan förebygga förekomst av ljumsksmärta hos herrfotbollsspelare. Nyckelord: Fotboll, prevention, ljumskskada, ljumsksmärta, höftsmärta<br>Background:Groin injuries, groin pain and hip pain for soccer players are often associated with decreased range of motion (ROM) in the hip, weakness in abdominal muscles and poor hip muscles. The risk of groinpain increases for athletes who do not practice any preventing exercises. Objective:To research if an injury prevention program with six exercises for strength and mobility has any effect on groin pain and hip pain for male soccer players. Measures and Methods: Quantitative experimental study with control group. 14 male soccer teams participated (7 teams in intervention group, 7 teams in control group). In the study 514 male soccer players participated, in the age of 15-47 years. Result: In the intervention group who practiced the prevention program did not the number of players with groinpain increased, compared with the control group where the numbers of players with grioinpain increased. Conclusion: An injury prevention program for male soccer players with exercises for strength and mobility could prevent increase of groinpain among male soccer players. Keywords: Soccer, prevention, groin injury, groin pain, hip pain

This Thesis aimed at studying the prevalence and severity and broadening the knowledge of aetiology and risk factors of groin injuries in male football. The four papers, which form part of this Thesis, are based on the same research project conducted on a cohort of amateur players from 17 Spanish teams. Variables such as information about groin pain in the previous season, pre-season short- and long-lever hip adductor squeeze strength, together with demographic and anthropometric data were collected at pre-season. Hip- and groin-related sporting function was registered at baseline, and every fourth week during the in-season, using the Sport and Recreation subscale from The Copenhagen Hip and Groin Outcome Score (HAGOS (Sport)) questionnaire. Time-loss groin injuries, registered by the team physiotherapist, in addition to self-reported groin pain, irrespective of time loss, were registered over 44 weeks to document all groin problems, and groin problems with and without time loss<br>Aquesta Tesi va tenir com a objectiu l'estudi de la prevalença i la severitat, i l’exemplar coneixement sobre l’etiologia i factors de risc de les lesions de l'engonal en futbolistes. Els quatre articles que formen la tesi estan basats en el mateix projecte de recerca, conduit en una cohort de futbolistes amateurs Espanyols. El dolor inguinal en la temporada passada, la força d'adductors, juntament amb dades demogràfiques i antropomètriques es van recollir a la pre-temporada. La funció esportiva relacionada amb el maluc i l'engonal es va registrar a l'inici de l'estudi i també durant la temporada cada quatre setmanes utilitzant el qüestionari Hip And Groin Outcome Score (HAGOS). Les lesions de l'engonal amb "time-loss", registrades pels fisioterapeutes dels equips, el dolor de l'engonal autoreportat i irrespectiu de "time-loss" es van registrar durant 44 setmanes per documentar tots els problemes de l'engonal, i problemes amb i sense "time-loss"

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia<br>Objetivo: Determinar de que forma o treino de prevenção pode atuar na prevenção e diminuição do risco da pubalgia em jogadores de futebol masculino. Metodologia: Realizou- se uma pesquisa computorizada nas bases de dados, PubMed, Web of Science e SPORTDiscus, com a combinação das seguintes palavras-chave (“prevention exercise” OR “prevention training”) AND (“groin injuries” OR “groin pain”) AND (“football players” OR “soccer players”) AND (physical therapy) de acordo com as guias do Prisma Flow Diagram. A qualidade metodológica dos estudos incluídos foi analisada através da Physiotherapy Evidence Database Scoring Scale (PEDro). Resultados: Nesta revisão foram incluídos 5 artigos que cumpriram os critérios de elegibilidade com um total de 1358 participantes e média aritmética de 7/10 na escala de PEDro. Verificou-se que o treino de prevenção promoveu, uma diminuição significativa do risco de lesão de pubalgia em jogadores de futebol masculino. Conclusão: Com base nos estudos analisados, parece ser possível afirmar que deve ser implementado um treino de prevenção para pubalgia, visto que parece existir uma diminuição do risco lesivo assim como o facto de potenciar a força excêntrica adutora da anca, bem como de otimizar o rácio da força excêntrica entre adutores-abdutores da anca.<br>Objective: To determine if the prevention training can promote a diminished risk and prevalence of groin injuries in male football players. Methodology: Computerized research conducted in the databases PubMed, Web of Science and SPORTDiscus, was performed using the combination of the following keywords: (“prevention exercise” OR “prevention training”) AND (“groin injuries” OR “groin pain”) AND (“football players” OR “soccer players”) AND (physical therapy) according to Prisma Flow Diagram. The including studies were analyzed using the Physiotherapy Evidence Database Scoring Scale (PEDro). Results: this review included 5 articles that met the eligibility criteria with a total of 1659 participants and with an arithmetic mean of 7/10 on the PEDro scale. It was found that the prevention training promoted a diminished prevalence and risk of groin problems in male football players. Conclusion: Based on the studies analyzed, seems to be possible to affirm that prevention training for groin injuries should be implemented, since there seems to exist a decrease in the risk of injury and also because of it enhances the eccentric hip adductor strength, as well as optimizing the ratio between eccentric hip adductor and eccentric hip abductor strength.<br>N/A

This thesis is the culmination of a program of research which initially began in 1995. It reflects a major professional interest in the imaging of sports injuries which developed gradually over the 10 year period between 1992 to 2001, based upon previous clinical experience and expertise in the management of musculoskeletal injuries and their anatomical and pathomechanical origins. The central theme of study relates to the use of cross-sectional imaging techniques to investigate the pathoanatomical basis for groin pain in althletes with particular reference to professional soccer players with chronic groin pain. The current thesis is based around two key postulates. Firstly, that most of the commonly diagnosed causes of groin pain in professional athletes are anatomically and functionally linked and, secondly, that modern cross-sectional imaging can demonstrate both the correct diagnosis and the underlying biomechanical causes. The program of study consists of three different but linked project themes. The first investigates the scope of the problem, i.e. the differential diagnosis and prevalence of groin pain in professional soccer players. The second investigates the precise "normal" anatomy, i.e. the gross topographical anatomy of the pubic symphysis and parasymphyseal regions as actually exists rather than the regional anatomy that appears in classical anatomical texts. The third builds upon the first two projects and, investigates the underlying pathomechanical processes using magnetic resonance imaging. The study results suggest that a unifying mechanism of injury exists which partly explains the diagnostic and therapeutic difficulties that occur in athletes with groin pain. It also demonstrates that better understanding of the true pubic symphyseal anatomy allows a more accurate diagnosis to be made and that magnetic resonance imaging can demonstrate the relevant underlying pathoanatomy. The thesis adds significantly to the body of scientific knowledge related to this important sports-related, clinical condition.

Background: il groin pain è una sintomatologia molto diffusa negli atleti e nella popolazione attiva generale. La complessità dell’approccio riabilitativo riguarda le numerose strutture anatomiche che possono essere coinvolte e la multifattorialità da cui può originare questa condizione dolorosa. A questo, in aggiunta, contribuisce una terminologia non uniforme tra i clinici. Obiettivo: valutare se l’esercizio terapeutico risulta efficace negli atleti (professionisti e non) affetti da groin pain durante l’attività sportiva da almeno 2 mesi, indagando soprattutto il dolore e il ritorno allo sport. Materiali e metodi: la ricerca è stata effettuata utilizzando le principali banche dati biomediche: PubMed, PEDro e CINAHL. Sono inclusi soltanto RCTs che confrontano l’esercizio terapeutico con altre tipologie di intervento fisioterapico, escludendo la chirurgia. Sono stati introdotti articoli di ogni lingua, senza limitazioni di genere, anno e follow-up. Risultati: gli RCTs inclusi al termine della ricerca sono 4. In 3 studi la categoria di groin pain esaminata è quella “adductor-related”, dove l’esercizio terapeutico è confrontato con fisioterapia passiva e trattamento multimodale; uno di questi, valuta inoltre se l’esercizio attivo è efficace anche a lungo termine. L’ultimo studio analizza la categoria “inguinal-related” mediante un confronto con la fisioterapia convenzionale passiva. Conclusioni: in seguito all’analisi emerge in ciascuno dei 4 studi una maggiore efficacia del trattamento attivo basato sull’esercizio in entrambe le categorie di groin pain, sia in termini di dolore che di ritorno allo sport. Il trattamento multi-modale proposto, sembrerebbe avere un miglior risultato in termini di tempo di ritorno all’attività sportiva precedente all’infortunio. Il follow-up che verifica se l’efficacia risulta persistere anche nel lungo periodo, mostra risultati positivi ma non certi essendo l’unico RCTs in letteratura sul groin pain con questo obiettivo.

Thesis (MScPhysio)--Stellenbosch University, 2014.<br>ENGLISH ABSTRACT: Introduction: Chronic groin injuries are common among athletes and have the potential to lead to chronic and career-ending pain. There is no evidence available whether pelvic kinematics can be perceived as a risk factor in developing chronic groin pain in sport or be the cause of further injuries of the lower quadrant or lumbar spine. Objective: The purpose of this study was to determine if there are any differences in pelvic kinematics of active sports participants with chronic groin pain compared to healthy controls during a single-leg drop-landing. Methodology: A descriptive study was conducted. The three-dimensional (3D) pelvic kinematics of ten cases with chronic groin pain and ten asymptomatic controls was analyzed. Pelvic kinematics was analyzed at the FNB 3D Vicon Laboratory at Stellenbosch University using an eight camera Vicon system. A physical examination, including functional movements, posture analysis, hip, knee and ankle passive range of motion measurements, sacro-iliac tests and anthropometric measurements was done by two physiotherapists prior to the 3D analysis. To analyze the pelvic kinematics, each participant performed six single-leg drop-landings. The main outcome measure was 3D pelvic kinematics at initial foot contact (IFC) and foot contact at lowest vertical position (LVP). The following sub-groups were analyzed: seven with unilateral groin pain and three with bilateral groin pain; the latter was further divided into those with the most painful leg and the least painful leg. Mean and standard deviations (SD) for pelvic kinematics were calculated and significant differences between sub-groups were determined using two-tailed Student’s t-tests. The Cohen’s D effect size calculator was used to calculate the effect size of significant differences in pelvic kinematics between case and control groups. Results: The findings indicated a significant difference (p=0.03) in frontal plane pelvic kinematics at IFC for the unilateral group. The most painful groin group showed significant differences at IFC (p=0.004) and at LVP (p=0.04) in the frontal plane pelvic kinematics. The least painful groin group showed a significant difference at LVP (p=0.01). All cases landed with pelvic downward lateral tilt during the landing phase compared to matched controls. The groin pain group with bilateral pain showed significant differences at IFC (p < 0.001) and LVP (p=0.005) for the most painful groin; and the least painful groin at IFC (p=0.01) and LVP (p=0.01) in the sagittal plane pelvic kinematics. The bilateral groin pain group showed an increase of anterior pelvic tilt in the sagittal plane during the landing phase when compared to matched controls. Increased internal pelvic rotation in the transverse plane was significant for the unilateral group at IFC (p=0.04) and for the most painful groin group at IFC (p < 0.001) and LVP (p < 0.001) compared to matched controls. Conclusion: Results from this study shows that pelvic kinematic changes in the frontal, sagittal and transverse planes do occur in patients with chronic groin pain when compared to controls. This may imply that muscle weakness around the hip and pelvis may contribute to the development of chronic groin pain in active sports participants. Rehabilitation of these muscles should be taken into consideration when treating patients with chronic groin injuries. Further research should be focused on muscular recruitment patterns in sports participants with groin pain to critically define the muscular causal factors in more depth.<br>AFRIKAANSE OPSOMMING: Inleiding: Kroniese lies beserings is ‘n algemene verskynsel onder die aktiewe sport populasie. Dit mag tot kroniese pyn lei en het die potensiaal om ‘n sport loopbaan te be-eindig. Tans, is daar geen verdere navorsing beskikbaar oor die invloed van bekken kinematika op onderste ledemaat beserings asook die moontlike oorsaak tot kroniese lies pyn in atlete nie. Oogmerk: Die doel van hierdie studie was om vas te stel watter verskille in die bekken kinematika ontstaan tussen aktiewe sport deelnemers met kroniese lies pyn teenoor aktiewe sport deelnemers sonder enige pyn of beserings tydens ‘n enkel been aftrap beweging. Metodologie: Tien deelnemers met kroniese lies pyn en tien asimptomatiese deelnemers is gebruik om die verskille tussen die 3D bekken kinematika te bepaal. Die FNB 3D Vicon Lab by die Stellenbosch Universiteit is gebruik vir die data analise en insameling. Deelnemers het ‘n fisiese ondersoek ondergaan wat die voglende ingesluit het: funksionele bewegings, postuur analise, omvang van beweging van die heup, knie en enkel, toetse ter uitsluiting van die ilio-sakrale gewrig asook antropometriese aftmetings. Elke deelnemer is versoek om ses enkel-been aftrap sessies te doen. Die hoof uitkomsmeting was die bekken hoeke in the frontale vlak by inisiële voet kontak (IVK) asook die voet kontak teen die laagste vertikale posisie (LVP). Resultate: Die resultate wys ’n beduidende verskil (p=0.03) in die frontale vlak vir bekken kinematika by IVK vir die unilaterale groep. Die mees geaffekteerde been wys ’n beduidende verskil by IVK (p=0.004) en by LVK (p=0.04) in die frontale vlak vir bekken kinematika. Die groep met die minste geaffekteerde been toon ’n beduidende verskil by LVP (p=0.01). Alle simptomatiese deelnemers het met die bekken in afwaartse bekken kanteling geland tydens die landings fase. Die groep met bilaterale pyn toon ’n beduidende verskil by IVK (p < 0.001) en by LVP (p=0.005) vir die mees geaffekteerde been en vir die minste geaffekteerde been by IVK (p=0.01) en LVP (0.01) in die sagittale vlak vir bekken kinematika. Die bilaterale groep met kroniese lies pyn land met meer anterior bekken kanteling in die sagittale vlak gedurende die landings fase teenoor die asimptomatiese groep. Interne bekken rotasie was beduidend meer vir die unilaterale groep by IVK (p=0.04) en vir die mees geaffekteerde been by IVK (p < 0.001) en LVP (p < 0.001) teenoor asimptomatiese deelnemers. Gevolgtrekking: Die resultate van hierdie studie bewys dat daar wel ‘n verskil is in die bekken kinematika van deelnemers met kroniese lies pyn teenoor asimptomatiese deelnemers. Hierdie verskille is waarneembaar in die frontale, sagittale en transverse vlakke. Dit impliseer dat spier swakheid van die bekken en heup spiere ‘n bydrae mag he tot die ontwikkeling van kroniese lies beserings in atlete. Rehabilitasie van bogenoemde spiere is belangrik in die behandeling van kroniese lies beserings. Verdere navorsing oor spier aktiverings patrone in aktiewe, sports deelnemers met kroniese lies pyn word benodig, om die oorsprongs faktore te ondersoek.

Thesis (MScPhysio)--Stellenbosch University, 2014.<br>ENGLISH ABSTRACT: Introduction: Groin injuries are among the top six injuries in contact sports and may lead to career ending chronic pain. Research on the role of knee kinematics in developing chronic groin pain in sport is scarce. Objective: The purpose of this study was to determine if there are differences in knee kinematics during a single-leg drop-landing in sports participants with chronic groin pain compared to asymptomatic controls. Methodology: A descriptive study was conducted. Twenty active sports’ participants were recruited from soccer and rugby clubs situated around the Cape Peninsula area, Western Cape, South Africa. The three-dimensional (3D) knee kinematics of ten cases with chronic groin pain and ten asymptomatic controls was analysed. Knee kinematics was analysed in the FNB-3D Vicon Laboratory at Stellenbosch University, using an eight camera Vicon system. A positive adductor squeeze test was used as a diagnostic test to include cases with chronic groin pain. Each participant performed six single-leg drop landings. The main outcome measure was 3D knee kinematics at initial foot contact and at the lowest vertical position of the drop landing. The following sub-groups were analysed: seven unilateral groin pain cases compared to their seven matched controls; three bilateral groin pain cases where their most painful leg and least painful leg were compared to their matched controls, respectively. Descriptive statistical techniques were used for all outcome measures; means and standard deviations (SD) were calculated, followed by a Student’s t-test to determine significant differences between the cases and controls. For all outcomes with p-values equal to or below 0.05, the effect size was calculated using the Cohen’s D. Results: The findings of this study indicated a significant difference (p=0.0001) between cases with unilateral groin pain having less knee internal rotation compared to the controls at the lowest vertical position of the drop landing in the transverse plane. Significantly less internal rotation (p<0.0001), was also noted in the cases with bilateral groin pain (in the most painful leg and the less painful leg), although this was noted at foot contact. Cases with bilateral groin pain also had significantly (p<0.001) more knee varus (adduction) during the landing phase. Conclusion: Differences in knee kinematics between sports participants with chronic groin pain and asymptomatic controls were found. These findings imply that the knee joint should be included during assessment and rehabilitation of individuals suffering with chronic groin pain. Due to the cross-sectional study design of the current study, it cannot be stated for certain whether the knee kinematics noted in the groin pain group are causative or as a result of groin pain. Future prospective studies are thus recommended; these studies should focus on the effect of contralateral knee kinematics on the hip adductors and may include exploration of the muscular components during a single-leg drop landing.<br>AFRIKAANSE OPSOMMING: Inleiding: Lies beserings is een van die top ses beserings in kontak sport en kan lei tot chroniese lies pyn en selfs die be-eindigging van ‘n sportloopbaan. Navorsing oor die rol van knie kinematika in die ontwikkeling van chroniese liesbeserings in sport is skaars. Doelwit: Die doel van hierdie studie was om te bepaal of daar verskille in die knie kinematika is tydens 'n enkel been val landing in sport deelnemers met chroniese lies pyn in vergelyking met gesonde kontroles. Metode: 'n Beskrywende studie was uitgevoer. Twintig aktiewe sport deelnemers is gewerf van rugby en sokker sportklubs geleë rondom die Kaapse Skiereiland, Wes-Kaap, Suid-Afrika. Die 3D knie kinematika van tien gevalle met chroniese lies pyn en tien asimptomatiese bypassende kontroles is ontleed. Knie kinematika was ontleed in die FNB-3D Vicon Laboratorium by die Universiteit van Stellenbosch, met behulp van 'n agt-kamera Vicon stelsel. 'n Positiewe Adduktor druk toets was gebruik as 'n diagnostiese toets om gevalle met chroniese lies pyn in te sluit. Om die knie kinematika te analiseer, het elke deelnemer ses enkel been val landings uitgevoer . Die belangrikste uitkomsmeting was 3D knie kinematika by die aanvanklike voet kontak en by die laagste vertikale posisie van die enkel-been val landing. Die volgende sub-groepe was ontleed: sewe unilaterale lies pyn gevalle in vergelyking met hul sewe bypassende kontroles; drie bilaterale lies pyn gevalle waar hul mees pynlike been, sowel as minder pynlike been onderskeidelik vergelyk was met hul bypassende kontroles. Beskrywende statistiese tegnieke was gebruik vir alle uitkoms maatreëls; gemiddeldes en standaardafwykings (SA) was bereken, gevolg deur 'n Studente’s t-toets om beduidende verskille tussen die gevalle en kontroles te bepaal. Vir al die uitkomste met p-waardes gelyk of onder 0.05, is die effekgrootte bereken deur die Cohen’s D. Resultate: Die bevindings van hierdie studie dui op 'n beduidende verskil (p=0,0001) tussen gevalle met unilaterale lies pyn met minder interne knie rotasie in vergelyking met die kontroles by die laagste vertikale posisie van die val landing in die dwars vlak. Aansienlik minder interne rotasie (p<0,0001), is ook opgemerk in gevalle met bilaterale lies pyn (in die mees pynlike been en die minder pynlik been), alhoewel tydens voet kontak. Gevalle met bilaterale lies pyn het ook betekenisvol (p <0.001) meer knie varus (adduksie) tydens die landingsfase gehad. Gevolgtrekking: Verskille bestaan in die knie kinematika tussen sport deelnemers met chroniese liesbesering pyn en gesonde kontroles. Hierdie bevindinge impliseer dat die knie behoort ingesluit te word tydens die assessering en rehabilitasie van individue met chroniese lies pyn. As gevolg van die deursnee-studie ontwerp van hierdie studie, kan dit nie bevestig word of die knie kinematika die oorsaak van die chroniese pyn is nie. Toekomstige voornemende studies word dus aanbeveel, hierdie studies moet fokus op die effek van die kinematika van die kontralaterale knie op die heup adduktore en kan moontlik die ondersoek van die spier kinetika tydens hierdie aktiwiteit insluit.

Athletic pelvic/groin injuries can be difficult to define, diagnose and therefore manage. These injuries are often the result of multifactorial dysfunction, making them susceptible to becoming chronic. Transverse pelvic belts have shown effectiveness in reducing pain and improving function in athletes with pelvic/groin pain, but there may be better alternatives. Exploring different pelvic belt configurations with athletes with pelvic/groin pain confirmed the role of a transverse belt but also found that diagonal belts produced significantly (< 0.05) greater effects upon clinical measures of pain and function. Dynamic elastomeric fabric orthoses (DEFOs) are Lycra®-based orthoses theorised as providing stability and enhancing proprioception. A DEFO was designed to apply diagonal force to the pelvic girdle and mimic transverse belt application. In a series of single case studies the DEFO was found to have beneficial effects upon pain and/or function in selected athletes with pelvic/groin pain. Athletes’ subjective reports suggested that balance and power may have also been positively influenced. Further work exploring appropriate measures of athletic balance led to the investigation of the intra-rater reliability of a functional measure; the multiple single-leg hop-stabilisation test. Good to excellent reliability (ICC = 0.85; CI 0.61-0.90) confirmed this measure as being reliable for use in a future study, and highlighted relationships with other factors such as age and training status. The findings of a pilot RCT indicated that with minor revisions this protocol could be effectively implemented in informing a future RCT. Findings also indicated that the DEFO led to moderate to large effect sizes on clinical measures (d = 0.6-1.1) of active straight leg raise and squeeze test force, and negligible to small effects on measures of power and functional balance (d = 0.1-0.3). This thesis therefore outlines the development and initial evaluation of a novel DEFO for supporting the management of athletic pelvic/groin injury. Further work is required to undertake a fully powered RCT, and to explore the mechanistic action of this DEFO.