Dissertations / Theses 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
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
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
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.
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.
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.
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.
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.
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.
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.

Thesis (MScPhysio)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Introduction-Groin injuries are among the top six most cited injuries in soccer and account for 10-18 per cent of all injuries reported in contact sport. Groin pain can result from a variety of pathologies, but according to literature, 63 per cent of groin pain is due to adductor pathology. Objective-The objective of this study was to explore if there are kinematic differences in the hip joint in sports participants with groin pain compared to matched healthy controls. Study design A cross sectional, descriptive study was conducted. Study setting-The study was conducted at the FNB -3D motion analysis laboratory at the University of Stellenbosch, South Africa. Outcome variables-The dependent variables included hip kinematics in the sagittal, frontal and transverse planes at foot strike, lowest vertical point of the pelvis and total range of hip motion during a single leg drop landing. Methodology-The study sample comprised 20 male club level soccer-and, rugby players, running and cycling participants between the ages of 18-55 years of age. Ten of the subjects had chronic groin pain and the other ten were healthy matched controls. An eight-camera Vicon system was used to analyse the kinematics of the hip joint during single leg drop landing. For the purpose of comparison, the data was analysed for participants with unilateral groin pain and matched controls (n=14) and participants with bilateral groin pain and controls (n=6). The full set of data was subdivided for analysis into three distinct sub-groups. Unilaterally injured groin cases (n=7) were matched with seven healthy controls for analysis. Bilaterally injured groin cases (n=3) were matched with three healthy controls. Results-Cases with unilateral groin pain at initial contact had significantly more abduction of the hip joint when compared to controls (p<0.05). The effect size of this difference was large (0.94). Cases with unilateral groin pain also demonstrated greater hip internal rotation while the controls had external rotation (p<0.05) during a drop landing activity. Bilaterally injured groin cases landed with significantly (p=?) greater ranges of hip flexion as well as in significantly (p=?) more hip abduction during a drop landing activity. They also demonstrated greater total range of motion in the frontal plan when compared to controls. Groin pain cases overall demonstrated greater ranges of motion and tended to land in more abduction compared to controls. Conclusion-This study found that during a single leg drop landing, sports participants with unilateral chronic groin pain landed with significantly greater hip abduction and exhibited larger total range of motion in the transverse plane, which may indicate impaired stability of the hip complex when compared to controls.
AFRIKAANSE OPSOMMING: Inleiding-Liesbeserings is een van die top ses mees prominente sokker beserings. Dit beloop 10-18 persent van alle beserings wat in kontaksport aangemeld word. Liespyn kan die gevolg wees van ‘n verskeidenheid patologië, maar volgens die literatuur is 63 persent van liespyn as gevolg adduktor patologie. Doelwitte-Die doelwit van hierdie studie was om ondersoek in te stel of daar enige kinematiese veranderinge in die heupgewrig is in spelers met liespyn in vergelyking met dieselfde vergelykbare spelers sonder liespyn. Studie Ontwerp-‘n Deursnit, beskrywende studie was onderneem. Studie Omgewing-Die studie was uitgevoer by die FNB-3D bewegingsanalise laboratorium van die Stellenbosch Universiteit, Suid-Afrika. Uitkomsveranderlikes-Die afhanklike veranderlikes het in gesluit die heup kinematika in die sagitale, frontale en transvers vlakke met voet kontak endie laagste vertikale punt van die pelvis sowel as die totale heup omvang van beweging gedurende een been landing. Metodologie-Die studie populasie het bestaan uit 20 manlike sokker- en, rugbyspelers, hardlopers en fietsryers tussen die ouderdomme van 18 en 55 jaar. Tien van die deelnemers het kroniese liespyn gehad en die ander tien in die gelyke gesonde groep was sonder liespyn. Die agt kamera Vicon sisteem was gebruik om die kinematika van die heupgewrig te analseer tydens een been landing. Vir die doel om ‘n vergelyking te kan maak, was die data geanaliseer van deelnemers met unilaterale liespyn en die vergelykende groep sonder liespyn (n=14) en deelnemers met bilaterale liespyn en hulle vergelykende groep sonder liespyn (n=6).. Die volledige stel data was onderverdeel in drie afsonderlike sub groepe. Vir die analiese was unilaterale liesbeserings (n=7) vergelyk met sewe deelnemers sonder liespyn in die kontrolegroep. Deelnemers met bilaterale liesbeserings (n=3) was vergelyk met drie in die kontrolegroep. Resultate-Die deelnemers met unilaterale liespyn het met eerste kontak beduidend meer abduksie van die heupgewrig gehad in vergelyking met die kontrolegroep (p<0.05). Die effek van hierdie verskil was groot (0.94). Die deelnemers met unilaterale liespyn het ook ‘n grooter interne rotasie getoon, terwyl die kontrole groep meer eksterne rotasie gedemonstreer het (p<0.05) met landing. Deelnemers met bilaterale liespyn het beduidend (p=?) meer heup fleksie en abduksie omvang van beweging tydens landing. Hulle het ook ‘n groter totale heup omvang van beweging in die frontale vlak gehad in vergelyking met die kontrolegroep. Deelnemers met liespyn het oor die algemeen ‘n grooter omvang van beweging getoon, en was geneig om met meer abduksie van die heup te land as die kontrolegroep. Gevolgtrekking-Die studie toon dat deelnemers met kroniese unilaterale liespyn, tydens een been landing, beduidende meerheup abduksie toon en dat die heup in die transverse vlak meer totale omvang van beweging gebruik wat kan dui op onstabiliteit in die heupkompleks in vergelyking met die kontrolegroep.

Approximately one in four men will have surgery for ingunial hernia in their lifetime. In Sweden, 16 000 procedures are performed each year. To investigate the possible link between handling of nerves and sensory disturbance, 97 groins in 92 patients were examined one year after inguinal hernia surgery. Sensory disturbances were found to be common after open surgery (29 %), but were not seen after the laparoscopic procedures. No significant relationship between sensory disturbance and handling of nerves or pain was seen. The risk for recurrence has been significantly reduced due to the use of prosthetic meshes, but continued surveillance of this important outcome will always be necessary. In that context, the time frame in which recurrence develops in relation to possible risk factors can help our understanding of the underlying mechanisms. To explore such temporal relationships, 142,578 patients were included in a register study. A relative over-risk for early recurrence was seen after suture repair, laparoscopic repair, after postoperative complications, and after surgery for previous recurrence. Corticosteroids are known to decrease pain and nausea after several surgical procedures. In a randomised trial on open hernia surgery, 398 patients were randomised to treatment with 12 mg of betamethasone or placebo. Decreased levels of pain were seen on the day of surgery, the next day and after one month. No difference was seen on days 2-7 and after one year. Nausea was not common and did not differ between the groups. Reoperation is sometimes performed to correct a presumed structural defect thought to cause the long-term pain. In order to evaluate the result of such treatment, 111 cases were analysed based on register data, questionnaires and medical records. Sixty-two per-cent of the patients reported an improvement compared to before the reoperation, but a high level of pain remaining (42 %), and impaired quality of life was seen. There was no clear advantage for any surgical intervention over the other.

Thesis (MScPhysio)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Aims: This study aims to ascertain if there are differences in ankle kinematics and ground reaction force in sports participants with chronic groin pain compared to healthy controls. Methods: A cross sectional descriptive study design was used. Twenty participants - 10 cases with chronic groin pain and 10 healthy controls participated. The 10 cases included participants with unilateral pain (n=7) and bilateral pain (n=3). For analysis, the bilateral pain group was divided into the most and less painful side. The study was conducted at the FNB 3D Motion Analysis Laboratory, Stellenbosch University. Sagittal plane kinematics and VGRF was analysed during a single leg drop landing. Results: The group with unilateral groin pain had a higher peak force compared to the matched side of the controls. The bilateral pain groups had less plantarflexion at foot contact (most affected p=<0.001; least affected p=<0.001) and total range of motion (p=<0.05) compared to the control group. The bilaterally injured groin pain groups demonstrated less peak force when compared to controls. Conclusion: This is the first study to indicate alterations in ankle kinematics and VGRF and that these changes are more apparent in sports participants with bilateral pain. Less range of motion during the landing task illustrated by the bilateral pain group suggests less effective force absorption of the distal segments. In the bilateral groups it suggests that force attenuation may have occurred high up the kinetic chain which may place more strain on the groin. Clinically rehabilitation of the athlete with chronic groin pain should include the distal segments of the lower limb. Further research should be conducted in larger groups.
AFRIKAANSE OPSOMMING: Doelstellings: Hierdie studie poog om vas te stel of daar verskille in enkelbeweging en grondvloer-reaksiekrag is in deelnemers van sport met chroniese liespyn in vergelyking met gesonde kontrole deelnemers. Metode: ‘n Deursnee beskrywende studieontwerp is gebruik. Twintig deelnemers, 10 gevalle met chroniese liespyn en 10 gesonde kontrole het deelgeneem. Die 10 gevalle het ingesluit deelnemers met eensydige pyn (n=7) en bilaterale pyn (n=3). Vir die analise, is die bilaterale pyngroep verdeel in die mees en mins geaffekteerde kant. Die studie is gedoen by die FNB3D Beweginsanalise-laboratorium, Universiteit van Stellenbosch. Sagitaal-platvlak kinematiek en vertikale reaksiekrag is geanaliseer gedurende ‘n enkele beenlanding. Resultate: Die groep met eensydige liespyn het ‘n hoër piekkrag gehad in vergelyking met dieselfde kant van die kontrolegroep. Die bilaterale pyngroep het minder plantaarfleksie met voetkontak getoon (mees geaffekteer p=<0.001; minste geaffekteer p=<0.001) en totale beweginsomvang (p=<0.05) in vergelyking met die kontrolegroep. Die bilateraal-liesbeseringsgroep het minder piekkrag getoon in vergelyking met die kontrolegroep. Gevolgtrekking: Hierdie is die eerste studie om veranderings in enkelbeweging en grondreaksiekrag aan te toon, asook dat hierdie veranderinge meer opvallend is in persone wat aan sport deelneem wat bilaterale pyn ondervind. Verminderde beweginsomvang gedurende die landingstaak deur die bilaterale pyngroep suggereer minder effektiewe kragabsorpsie van die distale segmente. In die bilaterale groep suggereer dit dat kragvermindering waarskynlik hoog op die kinematiese ketting voorgekom het wat weer meer stremming op die lies plaas. Kliniese rehabilitasie van die atleet met chroniese pyn behoort die distale segmente van die onderste ledemaat in te sluit. Verdere navorsing behoort in groter groepe uitgevoer te word.

Thesis (MScPhysio)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Chronic groin pain is widespread across many sporting disciplines. The aim of our research was to determine if there are kinematic differences of the thoracic spine in active sports people with chronic groin pain, compared with healthy controls. A cross-sectional descriptive design was followed. Participants were required to complete six single leg drop landings with each leg from a 20cm height. The study was done in the 3D Movement Analysis Laboratory at the University of Stellenbosch. Ten male participants with unilateral or bilateral chronic groin pain of more than 3 months duration and 10 asymptomatic males, matched for age and sports participation, were recruited. The main outcome measures were: thoracic spine angle at initial foot contact, maximum thoracic spine angle, range of movement (ROM) (difference between the minimum and maximum values) and thoracic spine angle at lowest vertical point of the pelvis. This was assessed in all 3 movement planes: the sagittal plane (X plane), the coronal plane (Y plane) and the transverse plane (Z plane). The results of our study showed that for the unilaterally affected groin pain group, the cases landed in significantly more thoracic flexion (P<0.001 with large effect size) and were in significantly more thoracic flexion still at the lowest point. Peak thoracic flexion was significantly more in the cases than the controls. (P<0.001 with medium effect size) The same was true for the bilaterally affected group when landing on the most painful side, although this was not statistically significant. There were no significant differences in the frontal or transverse planes. In the bilaterally painful group, axial rotation ROM was significantly reduced when landing on either leg (worst affected side: P=0.040 with medium effect size and least affected side: p=0.006 with large effect size). The same occurred in the unilaterally affected group, although this was not statistically significant. Our study suggests that, in participants with chronic groin pain, there is greater thoracic forward flexion away from neutral during landing and that total axial rotation ROM during landing is diminished.
AFRIKAANSE OPSOMMING: Kroniese liespyn kom dikwels en in verskeie sportsoorte voor. Die doel van ons studie was om te bepaal of daar kinematiese verskille van die torakale werwelkolom is in aktiewe sportmense met chroniese liespyn, in vergelyking met gesonde kontroles. ‘n Dwars-deursnit beskrywende studiemetode is gevolg, en uitgevoer in die 3D Beweging Analise Laboratorium, Universiteit van Stellenbosch. Deelnemers moes ses landings op een been doen, met elke been, vanaf 'n 20cm hoogte. Tien mans met eensydige of bilaterale chroniese liespyn vir langer as 3 maande, en 10 asimptomatiese mans (ooreenstemmende ouderdom en sport deelname) het deelgeneem. Die hoof uitkomste wat gemeet is, was torakale werwelkolom krommingshoek by aanvanklike voet-kontak, maksimum torakale werwelkolom krommingshoek, omvang van beweging (OVB) (verskil tussen die minimum en maksimum waardes) en torakale werwelkolom krommingshoek by die laagste punt van die bekken. Dit is beoordeel in al 3 beweging vlakke: die sagittale (X) vlak, die koronale/frontale (Y) vlak en die transversale (Z) vlak. Die resultate van die studie het getoon dat, in die eensydig-geaffekteerde liespyn groep, die deelnemers in beduidend meer torakale fleksie geland het(P < 0.001, met 'n groot effekgrootte), asook met aansienlik meer torakale fleksie by die laagste punt na landing. Piek torakale fleksie was aansienlik meer in die liespyn-gevalle as in die kontroles. (P < 0.001, met middelmatige effekgrootte ) Dieselfde het vir die bilateraalgeaffekteerde groep gegeld wanneer hulle op hul mees pynlike kant geland het, hoewel dit nie statisties beduidend was nie. Daar was geen betekenisvolle verskille in die frontale of transversale vlakke van beweging nie. In die bilateraal pynlike groep, was aksiale rotasie OVB aansienlik verminder wanneer die gevalle op hul pynlikste been óf op hul minder pynlike been geland het ( mees pynlike been : P = 0,040, met 'n middelmatige effekgrootte en minder pynlike been : p = 0,006, met 'n groot effekgrootte ). Dieselfde het in die eensydig-geaffekteerde groep gebeur, hoewel dit nie statisties beduidend was nie. Ons studie dui daarop dat, in deelnemers met chroniese liespyn, daar meer torokale fleksie weg van neutraal tydens landing is en dat die totale aksiale rotasie OVB tydens die landing verminder is, in vergelyking met die kontrolegroep.

Background: Minor procedures in surgery and urology such as groin hernia and hydrocele repair, as well as prostate biopsies are very frequently done in routine practice. Complications and insufficient outcomes thus affecting many patients and the cumulative effect of this are of major importance in a population perspective. Aim: To explore complications and outcomes of surgical or diagnostic procedures and possible risk factors or predictors for adverse effects. Methods: By using both national quality and administrative registers, and by complementing registers with patient reported outcome measures, examine outcomes such as complications, persistent pain and recurrences. Also, in the case of hydro and spermatoceles, report incidence numbers. Further, by using a randomized trial, explore minimally invasive procedure such as sclerotheraphy compared to conventional surgery in respect to cure and adverse events. Results: When comparing with the open anterior mesh repair, endoscopic technique is advantageous in respect to the patient reported outcome of persistent pain. The drawback was an increased risk of postoperative complications and reoperation for recurrence. Incidence numbers for hydro and spematocele were 100/100000 men. Aspiration (± sclerotherapy) had a significantly lower rate of complications as compared to conventional surgery. In the interim analysis of the randomized trial, comparing sclerotherapy to Lord´s procedure for hydroceles, the cure rate was similar between treatments. Definite conclusions cannot be made due to the risk of type 2 errors, and the study will thus continue. In the case of trans-rectal prostate biopsy, the rates increased every year during the study time frame, up to an approximate risk of two per cent in 2012 for hospital readmission within 30 days, without an increased mortality within 30 days. Conclusions: The open anterior mesh procedure is still the preferred method for groin hernia repair in routine surgical practice. Hydro and spermatocele surgery is associated with high rates of complications, and the indication for repair should be scrutinized. The rates of infection after prostate biopsy is increasing and methods to reduce unnecessary biopsies as well as improved prophylaxis should be investigated.

Background: Hip and groin pain is common in ice hockey and particular in goaltenders, because their movement patterns make them particularly vulnerable. "Skate to the post-technique” (SMS-technique) is a relatively new technique that the goaltenders uses and no studies have been published where the SMS-technique is studied and the hypothesis is that the hip is subjected to high stresses which can lead to hip and/or groin pain. Purpose: The purpose of this study was to investigate the prevalence of hip/groin pain in male ice hockey goaltenders of elite level in Sweden and if factors such as age, level of SMS-technique use and prevention training can be linked with the pain. The study also examines whether the goalies are concerned of injuring the hip and/or groin. Method: Descriptive and comparative cross-sectional study consisted of an online survey in which 57 % of 94 goaltenders participated. Results: A total of 63 % responded that they have pain in the hip/groin every month or more frequently. Over half of the goaltenders follow a specific training program and a significant difference in pain incidence was seen between them and those who do not follow a training program, p = 0.01. Most responded that they are more or less worried of getting hurt in the hip/groin. No significant difference in the occurrence of pain could be observed at different degrees of using SMS-technique. Conclusion: Many goaltenders have hip/groin pain and those who have pain are more often following a specific exercise program to prevent injuries in the hip and/or groin.
Bakgrund: Höft och ljumsksmärta är vanligt inom ishockey och främst hos målvakterna eftersom deras rörelsemönster gör dem extra utsatta. ”Skridsko mot stolpe-tekniken” (SMS-tekniken) är en relativt ny teknik som målvakter använder och inga studier har i nuläget publicerats där den studerats och hypotesen är att höften utsätts för stora påfrestningar vilket kan leda till höft/ljumsksmärta. Syfte: Syftet med studien var att undersöka prevalensen av höft/ljumsksmärta hos manliga ishockeymålvakter på elitnivå i Sverige samt om faktorer som grad av SMS-teknikanvändande och förebyggande träning kunde kopplas samman med den smärtan samt om målvakterna var oroliga för att skada sig. Metod: Deskriptiv och komparativ tvärsnittsstudie som bestod av en webbaserad enkät som distribuerades till 94 målvakter och där 57 % deltog. Resultat: Totalt 63 % hade ont i höft/ljumske varje månad eller oftare. Över hälften av målvakterna följde ett specifikt träningsprogram och en signifikant skillnad i smärtprevalens kunde ses mellan dem och de som inte följde ett träningsprogram, p=0,01. De flesta var mer eller mindre oroliga för att skada sig i höft/ljumske. Ingen signifikant skillnad i smärtförekomst kunde ses vid olika grader av SMS-teknikanvändande. Konklusion: Många målvakter hade höft/ljumsksmärta och de som hade ont följde i högre grad ett specifikt träningsprogram för att förebygga skador.

Abstract Decreased adductor muscle strength has been shown to be a risk factor for the development of future groin injury. The purpose of this study was therefore to examine standard values of isometric adductor muscle strength in Swedish male soccer and to map any differences in muscle strength between non-injured players and previously injured players. Twenty-one male soccer players were included in the study. A handheld dynamometer was used to record maximal isometric adductor muscle strength. The average value for isometric adductor muscle strength for all included players was 2,709 N/kg [± 0,37 SD]. Average values for non-injured and previously injured players were 2,716 N/kg [± 0,41 SD] and 2,537 N/kg [± 0,25 SD] respectively. The average value for the contralateral, non-injured side within the previously injured players was 2,86 N/kg [± 0,43 SD]. The difference in muscle strength between previously injured players and non-injured players was not statistically significant (p = .162). Conversely the difference between the non-injured side and the injured side in previously injured players was statistically significant (p = .018). Future studies should focus on including players of different levels to conclude whether the differences observed in this study is present regardless of the level of play.

Title The issue of groin injuries and risk factors affecting this type of injuries among football players. Objectives The main objective of this thesis is to summarize theoretical findings regarding the groin injuries among soccer players and to prove efficiency of preventive training program aimed at reduction of groin injuries incidence in soccer players. Methods The theoretical part deals with the given issue as a research and theoretical overview of the current findings, based on Czech and especially foreign literature. Findings of theoretical part were obtained by foreign periodicals, monographies and electronic database, mostly PubMed and PEDro. In the second part of thesis a preventive training program was applied at a specific group of soccer players (n=42) in age U16 (n=20) and U17 (n=22). Selected group of probands performed preventive intervention training once a week for 6 months. After that results were compared with the same time of season in the previous year, when no preventive measures had been taken. Information about previous injury has been obtained by non-standardized questionnaire. Results Based on the literature review previous injury is considered to be the most significant risk factor for new injury in groin. Other significant risk factors include untimely return to...

A prospective study was performed in order to examine the relationship of internal hip rotation to groin pain in Australian Rules Football players. 101 subjects were tested using a plurimeter placed on the lateral aspect of the tibia whilst lying prone on a plinth. Subjects were tested twice at an interval of six weeks and episodes of groin pain that occurred between the first and second testing dates were recorded. This study may have implications for the treatment and prevention of groin injuries in the athletic population and in particular Australian Rules Football players. This minor thesis was written by post-graduate students as part of the requirements of the Master of Health Science (Osteopathy) program.