Everybody's Talking about Groin Pain – Some Hard Facts and Preventive Approaches

Groin pain becomes more and more the focus of attention in the last couple of years in competitive sports [3], especially in sports requiring immediate changes in direction, repetitive kicking and rotational movements [1, 5]. Common sport activities dealing with groin pain are football/soccer, ice hockey, rugby [2], fencing, cross country skiing and hurdling [3]. Provided information concerning percentage of groin pain among sport-induced injuries varies, from 2 to 5% [4] up to 5 to 18% [3] of all athletic injuries, with the adductor muscle tendon region as the most common reported location (> 50%) of groin pain [2]. Groin pain ranks only behind knee, anterior cruciate ligament injuries and bone fractures concerning absence from sports [3]. Pathology/Pathophysiology is vaguely designed, most of the time with a multi- factorial cause of pain [4] and various involved anatomical structures [3], underlying the importance of a high quality clinical examination and further differential diagnosis. If there is a good understanding of the athletes at risk, prevention strategies may be effectively developed. Previous injuries, age, gender, sports experience, hip range of motion and an unbalanced hip abduction adduction strength ratio need to be mentioned as risk factors for groin pain and groin injuries and some of them may be modifiable to prevent injuries by implemented prevention strategies [2]. Holistically seen sport- specific prevention strategies to decrease the risk of groin injuries need to implicate adequate rehabilitation for previous injuries, recognizing deficits in sport specific range of motion and strength, as well as muscle timing of recruitment requirements [2]. An expert team including physiotherapists, musculoskeletal radiologists and surgeons advises to emphasize the stabilizing role of the little noticed internal obliques, transversus abdominis, gluteals and adductors in terms of functional movement and postures [5]. The hold lecture will give a literary overview of preventive strategies and their potentials.

References:

[1] ALMEIDA et al.: Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain (Review). The Cochrane Library, 2013, 6.

[2] HÖLMICH et al.: Preventing groin injuries. In: Handbook of Sports Medicine and Science. Sports Injury Prevention. Bahr & Engebretsen (Edt.), 2009, 91 – 113.

[3] KINCHINGTON: Groin pain: a view from below. Aspetar Sports Medicine Journal, 2013, 2 (3).

[4] SEDAGATHI et al.: Review of Sport-Induced Groin Injuries. Trauma Monthly, 2013, 18 (3).

[5] SHEEN et al.: ‘Treatment of the Sportman's groin’: British Hernia Society's 2014 position statement based on the Manchester Consensus Conference. British Journal of Sports Medicine, 2014, 48.