Long-Standing Adductor-Related Groin Pain

BACKGROUND: Adductor-related groin pain (ARGP) is the most common groin injury in athletes. If conservative treatment fails, then adductor tenotomy to relieve tension can be considered. The use of botulinum toxin A (BoNT-A) has shown good results in other musculoskeletal pathologies. OBJECTIVE: Assess the effectiveness of BoNT-A injections in ARGP in cases where usual treatment has failed. DESIGN: Retrospective cohort study. SETTING: Orthopedic Medicine and Rehabilitation Unit, University of Bordeaux...

Adductor-related groin pain is a common problem in sports. Evidence-based management of athletes with adductor strains, adductor ruptures, and long-standing adductor-related groin pain can be approached in a simple yet effective and individualized manner. In most cases, managing adductor-related pain in athletes should be based on specific exercises and loading strategies. In this article, I provide an overview of the different types of adductor injuries, from acute to overuse, including their underlying pathology, functional anatomy, diagnosis, prognosis, mechanisms, and risk factors...

BACKGROUND: Groin pain is a very common injury in multidirectional sports such as soccer, ice hockey, rugby and Australian football. Long-standing adductor-related groin pain is a persistent clinical condition and a frequent complaint in athletes involved in sports that require multiplanar movement patterns (change of direction, high-speed sprinting and kicking). To date, the lack of rehabilitation guidelines and return-to-play criteria makes this clinical entity difficult to manage. The aim of the present Delphi was to suggest, based on opinion and practical experience of a panel of experts, potential criteria that could be taken into consideration by clinicians in the RTP decision-making process in athletes suffering from long-standing adductor-related groin pain...

BACKGROUND: Long-standing groin pain syndrome (LSGPS) is a form of groin pain syndrome in which the cohort of symptoms reported by patients is experienced for a long period, typically for over 12 weeks, and is recalcitrant to any conservative therapy. The aim of this prospective epidemiological study was to describe the clinical causes of LSGPS in 37 female athletic subjects in Italy through the Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athletes classification and guidelines...

OBJECTIVES: We aimed to prospectively evaluate the prevalence of long-standing groin pain and related MRI findings in contact sports. METHODS: This case-control study followed three male elite-level soccer, ice-hockey and bandy teams (102 players) for 2 years. All athletes with long-standing groin pain lasting >30 days and age-matched controls (1:3) from the same teams were examined clinically, using pelvic MRI and Hip and Groin Outcome Scores (HAGOS). Primary outcome measures were annual prevalence of groin pain and underlying MRI findings...

Aim: To objectively evaluate the effect of Holmich protocol-based exercise therapy on long-standing adductor-related groin pain (LSAGP). Methods: We reproduced the Holmich protocol of exercise therapy and objectively evaluated its effect on 17 male athletes (mean age, 25.07±4.96 years) suffering from LSAGP, of whom 14 participants completed the 10 weeks treatment period. The study was designed as a single-blinded, before-and-after clinical trial. Main outcome measures included pain, functional ability, hip range of motion (ROM), hip abductor and adductor muscle strength, and successful return to sports activity...

OBJECTIVE: The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. DESIGN: The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26...

OBJECTIVE: The association between groin pain and range of motion is poorly understood. The aim of this study was to develop a test to measure sport specific range of motion (SSROM) of the lower limb, to evaluate its reliability and describe findings in non-injured (NI) and injured football players. DESIGN: Case-controlled. SETTING: 6 Dutch elite clubs, 6 amateur clubs and a sports medicine practice. PARTICIPANTS: 103 NI elite and 83 NI amateurs and 57 football players with unilateral adductor-related groin pain...

OBJECTIVES: To describe a multi-dimensional MRI assessment approach with a focus on acute musculotendinous groin lesions, and to evaluate scoring reproducibility. METHODS: Male athletes who participated in competitive sports and presented within 7 days of an acute onset of sports-related groin pain were included. All athletes underwent MRI (1.5 T) according to a standardized groin-centred protocol. From several calibration sessions, a system was developed assessing grade, location and extent of muscle strains, peri-lesional haematoma, as well as other non-acute findings commonly associated with long-standing groin pain...

The doctoral thesis is based on eight papers published in peer-reviewed journals and a review of the literature. The papers are published between 1997 and 2013 in cooperation with Sankt Elisabeth Hospital, Herlev Hospital, Glostrup Hospital, Rigshospitalet, Hvidovre Hospital, Amager Hospital, Copenhagen Trial Unit, and Institute of Preventive Medicine, Copenhagen. Groin injuries in sport are very common and in football they are among the most common and most time-consuming injuries. These injuries are treated very differently around the world...

AIM: To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. METHODS: PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review...

BACKGROUND: Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint-, adductor-, pubic bone stress injury-, iliopsoas-, or abdominal wall-related pathology. However, their prevalence patterns and coexistence in an active population are unclear. PURPOSE: This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region...

BACKGROUND: Soccer players are commonly affected by long-standing adductor-related groin pain (ARGP), but the clinical significance of MRI findings in these athletes is largely unknown. Our aims were (1) to evaluate whether MRI findings are associated with long-standing ARGP in soccer players, (2) to assess MRI findings in asymptomatic soccer players and non-soccer playing controls. METHODS: This cross-sectional study included 28 male soccer players with long-standing ARGP, 17 male asymptomatic soccer players and 20 male asymptomatic non-soccer playing athletes of matching age and athletic exposure...

Long-standing symphyseal and adductor-related groin pain is a common problem for many athletes, and requires a multidisciplinary approach. Radiological evaluation of symptomatic individuals is a cornerstone in the diagnostic workup, and should be based on precise and reliable diagnostic terms and imaging techniques. The authors performed a review of the existing original evidence-based radiological literature involving radiography, ultrasonography and MRI in athletes with long-standing symphyseal and adductor-related groin pain...

BACKGROUND: The treatment of exercise-related injuries is often a problem, and recurrent injuries are common. Two recent systematic reviews found only one high-quality paper on the treatment of long-standing groin pain. In this randomized clinical trial, a training program including strength training resulted in a return of 79% of the athletes to the previous level of sport without any groin pain. The long-term effect of this exercise program was evaluated. HYPOTHESIS: The effect of the exercise program for adductor-related groin pain is long lasting...

HYPOTHESIS: A multi-modal treatment program (MMT) is more effective than exercise therapy (ET) for the treatment of long-standing adductor-related groin pain. STUDY DESIGN: Single blinded, prospective, randomised controlled trial. PATIENTS: Athletes with pain at the proximal insertion of the adductor muscles on palpation and resisted adduction for at least two months. INTERVENTIONS: ET: a home-based ET and a structured return to running program with instruction on three occasions from a sports physical therapist...

OBJECTIVE: A decreased range of motion (ROM) of the hip joint is known to predispose to athletic groin injury. Femoroacetabular impingement (FAI) of the hip leads to a reduced ROM. This study examined the prevalence of radiological signs of FAI in patients presenting with long-standing adductor-related groin pain (LSARGP). DESIGN: Prospective case series. SETTING: Outpatient Sports Medicine Department. PATIENTS: 34 athletes with LSARGP defined as pain on palpation of the proximal insertion of adductor muscle and a painful, resisted adduction test...

BACKGROUND: Groin pain remains a major challenge in sports medicine. AIM: To examine 207 consecutive athletes (196 men, 11 women) with groin pain using a standardised and reliable clinical examination programme that focused on signs that suggest pathology in (1) the adductors, (2) the ilopsoas and (3) the rectus abdominis. PATIENTS AND METHODS: Most patients were football players (66%) and runners (18%). In this cohort, the clinical pattern consistent with adductor-related dysfunction, was the primary clinical entity in 58% of the patients and in 69% of the football players...

BACKGROUND: Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-related groin pain in athletes. METHODS: 68 athletes with long-standing (median 40 weeks) adductor-related groin pain--after examination according to a standardised protocol--were randomly assigned to AT or PT...