Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 207 patients
- 29 January 2007
- journal article
- research article
- Published by BMJ in British Journal of Sports Medicine
- Vol. 41 (4), 247-252
- https://doi.org/10.1136/bjsm.2006.033373
Abstract
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. Iliopsoas-related dysfunction was the primary clinical entity in 36% of the patients. Rectus abdominis-related dysfunction was found in 20 (10%) patients but it was associated with adductor-related pain in 18 of these patients. Multiple clinical entities were found in 69 (33%) patients; of these, 16 patients had three clinical entities. Conclusions: These descriptive data extend previous findings that physical examination for groin pain can be reliable. While underscoring the prevalence of adductor-related physical examination abnormality in football players, the data highlight the prevalence of examination findings localising to the iliopsoas among this cohort. Also, the fact that combinations of clinical entities were present has important implications for treatment. The finding of multiple abnormal clinical entities also raises the possibility that earlier presentation may be prudent; it is tempting to speculate that one clinical entity likely precedes other developing entities. These data argue for the need for a trial where clinical entities are correlated with systematic investigation including MRI and ultrasonography.This publication has 62 references indexed in Scilit:
- “Sports” hernia: treatment with biologic mesh (Surgisis)Surgical Endoscopy, 2006
- Osteitis Pubis and Assessment of Bone Marrow Edema at the Pubic Symphysis With MRI in an Elite Junior Male Soccer SquadClinical Journal of Sport Medicine, 2006
- Core Stability Measures as Risk Factors for Lower Extremity Injury in AthletesMedicine & Science in Sports & Exercise, 2004
- Hip Adductor Injury in Competitive SwimmersThe American Journal of Sports Medicine, 2004
- Pelvic stress injuries: the relationship between osteitis pubis (symphysis pubis stress injury) and sacroiliac abnormalities in athletesSkeletal Radiology, 1997
- 'Gilmore's groin'--or is it?British Journal of Sports Medicine, 1995
- Abdominal Wall Muscle Tears in Hockey PlayersInternational Journal of Sports Medicine, 1995
- Sports tumorsThe American Journal of Sports Medicine, 1987
- Infectious osteitis pubisUrology, 1978
- Lesions of the Symphysis in AthletesBMJ, 1974