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      'Treatment of the sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference.

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          Abstract

          The aim was to produce a multidisciplinary consensus to determine the current position on the nomenclature, definition, diagnosis, imaging modalities and management of Sportsman's groin (SG).

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          Most cited references37

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          Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial.

          Per Hölmich, Pernille Uhrskou, Lisbeth Ulnits … (1999)
          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. 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. The treatment period was 8-12 weeks. 4 months after the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome measure was full return to sports at the same level without groin pain. Analyses were by intention to treat. 23 patients in the AT group and four in the PT group returned to sports without groin pain (odds ratio, multiple-logistic-regression analysis, 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p=0.006) linear trend towards a better effect in the AT group. A per-protocol analysis did not show appreciably different results. AT with a programme aimed at improving strength and coordination of the muscles acting on the pelvis, in particular the adductor muscles, is very effective in the treatment of athletes with long-standing adductor-related groin pain. The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, clinical trials.
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            Exercise program for prevention of groin pain in football players: a cluster-randomized trial.

            P Hölmich, Junilla Larsen, K Krogsgaard … (2010)
            Groin injuries cause major problems in sports and particularly in football. Exercise is effective in treating adductor-related groin pain, but no trials have been published regarding the specific prevention of groin pain or prevention specifically targeting overuse injuries in sport using exercise programs. We performed a cluster-randomized trial including 55 football clubs representing 1211 players. The clubs were randomized to an exercise program aimed at preventing groin injuries (n=27) or to a control group training as usual (n=28). The intervention program consisted of six exercises including strengthening (concentric and eccentric), coordination, and core stability exercises for the muscles related to the pelvis. Physiotherapists assigned to each club registered all groin injuries. Twenty-two clubs in each group completed the study, represented by 977 players. There was no significant effect of the intervention (HR=0.69, 95% CI 0.40-1.19). The risk of a groin injury was reduced by 31%, but this reduction was not significant. A univariate analysis showed that having had a previous groin injury almost doubles the risk of developing a new groin injury and playing at a higher level almost triples the risk of developing a groin injury.
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              Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman's hernia (athletic pubalgia).

              Hannu Paajanen, Tuomas Brinck, Heikki Hermunen … (2011)
              Chronic groin pain in athletes presents often a diagnostic and therapeutic challenge. Sportsman's hernia (also called "athletic pubalgia") is a deficiency of the posterior wall of the inguinal canal, which is often repaired by laparoscopic mesh placement. Endoscopic mesh repair may offer a faster recovery for athletes with sportsman's hernia than nonoperative therapy.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Br J Sports Med
                Title: British journal of sports medicine
                ISSN (Electronic): 1473-0480
                ISSN (Print): 0306-3674
                Publication date (Electronic): Jul 2014
                Volume: 48
                Issue: 14
                Affiliations
                [1 ] Department of Surgery, Central Manchester Foundation Trust, Manchester Royal Infirmary, Manchester, UK.
                [2 ] Department of Surgery, Royal Gwent Hospital, Newport, UK.
                [3 ] Department of Surgery, Leicester General Hospital, Leicester, UK.
                [4 ] Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Chapel Allerton Hospital, Leeds, UK.
                [5 ] Department of Sports Medicine, Blackburn Rovers STC, Blackburn, UK.
                [6 ] Department of Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
                [7 ] Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
                [8 ] Department of Surgery, Derriford Hospital, Plymouth, UK.
                [9 ] Department of Surgery, Gilmore Groin and Hernia Clinic, London, UK.
                [10 ] Department of Surgery, Royal Bournemouth Hospital, Bournemouth, UK.
                [11 ] Department of Surgery, Western Infirmary, Glasgow, UK.
                [12 ] Department of Surgery, London Hernia Centre, London, UK.
                Article
                Publisher Item ID: bjsports-2013-092872
                DOI: 10.1136/bjsports-2013-092872
                PubMed ID: 24149096
                SO-VID: a980b6c4-cce6-47ab-b8b8-29af807e7aee
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
                History

                Keywords: Groin injuries
                Data availability:
                Keywords: Groin injuries

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