15
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Groin Injuries (Athletic Pubalgia) and Return to Play

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Context:

          Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures. A variety of surgical options have been used, and most patients improve and return to high-level competition.

          Evidence Acquisition:

          PubMed databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms groin pain, sports hernia, athletic pubalgia, adductor strain, osteitis pubis, stress fractures, femoroacetabular impingement , and labral tears.

          Study Design:

          Clinical review.

          Level of Evidence:

          Level 4.

          Results and Conclusion:

          Athletic pubalgia is an overuse injury involving a weakness in the rectus abdominis insertion or posterior inguinal wall of the lower abdomen caused by acute or repetitive injury of the structure. A variety of surgical options have been reported with successful outcomes, with high rates of return to the sport in the majority of cases.

          Related collections

          Most cited references85

          • Record: found
          • Abstract: found
          • Article: not found

          Femoroacetabular impingement: a cause for osteoarthritis of the hip.

          A multitude of factors including biochemical, genetic, and acquired abnormalities may contribute to osteoarthritis of the hip. Although the pathomechanism of degenerative process affecting the dysplastic hip is well understood, the exact pathogenesis for idiopathic osteoarthritis has not been established. Based on clinical experience, with more than 600 surgical dislocations of the hip, allowing in situ inspection of the damage pattern and the dynamic proof of its origin, we propose femoroacetabular impingement as a mechanism for the development of early osteoarthritis for most nondysplastic hips. The concept focuses more on motion than on axial loading of the hip. Distinct clinical, radiographic, and intraoperative parameters can be used to confirm the diagnosis of this entity with timely delivery of treatment. Surgical treatment of femoroacetabular impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. It is proposed that early surgical intervention for treatment of femoroacetabular impingement, besides providing relief of symptoms, may decelerate the progression of the degenerative process for this group of young patients.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The association football medical research programme: an audit of injuries in professional football.

            To undertake a prospective epidemiological study of the injuries sustained in English professional football over two competitive seasons. Player injuries were annotated by club medical staff at 91 professional football clubs. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status. A total of 6,030 injuries were reported over the two seasons with an average of 1.3 injuries per player per season. The mean (SD) number of days absent for each injury was 24.2 (40.2), with 78% of the injuries leading to a minimum of one competitive match being missed. The injury incidence varied throughout the season, with training injuries peaking during July (p<0.05) and match injuries peaking during August (p<0.05). Competition injuries represented 63% of those reported, significantly (p<0.01) more of these injuries occurring towards the end of both halves. Strains (37%) and sprains (19%) were the major injury types, the lower extremity being the site of 87% of the injuries reported. Most injury mechanisms were classified as being non-contact (58%). Re-injuries accounted for 7% of all injuries, 66% of these being classified as either a strain or a sprain. The severity of re-injuries was greater than the initial injury (p<0.01). Professional football players are exposed to a high risk of injury and there is a need to investigate ways of reducing this risk. Areas that warrant attention include the training programmes implemented by clubs during various stages of the season, the factors contributing to the pattern of injuries during matches with respect to time, and the rehabilitation protocols employed by clubs.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

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

              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.
                Bookmark

                Author and article information

                Journal
                Sports Health
                Sports Health
                SPH
                spsph
                Sports Health
                SAGE Publications (Sage CA: Los Angeles, CA )
                1941-7381
                1941-0921
                14 June 2016
                July 2016
                1 July 2017
                : 8
                : 4
                : 313-323
                Affiliations
                []Orthopaedic Sports Medicine, University of Massachusetts, Worcester, Massachusetts
                []Director of Clinical Services, Physical Therapy Innovations, Auburn, Massachusetts
                Author notes
                [*] [* ]Brian Busconi, MD, Chief of Sports Medicine, Department of Orthopaedic Surgery, University of Massachusetts, 281 Lincoln Street, Worcester, MA 01605 (email: brian.busconi@ 123456umassmemorial.org ).
                Article
                10.1177_1941738116653711
                10.1177/1941738116653711
                4922526
                27302153
                bb793569-2bf8-4b7a-8803-08e7f7209daf
                © 2016 The Author(s)
                History
                Categories
                Focus Topic: Evidence for Return to Sports
                Custom metadata
                July/August 2016

                Sports medicine
                groin,pain,hip,athletic pubalgia (ap),differential diagnosis,surgical treatment,return to sports

                Comments

                Comment on this article