Managing Hip and Groin Pain in Athletes: A Chiropractic Approach
Hip and groin pain (HGP) is common in field sports characterized by repetitive kicking, accelerations, decelerations, jumps, and changes of direction
During a competitive season, groin problems are reported by over 59% of male soccer players and 45% of female soccer players
The most commonly reported sports injuries in soccer games are hamstring injuries and groin pain
What is groin pain?
groin pain was classified at the Doha Consensus Conference as adductor muscle-related pain, iliopsoas muscle-related pain, groin-related pain, pubis-related pain, and hip-related pain
The adductor muscles often cause such pain, and 61% of patients are reported to have adductor muscle-related pain
Elite female players had a 3-times lower risk of reporting groin problems as compared with elite male players
A condition , known as femoracetabular impingement may cause hip pain: Femoroacetabular impingement (FAI) syndrome is defined as a motion-related clinical hip disorder with a triad of hip/groin pain, clinical signs, and imaging findings of cam and/or pincer morphology.
Restricted hip ROM, particularly internal rotation, is a key clinical sign associated with the diagnosis of FAI syndrome
What goes wrong with athletes?
Reduced hip adductor strength has been identified as the principal intrinsic factor associated with hip and groin pain in male adult soccer players.
In pre-season testing, hip adductor strength was up to 5.4% weaker in players with previous-season groin pain than in those without
Female players, with current longstanding hip and groin pain, exhibited higher abductor isometric strength and lower adductor/abductor ratio compared to non-injured women players
Research investigated the relationship between the presence of hip/groin pain and hip ROM in amateur soccer and Australian Rules football players.
Hips with hip/groin pain and cam morphology (ie, hips fitting the definition of FAI syndrome ) were found to have lower internal rotation ROM than asymptomatic hips with cam morphology.
What treatments may help?
Adduction exercise, which utilizes centrifugal contraction of the adductor muscles, has been reported with good results in semi-professional and male high school soccer player
Players using the Copenhagen Adductor Strengthening Program, hip adductor strength training reduced groin injury rates by 41%
What Chiropractors will focus on is , activating the adductors and GLut Max muscles , realigning the hips to allow proper function and posture to allow the muscle to expand and contract correctly
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Jaenada-Carrilero E, Baraja-Vegas L, Blanco-Giménez P, Gallego-Estevez R, Bautista IJ, Vicente-Mampel J. Association between Hip/Groin Pain and Hip ROM and Strength in Elite Female Soccer Players. J Clin Med. 2024 Sep 23;13(18):5648. doi: 10.3390/jcm13185648. PMID: 39337134; PMCID: PMC11433419.
Mosler AB, Heerey JJ, Kemp JL, Semciw AI, King MG, Agricola R, Lawrenson PR, Scholes MJ, Mentiplay BF, Crossley KM. Relationship Between Hip and Groin Pain and Hip Range of Motion in Amateur Soccer and Australian Rules Football Players. Orthop J Sports Med. 2024 Oct 25;12(10):23259671241277662. doi: 10.1177/23259671241277662. PMID: 39492872; PMCID: PMC11529365.
Fujisaki K, Yokoyama D, Yokoyama M, Otani T, Seino K, Hall T, Akasaka K. Predicting the occurrence of in-season groin pain in male high school soccer players: a cohort study. J Phys Ther Sci. 2024 Aug;36(8):452-456. doi: 10.1589/jpts.36.452. Epub 2024 Aug 1. PMID: 39092415; PMCID: PMC11290856.
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