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SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Gilmore’s groin is a syndrome of groin disruption. Patients present with chronic pain, which is aggravated by sudden and twisting movements. Commonly known as the ‘sportsman’s hernia’ or ‘athletic pubalgia’. In general, there is no associated lump.
The impact of nonoperative hip and core injuries on National Football League athlete performance
Published in The Physician and Sportsmedicine, 2023
Joseph S. Tramer, Toufic R Jildeh, Joshua P Castle, Patrick Buckley, Caden Nowak, Kelechi R. Okoroha
Hip and core injuries in the NFL account for approximately 10% of NFL injuries; the majority are classified as muscle strains [9,10]. In fact, hip flexor strains occurred 268 times over a 10 year period in the NFL, and were the most common hip injury [10]. Football players are particularly vulnerable to core injuries such as rib fractures or contusions, back stiffness as well as abdominal/oblique strains, and athletic pubalgia due to the physical nature of the game [11,12]. Prior studies have examined the effect of surgical intervention on groin injuries, showing that operative intervention for athletic pubalgia led to significantly shorter career length and games per season compared to matched controls [13]; however, the impact of nonoperative hip and core injuries on NFL player performance has not been elucidated.
Adductor injuries in the National Basketball Association: an analysis of return to play and player performance from 2010 to 2019
Published in The Physician and Sportsmedicine, 2020
Bhavik H. Patel, Kelechi R. Okoroha, Toufic R. Jildeh, Yining Lu, James D. Baker, Benedict U. Nwachukwu, Mitchell G. Foster, Answorth A. Allen, Brian Forsythe
Although a large number of studies have reported epidemiological and return to sport data following groin injuries, very few studies have examined the implications of the injury on performance. In a retrospective review of 57 National Football League (NFL) players who underwent operative intervention and rehabilitation of athletic pubalgia, Jack et al. found no statistically significant differences in performance between those with athletic pubalgia and control players [45]. Furthermore, in a retrospective review of 330 MLB pitchers placed on the disabled list, Marshall et al. [14] found a negligible effect of hip injury on performance – starting pitchers lost only 0.8 mph of velocity on average (90.5 vs 91.3 mph, P = 0.005), which the authors attributed to deconditioning, and relief pitchers experienced no change in pitch velocity (92.3 mph vs. 91.8 mph, P = 0.490). Similarly, in the present investigation, we found that adductor injury did not significantly affect player performance following injury. This suggests a high healing rate of adductor injuries and the ability of players to make a complete recovery following treatment of the injury. Current PT regimens emphasize an active training program directed at strengthening and conditioning of muscles, which has been independently shown to be effective in treating and preventing groin strain in professional athletes [7,12,43,46–48]. In the NBA, training protocols commonly include exercises for flexibility development and plyometrics, as well as Olympic-style lifts [43].
Management of a nonathlete with a traumatic groin strain and osteitis pubis using manual therapy and therapeutic exercise: A case report
Published in Physiotherapy Theory and Practice, 2020
Kyle Feldman, Carla Franck, Christine Schauerte
The rectus abdominis, adductor longus, adductor magnus, adductor brevis, and gracilis are also reported as the sources of groin pain in at least 10% of cases (Hölmich et al., 2014; Serner et al., 2015). Typical diagnosis is based on palpation of the muscle region and resisted muscle activation (Brix, Lohrer, and Hoeferlin, 2013; Hölmich et al., 2014). When the injured muscle is unknown, “athletic pubaglia”, sometimes referred to as “groin disruption” is the medical diagnosis typically given. Athletic pubalgia is described as posterior abdominal wall weakening and the conjoined tendon separates, without evidence of a hernia on imaging or a palpable defect (Garvey and Hazard, 2014; Sheen et al., 2014). Pain occurs with exertion, Valsalva’s maneuver, resisted hip adduction, pressure, and a partial sit up, but not with coughing or sneezing (Meyers et al., 2000; Morelli and Smith, 2001). Outcomes for return to pre-injury level often require surgical repair due to poor outcomes reported with conservative management (Elattar, Choi, Dills, and Busconi, 2016; Morelli and Smith, 2001).