SBA Answers and Explanations
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury in SBAs for the MRCS Part A, 2018
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.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
Groin pain is common in sporting activities that involve kicking, quick sprinting, change of direction and cutting swiftly as in hockey, soccer and basketball. Athletic pubalgia (AP) is a commonly used term that is broadly defined as pain in the groin and pubic region. However, groin pain in athletes was the preferred umbrella term (using specific defined clinical entity) ahead of other such as athletic pubalgia, athletic groin pain, sports groin pain, athlete’s groin because it is clearly descriptive based on the Doha agreement meeting on terminology and definitions in groin pain in athletes 2015 [1]. Groin pain can occur in both male and female athletes but it is more prone to male. Campanelli [2] suggests that males are at an increased risk of groin pain as females have a wider and larger subpubic angle and stronger rectus abdominis attachments at the symphysis pubis. The larger and wider pelvis biomechanically dissipates forces away from the pubic symphysis and groin region, thus reducing the incidence in females. There is no dearth of literature describing groin pain and its various causes, however, largely this condition is poorly defined and poorly understood due to unclear aetiopathology. This lack of understanding is further compounded due to the involvement of multiple structures posing a clinical challenge. Therefore, only using traditional methods (without using instrumental diagnosis) of examination and assessment may mislead the clinician and result in failed treatment. Garvey et al. [3] and Balconi [4] suggest the following causes for groin pain as shown in Table 1.
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).
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].
Related Knowledge Centers
- Inguinal Canal
- Pubic Symphysis
- Pubic Tubercle
- Supine Position
- Pathology
- Magnetic Resonance Imaging
- Post Herniorraphy Pain Syndrome
- ADDuctor Muscles of The Hip
- Aponeurosis of The Abdominal External Oblique Muscle
- Conjoint Tendon