Groin Pain Rehabilitation
Groin pain is a common complaint in athletes and active populations as well as a common source of frustration. What makes it so frustrating is the poor understanding of proper management because of the number complexities related to the true cause of groin pain.
15% of all injuries responsible for competition time lost in hockey players is due to groin pain from common conditions such as groin strain, femoral acetabular impingement (FAI), labral tears, and sports hernia.
Sports hernia is one of the most difficult causes of chronic groin pain to identify and manage. Sports hernia is a weakness and/or injury to the abdominal wall and supporting musculature which can result in groin pain. The difficulty in diagnosis lies the fact that most sports hernias do not produce a palpable hernia and are not seen on advanced medical imaging such as radiograph, ultrasound, MRI, or CT. Surgical exploration is generally the most excepted method in producing a definitive diagnosis of sports hernia after other potential sources of groin pain have been eliminated.
Diagnostic methods in determining the presence of sports hernia may include the identification of five classic signs and symptoms:
- Complaint of deep groin/lower abdominal pain,
- Exacerbation of pain with participation of sport activities that is relieved by rest,
- Tenderness with palpation of the pubic ramus,
- Pain with resisted hip adduction,
- Pain with resisted sit-up test
Surgical intervention has been shown to be an effective method, both in the short-term and long-term, for the management of sports hernia while little is understood about the long-term effects of conservative, non-surgical treatment of this condition.
This model will be vital for proper progression through treatment and functional training prior to return to sport. Rehabilitation must address underlying functional deficits of the core and hips while building a foundation of movement control and awareness necessary for the future development of strength, speed, and power.
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