Podcast
Questions and Answers
What is a red flag that may indicate the need for further investigation in an athlete with groin pain?
What is a red flag that may indicate the need for further investigation in an athlete with groin pain?
Why are adolescent athletes more at risk of avulsion fractures?
Why are adolescent athletes more at risk of avulsion fractures?
What is included in the physical evaluation of the groin?
What is included in the physical evaluation of the groin?
What is the purpose of the Doha agreement meeting?
What is the purpose of the Doha agreement meeting?
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What may indicate movement restrictions in an athlete with groin pain?
What may indicate movement restrictions in an athlete with groin pain?
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What should be included in the objective assessment of an athlete with groin pain?
What should be included in the objective assessment of an athlete with groin pain?
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What is the limitation of clinical hip testing?
What is the limitation of clinical hip testing?
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What is challenging to diagnose using only clinical tests?
What is challenging to diagnose using only clinical tests?
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What is the main challenge in managing groin pain in athletes?
What is the main challenge in managing groin pain in athletes?
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What is the recommended approach to rehabilitation in athletic groin pain (AGP)?
What is the recommended approach to rehabilitation in athletic groin pain (AGP)?
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During subjective assessment, what should practitioners identify?
During subjective assessment, what should practitioners identify?
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What is the goal of exercise therapy in managing AGP?
What is the goal of exercise therapy in managing AGP?
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What is a limitation of current research on exercise interventions for AGP?
What is a limitation of current research on exercise interventions for AGP?
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What is the main reason for the complexity of groin pain management?
What is the main reason for the complexity of groin pain management?
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What is the expected outcome of an active approach to rehabilitation in AGP?
What is the expected outcome of an active approach to rehabilitation in AGP?
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What is essential in the development of a treatment plan for AGP?
What is essential in the development of a treatment plan for AGP?
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What is the primary purpose of the lumbar spine and SIJ screening tests in assessing groin pain?
What is the primary purpose of the lumbar spine and SIJ screening tests in assessing groin pain?
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What is a common characteristic of groin pain?
What is a common characteristic of groin pain?
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What is the most appropriate imaging modality for investigating inguinal-related groin pain?
What is the most appropriate imaging modality for investigating inguinal-related groin pain?
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What is the purpose of the thigh thrust test in assessing groin pain?
What is the purpose of the thigh thrust test in assessing groin pain?
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What is a limitation of using Computed Tomography (CT) in assessing youth athletes with groin pain?
What is a limitation of using Computed Tomography (CT) in assessing youth athletes with groin pain?
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What is the name of the clinical test described as a 5-m sprint with 75° cut and 5-m sprint finish?
What is the name of the clinical test described as a 5-m sprint with 75° cut and 5-m sprint finish?
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Study Notes
Red Flags and Referral
- Red flags include history of fever, trauma, unexplained weight loss, night pain, painful urination, and prolonged corticosteroid use
- Red flags coupled with a history of prostate or reproductive organ cancer and abdominal and pelvic organ disorders warrant referral to relevant specialists for further investigation
Assessment
- Physical evaluation of the groin requires a thorough clinical examination, including palpation, pain provocation, joint ROM assessment, muscular strength, and sport-specific function
- The Doha agreement meeting provides a framework to assess and diagnose groin pain according to the location of pain on palpation or provocation
- Objective assessment should include passive range of motion and hip special tests, such as flexion-abduction-external rotation (FABER) and flexion-adduction-internal rotation (FADIR) test
Groin Related Disorders
- Groin pain remains a challenging sports injury to manage due to complex regional anatomy and limited consensus among researchers
- Clinicians consider the groin the ‘Bermuda Triangle’ of sports medicine due to the complexity of the underlying pathology and intricate regional anatomy
Conservative Management
- Practitioners approach conservative AGP management with massage, mobilization, electrotherapy, and exercise interventions
- An active approach to rehabilitation, including supervised physical training, results in a higher successful return to play (RTP)
Assessment (continued)
- Subjective assessment should identify red flags, and timed 10-m cutting sprint or T-agility test can be used to assess groin pain
- Lumbar spine and SIJ screening tests, such as the thigh thrust test, can rule out discogenic or radiculopathy pathology of the lumbar spine and SIJ pathology
Differential Diagnosis
- Groin pain can be multifactorial, including strains of muscles attaching to the pelvic girdle, bony injury to the pelvic girdle, the inguinal canal or hip, and lumbar spine pathology
- Imaging may be helpful for acute groin pain, with MRI being slightly more sensitive than ultrasound for acute groin injuries and indicated for adductor-, pubic-, and hip-related groin pain
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Description
Identify red flags and health risks in athletes, including cancer, trauma, and steroid use. Know when to refer to specialists and consider age, sport, and level of participation.