Groin pain is complex!

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06 JUL

Groin pain is complex!

By Dean Phelps on Wednesday, 6th of July    Tag: Groin Pain, Osteitis Pubis, Physio for groin injury,

Why you need a trained and experienced therapist in dealing with groin related pain and injury.

Groin Pain in Athletes

This is probably one of the most vulnerable areas to assess and treat in the body. It’s complex and not so pleasant for the sufferer to have pain. The complexity of this area lies in a number of areas

Anatomy.

Who wants a stranger poking around there? I learnt this the hard way at a groin course a few years back, my partner in palpation was a very experienced clinican, but had horrible touch. It’s unpleasant at the best of times, but in injury to the structures around the area, ouch. There is a bunch of bones, joints, cartiage, tendon, muscles and nerves all that can be problematic and without sound clinical reasoning, excellent palpation and most importantly an understanding of testing methodology to lead us toward a definitive diagnosis.

Pathoanatomy

A big scary word, but knowledge of what structure is affected and why it has become pathological is important. The pathology that may influence each different structure is important in gaining our diagnoisis and plan for recovery. Adductor related groin pain can be a result of an issue with the bone, enthesis (tendon meets bone), tendon or the muscle. It may involve bone stress, conjoint tendon and external oblique or maybe not. Understanding what structure is involved, why it is involved and the pathological issue of the structure is important in planning your intervention and rehabilitation.

Biomechanics

Wow it’s complex. What needs to be the centre of stability in movement, be the bearer of so many forces and have influences from everything above and below it is crazy. A sound understanding of the biomechanics and why your groin pain may have external influences is again complex and intriguing. Once the anatomy and pathoanatomy is identified, identifying other influences both internal (within the body above and below the injury) and external (enviorment and load) is so very important.

Here is a list of common groin related injuries and pain

  • Adductor Tendinopathy
  • Adductor Enthesopathy
  • Conjoint tendon tear
  • External oblique or abdominal apponeurosis pain
  • Bone stress injury (stress reaction or fracture)
  • Pubic Symphasitis (Osteitis Pubis)

Not to be missed or confused for

  • Referred pain from injury or pathology in the hip
  • Referred or radicular (nerve pain) from the lumbar spine
  • Illioinginal nerve entrapment
  • Inguinal hernia

How I will help you recover from groin pain or injury?

  • Undertake a groin specific subjective assessment – ask you the relevant questions and gain the most information about your history with groin pain.
  • Provide a battery of clinical tests during the objective assessment that determines what structures are affected and why
  • Use my sound clinical reasoning and experience in assessing and treating groin pain to give you a diagnosis
  • Determine the most appropriate scans and/or interventions in conjuction with your GP or sports physician
  • Treat you with the best physiotherapy techniques and exercise therapies
  • Develop a plan for recovery and rehabilitation to get you back to sport or daily living
  • Provide sports, functional or life specific rehab programs in our strength and rehab lab
  • We have lived, personal experience with adductor related groin pain to usderstand what you are going through and coach you back to sport

If you suffer intermittent or persistent groin pain or injury please feel free to give us a call at anytime to discuss your problems and how we can help you.

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A few pics of exercises during groin rehabilitation...

Adductor squeeze with single leg bridge - mid phase rehabilitation exercise used to improve groin and hip strength/endurance. Note specific exercises used prior are important with monitoring and progression/regression where needed. 

A late stage adductor side plank. This can be used both isometrically with addected side on bar or concentric/eccentrically with affected hanging. Note there is different times where these are appropriate with late stage rehab and should be prescribed only by a professional with expereince and sound clinical reasoning. 

 

 

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Dean Phelps - Head Physiotherapy

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

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