Ooh Thats Gotta Hurt - Avoiding Groin Injuries
The are a few tyoes of groin injury which we will begin to
explore. Groin injury may have varied reasons and in most cases,
have more than one reason. Chronic groin pain is attributed to
adductor tendinopathy, osteitis pubis or inguinal hernia. It is
very common that two or all these conditions coexist at the same
time. There are of course many more reasons for groin pain. We
will deal with the most common groin injury which is
tears/strains of the adductor muscles.
Sports like football or basketball that involve steeping,
kicking, twisting and turning strain the adductor muscles. In
these kinds of sports, the groin is more susceptible to injury.
Injury of groin muscle is normally caused due to excessive
stretching and contraction of the adductor muscles. This
condition of excessive stretching or contraction may cause the
muscle to tear, which in turn may lead to other complications
like inguinal hernia resulting in multiple pathological
conditions that are a hallmark of groin injuries.
A person or athlete complaining of a groin injury would be in
the know of how the injury was caused, while, running, kicking
or turning, since a groin injury results in a sharp pain in the
adductor attachment or a little below it. The result is
functional difficulty. Many a time, the injury is preceded by an
abdominal or groin pain or some days or weeks. The injuries that
give such indicators are generally caused due to inherent
weakness in the posterior abdominal wall or related
physiological structure.
Assessment of Groin injuries: The simplest way to test the
adductor muscles is to apply the Adductor Squeeze. The patient
lies on a table with legs extended, and the examiner puts his
clenched fists between the knees. The patient then applies
pressure to the examiner's fists using his knees. The patient
increases the pressure slowly until he can exert the maximum
pressure. Pain points and functional inhibition is physically
assessed using this test. The test can be repeated with legs
raised to 45 degrees and again with legs raised 90 degrees. This
can give an accurate picture of the kind and location of the
groin injury.
The groin area is connected to lumbar spine, hip joint and
sacroiliac joints by kinematic chains.
Adductor problems are best judged by the hip joint rotation. The
direction of the rotation would be the best clue to judge
adductor problems. Decrease in rotation signifies osteitis pubis
or hernia. This may result in a compensatory stepping up of
abduction resulting in exertion of excessive force on abductor
muscles leading to injury. It has been observed that an adductor
muscle strain is preceded by a restricted lumbar spine for a few
days. This is attributed to the kinematic relationship.
Controlling the movement of the pelvis and lumbar spine is
essential for proper functioning of thigh muscles. This will
result in reduction of stress on the spine and consequently the
pressure on thigh muscles, easing the groin injury risk.