scholarly journals Groin Pain in Athletes — Sports Hernia and Osteitis Pubis

10.5772/58621 ◽  
2014 ◽  
Author(s):  
Baki Ekçi ◽  
Tahsin Beyzadeoglu
2019 ◽  
Vol 185 (7-8) ◽  
pp. e1298-e1299
Author(s):  
Jackson P Beall ◽  
Joshua J Oliver ◽  
Rachel E Bridwell ◽  
Scott E Young

Abstract Osteitis Pubis (OP) is groin pain caused by overloading stresses on the pubic symphysis. This is often caused by the repetitive stress seen in competitive sports, but can also be caused by rapid acceleration or deceleration. It is a diagnosis of exclusion made after other entities such as fracture or infection are ruled out. It is often treated conservatively with rest, Non-Steroidal Anti-inflammatories (NSAIDS), and Physical Therapy (PT). After these treatment modalities have failed, intra-articular injection with local anesthetics and steroids can be considered. We report a case of a 22-year-old Male Active Duty Army Soldier who presented with OP immediately after landing during a routine Airborne Jump exercise. The Soldier reported landing in such a way that his feet did not impact the ground at the same time, creating a sheering force on his pelvis. Following two months of failed treatment involving NSAIDS and PT, the patient was referred to Sports Medicine where he received an injection of 1 mL of 1% lidocaine and 40 mg of triamcinolone into the pubic symphysis joint space. Shortly afterward the patient endorses complete resolution of his symptoms without return of symptoms at 1-month follow-up. Although injection of the pubic symphysis with local anesthetic and steroids has been previously described, this is the first time it has been described in a jump injury.


2013 ◽  
Vol 97 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Muhammad R. S. Siddiqui ◽  
Makysym Kovzel ◽  
Stephen Brennan ◽  
Oliver H. Priest ◽  
Shaun R. Preston ◽  
...  

Abstract A literature review was made on the role of totally extraperitoneal (TEP) hernia repairs for groin pain in athletes. Electronic databases were searched for literature published from January 1993 to November 2011. There were 10 articles incorporating 196 patients included in this review. Thirty percent of patients were reported to have direct inguinal hernias, 22% had indirect inguinal hernias, and 41% had dilated internal rings. Of note, 30% of cases had no macroscopic abnormality. Four studies reported on an early follow-up ranging between 3 and 6 weeks. Only minimal or mild symptoms were reported. Up to 33% of patients had impaired ability to perform at peak levels. Up to 53% of patients had persistence of symptoms at the early follow-up. Total follow-up time ranged from 3 to 80 months, and most patients were active (90%–100%). At long-term follow-up, 3% to 10% were unable to play, and 5% were reported as being unable to train. Two studies from the same center reported on TEP surgery for osteitis pubis, and most patients returned to sporting activity after 4 to 8 weeks. TEP repair is a good operative intervention in athletes with chronic groin pain not relieved by conservative measures. Athletes recover quickly and return to sport early.


2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989610
Author(s):  
Thomas James Gill ◽  
Andrew J. Wall ◽  
Frank W. Gwathmey ◽  
James Whalen ◽  
Amun Makani ◽  
...  

Background: Chronic strain and/or tendinopathy of the adductor longus tendon can be a cause of long-standing groin pain in the elite athlete, resulting in significant time lost from competition. Accurate diagnosis and treatment can expedite return to play. Purpose/Hypothesis: To evaluate return to sport and performance in National Collegiate Athletic Association (NCAA) Division I football players and National Football League (NFL) players following adductor longus release with or without sports hernia repair. We hypothesized that adductor release will be an effective method of treatment for recalcitrant groin/adductor pain in these athletes. Study Design: Case series; Level of evidence, 4. Methods: A cohort study was performed of all NFL players and NCAA Division I college athletes who had undergone an adductor longus tendon release with or without sports hernia repair by 1 of 2 fellowship-trained orthopaedic surgeons between May 1999 and January 2013. All patients reported groin pain below the inguinal ligament and localized to their adductor longus. Symptoms lasted longer than 10 weeks and limited their ability to effectively perform during sport, as assessed by their coach and self-assessment. Questionnaires were given to all 26 patients to assess long-term surgical outcomes. A subgroup analysis was performed for NFL players, in which “performance scores” were calculated according to individual player statistics while playing. Scores obtained before the diagnosis of chronic adductor longus tendinopathy or strain were compared with those after surgery. Patients with prior abdominal or pelvic surgery, radiographic evidence of degenerative joint disease of the hip, labral tears or femoral acetabular impingement, prostatic or urinary tract disease, or nerve entrapment of the ilioinguinal, genitofemoral, or lateral femoral cutaneous nerves were excluded from the study. Results: A total of 32 athletes underwent an adductor longus tenotomy during the study period. Of these patients, 28 were college- or professional-level athletes who underwent an adductor longus tenotomy, with a mean ± SD follow-up time of 6.2 ± 4.2 years (range, 12-178 months). Of the 32 patients, 20 had a concomitant sports hernia repair in addition to an adductor longus tenotomy. Thirty-one patients (97%) were able to return to their previous sport, and 30 (94%) were able to return at their previous level of play. Thirty patients (94%) reported that they were satisfied with their decision to have surgery. No player complained of weakness or a decrease in running speed or power. Mean return to play was 12 weeks from date of surgery. In the subgroup analysis of 16 NFL players, there were no statistically significant differences for the pre- versus postoperative comparisons of the athlete performance scores ( P = .74) and the percentage of the games started versus played ( P = .46). After separation of players who had a concomitant hernia repair from players who did not, there was no statistically significant difference in performance scores or percentages of games started. Conclusion: In this study of elite athletes, adductor longus tenotomy with or without a concomitant sports hernia repair provided overall acceptable and excellent results. Athletes were able to return to their previous level of athletic competition and performance with consistent relief of groin pain. Return to play in an NFL game averaged 12 weeks following surgery.


JAMA Surgery ◽  
2020 ◽  
Vol 155 (9) ◽  
pp. 895
Author(s):  
Kristian Thorborg ◽  
Per Hölmich
Keyword(s):  

Joints ◽  
2021 ◽  
Author(s):  
Vincenzo Candela ◽  
Angelo De Carli ◽  
Umile Giuseppe Longo ◽  
Sofia Sturm ◽  
Giorgio Bruni ◽  
...  

Abstract Purpose The aim of this article is to illustrate the recent framework necessary to standardize studies on groin pain and review the existing literature on groin pain in football. Methods The common pathological processes underlying groin pain such as muscle, tendon or ligament strain, bone injury or fracture, sport hernia, bursitis, osteitis pubis, and hip-related diseases have been reviewed and current management options have been considered. Results Groin pain is considered a pain in pubic or lower abdominal or adductors region which can be monolateral or bilateral. It is common in high-intensity team sports and can negatively affect an athlete's professional carrier, causing serious disruption in the performance. Despite a high prevalence of groin pain in athletes, diagnosis and management of the underlying pathological processes remain a challenge for surgeons, radiologists, and physiotherapists alike. Conclusion A multidisciplinary approach is essential for patients with groin pain allowing prompt diagnosis and initiation of treatment thus facilitating more rapid return to play and preventing potential long-term sequelae of chronic groin pathology.


2020 ◽  
Vol 116 (2) ◽  
pp. 58-66
Author(s):  
Anastasiia Omelchenko

Sports hernia is an important problem in professional and amateur sports. The article systematizes the literature and approaches to solving the groin pain during exercises, which is the main manifestation of sports hernia in football players. The presented research results show that a characteristic feature of a sports hernia is the presence of weakness of the posterior wall of the inguinal canal without anatomical signs of a typical hernia. For verification, the diagnosis is ultrasound and magnetic resonance imaging of the groin. The study conducted a comparative analysis of the results of surgical treatment of sports hernia. This research can be useful for general surgeons, sports physicians, family physicians, orthopedists and traumatologists.


2012 ◽  
pp. 181-193
Author(s):  
Nathaniel Stoikes ◽  
L. Michael Brunt
Keyword(s):  

JAMA Surgery ◽  
2020 ◽  
Vol 155 (4) ◽  
pp. 340 ◽  
Author(s):  
Brian S. Zuckerbraun ◽  
Anthony R. Cyr ◽  
Craig S. Mauro

2020 ◽  
Vol 73 (4) ◽  
pp. 755-760
Author(s):  
Oleksandr Yu. Ioffe ◽  
Natalia M. Negria ◽  
Anastasiia V. Omelchenko ◽  
Oleksandr P. Stetsenko ◽  
Yuri A. Dibrova ◽  
...  

The aim of the study is to specify diagnostic MRI and ultrasound criteria for a sports hernia in order to verify its diagnosis in football players. Materials and methods: The study included 50 professional and amateur football players aged 15 to 34 from 2016 to 2019. The criteria for inclusion in the study were: the presence of groin pain in football players, which prevented them from continuing to actively participate in sports activities. Results: The findings of the study revealed that during MRI the two factors, which had the strongest influence, were “increased MR signal intensity on PDfs observed from the structures of the inguinal canal” and “increased MR signal intensity on PDfs observed from bone marrow of superior ramus of the pubic bone”. During ultrasound of the inguinal area, the main criterion for a sports hernia diagnosis was “increased size of the inguinal canal”. The verification of the diagnosis was carried out on the basis of the presence of a protrusion in the posterior wall of the inguinal canal. For a sports hernia diagnosis the MRI sensitivity is 91.67% (95% CI 77.5 – 98.2), specificity –78.57% (95% CI 49.2 – 95.3) and the sensitivity of ultrasound is 88.89% (95% CI 73.9 – 96.9), the specificity – 50% (95% CI 23.0 – 77). Conclusions: The combination of MRI and ultrasound makes it possible to accurately detect the presence of a sports hernia in the football player. Based on the findings of our study, we formulated MRI and ultrasound criteria for a sports hernia diagnosis.


2008 ◽  
Vol 40 (Supplement) ◽  
pp. S149-S150
Author(s):  
Jonathan C. Crist ◽  
David J. Petron

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