Injury Prevention: Part ONE – Groin Injuries
Prevention of an injury can be difficult as injury occurrence is usually a multi-modal. Extensive research has gone into the development of programs designed to address contributing factors of certain common injuries. Two common injury sites in sport are; groin and hamstring and both have been the subject of research articles investigating the efficacy of specific exercise intervention on prevention of injuries to those areas.
Prevention is the best cure - Desiderius Erasmus
Prevention of an injury can be difficult as injury occurrence is usually multi-modal. Extensive research has gone into the development of programs designed to address contributing factors of common injuries. Two common injury sites in sport are; groin and hamstring and both have been the subject of research articles investigating the efficacy of specific exercise intervention on prevention of injury.
GROIN
Groin injuries are a common occurrence in change of direction sports like soccer, basketball (e.g Lebron James recent injury) and Australian rules football. With the highest paid player in soccer earning $111 million per year, you can see why prevention of these injuries becomes very important.
Haroy et al (2017) looked at the inclusion of the Copenhagen exercise in the FIFA 11+ program (used as a warm up for soccer players) on improving hip adduction strength.
The Copenhagen Adductor (CA) exercise is a partner exercise where the player lies on the side with one forearm as support on the floor and the other arm placed along the body. The upper leg is held at approximately hip height of the partner, who holds the leg with one arm supporting the ankle and the other supporting the knee (position A in figure 1). The player then raises the body from the field and the lower leg is adducted so that the feet touch each other and the body is in a straight line (position B in figure 1). The body is then lowered halfway to the ground while the foot of the lower leg is lowered so that it just touches the floor without using it for support. It is performed on both sides.
Figure 1 The Copenhagen Adduction exercise. A start/end-position. B mid-position.
The article found that the CA exercise delivered in the below protocol (figure 2) resulted in an increase in hip adduction strength and as this is a risk factor for groin injuries, should be included in the FIFA 11+ to try to reduce the incidences of these injuries.
Figure 2 The prescription parameters for the CA exercise.
The CA is a fairly safe and easy exercise to self- integrate into the pre-existing FIFA 11+ protocol. However, even with the diligent performance of the protocol, groin injuries can still occur. It is always best to be assessed by a physiotherapist to ascertain a correct diagnosis so you can receive the best treatment possible for your specific condition. Here at East Vic Park Physiotherapy, our physiotherapists are very experienced in assessing and treating groin pain. Additionally, if you would like to know more about the CA exercise or the FIFA 11+ program then click the link at the top of the webpage to book an appointment or call us on 9361 3777. Below is a quick link to review:
https://www.fifamedicinediploma.com/lessons/prevention-fifa-11/
Groin Pain
As pre-season training gets underway for winter sports codes we generally see an increase in the number of patients with groin pain presenting to our clinic. Discussing groin pain as a whole is a very large topic, so for the purposes of this blog I will discuss non-traumatic groin pain and in particular the most common factors that can lead to injury.
Non-traumatic groin injuries are typically complex and require a thorough assessment to determine the factors that have led to the injury and a comprehensive exercise rehabilitation program to recondition the athlete to be ready to return to their sport.
WHAT IS IT?
Groin pain is an umbrella term for pain felt in the groin area. It is not diagnostic and does not indicate a specific pathology or tissue(s) affected. Groin pain can be sub-grouped into 6 different areas:
· Adductor related
· Hip flexor (iliopsoas) related
· Abdominal (inguinal) related
· Pubic related
· Hip joint related
· Other (neural, referred pain, fractures, abdominal/gynaecological conditions etc)
It is common more than one of these sub-groups to be affected and insufficiencies in one area can lead to an overload in another.
WHY DOES IT OCCUR?
Three common reasons for the development of groin pain in sporting people include training errors, poor mechanics and age.
· Training errors causing injury usually refers to “too much too fast” and is usually seen with athletes rapidly increasing their training amounts without adequate recovery between sessions causing a progressive overload of structures in the groin area. Groin pain will commonly present as preseason training reaches 3-4 weeks in and more commonly as running demands transition into higher amounts of sprinting and agility.
· Poor mechanics refers to muscle imbalances, poor movement control and patterns, poor posture, inadequate strength, lack of flexibility and sub-optimal technique for sport specific skill. This is where a good sports physiotherapist will be able to conduct a comprehensive assessment to determine which of these factors are contributing to your groin pain.
· Younger athletes are more susceptible to developing groin pain as their skeletal system is less mature to withstand the stress that training can put on the body compared to older athletes (25+ years).
MANAGEMENT
The pain will generally settle with a combination of rest and anti-inflammatory medication. During this rest period it is important to address the factors that have led to developing groin pain (poor mechanics) to avoid reaggravating the injury when you return to running. It is very important to have a graduated return to running plan in place to allow for optimal recovery between sessions and avoiding too much load too soon.
PREVENTION
The old adage “prevention is the best cure” is applicable for groin pain and there is plenty that can be done to prevent it. If you have had groin pain in the past, having a preseason screen with your physiotherapist is beneficial to assess if any predisposing factors are present. A comprehensive strength and conditioning program to address any factors as well as condition your body to tolerate the training loads can help prevent groin injuries. Also making sure to optimise your recovery between sessions – for helpful tips read our blogs on recovery – will help prevent the development of groin pain.
