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A new view on adduction-related groin pain
Jan Mens1, Han Inklaar, Bart W Koes
1Division Low Back Pain Research, Rehabilitation Medicine, Erasmus Medical Centre-Faculty, Rotterdam, The Netherlands. info@janmens.com
Objective:
To evaluate the hypothesis that groin pain at isometric hip adduction may not be caused by adductor tendinitis.
Design:
Symptoms and signs in a cross-sectional analysis.
Setting:
Multicenter primary care institutes.
Subjects:
Athletes with pain in the groin(s), provoked by playing sports, with a duration of complaints for at least 1 month and pain provocation on isometric adduction of the hips.
Interventions:
Data on medical history and symptoms were collected. Pain provocation tests and strength measurements were performed. A pelvic belt was used to investigate its influence on pain provocation and strength.
Main Outcome Measurements:
Site of the pain, duration of the complaints, severity of the pain, hip adduction force, pain at isometric hip adduction, restriction to perform active straight leg raising, influence of a pelvic belt on pain and strength of isometric hip adduction and straight leg raising.
Results:
Groin pain was bilateral in 41%; pain was also located at the posterior aspect of the pelvis in 32%; Active Straight Leg Raise (ASLR) test was positive in 39%. When tested with a pelvic belt, the weakness of ASLR improved in all with a positive ASLR, hip adduction force increased significantly in 39% and pain at forceful isometric hip adduction decreased in 68%.
Conclusions:
Groin pain at isometric hip adduction may not be caused by adductor tendinitis in a large proportion of athletes with adduction-related groin pain. The results suggest that adduction-related groin pain with a positive belt test may be treated by stabilization of the pelvis.
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