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Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial
A Weir1, J A C G Jansen, I G L van de Port
1The Hague Medical Centre, Antoniushove Hospital, Department of Sports Medicine, Burgemeester, Leidschendam, The Netherlands. a.weir@mchaaglanden.nl
Hypothesis:
A multi-modal treatment program (MMT) is more effective than exercise therapy (ET) for the treatment of long-standing adductor-related groin pain.
Study Design:
Single blinded, prospective, randomised controlled trial.
Patients:
Athletes with pain at the proximal insertion of the adductor muscles on palpation and resisted adduction for at least two months.
Interventions:
ET: a home-based ET and a structured return to running program with instruction on three occasions from a sports physical therapist. MMT: Heat, Van den Akker manual therapy followed by stretching and a return to running program.
Primary Outcome:
time to return to full sports participation.
Secondary Outcome Measures:
objective outcome score and the visual analogue pain score during sports activities. Outcome was assessed at 0, 6, 16 and 24 weeks.
Results:
Athletes who received MMT returned to sports quicker (12.8 weeks, SD 6.0) than athletes in the ET group (17.3 weeks, SD 4.4. p = 0.043). Only 50-55% of athletes in both groups made a full return to sports. There was no difference between the groups in objective outcome (p = 0.72) or VAS during sports (p = 0.12).
Conclusions:
The multi-modal program resulted in a significantly quicker return to sports than ET plus return to running but neither treatment was very effective.