Jan Mens1, Han Inklaar, Bart W Koes, Henk J Stam. 1. Division Low Back Pain Research, Rehabilitation Medicine, Erasmus Medical Centre-Faculty, Rotterdam, The Netherlands. info@janmens.com
Abstract
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.
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.