Evaluating the effectiveness of exercise therapy for groin pain in athletes
Information on treatment for groin pain in athletes extremely scarce
Groin pain is a common ailment for athletes, and those who participate in sports that require running, changes in direction and physical contact (e.g. football, soccer, hockey) are at an increased risk. The pain associated with it can be local or diffuse and usually arises from a musculoskeletal source such as the lumbar spine, hip joint or anterior pelvis due to acute and/or longstanding injury. Diagnosing the specific source of groin pain is difficult as two or more pathologies may at times be responsible, and current strategies to treat it rely on composite therapies without a definitive rehab protocol. The issue is complicated by the extreme lack of literature on effective treatments, with no powerful studies yet performed on the subject. A systematic review was therefore conducted to evaluate available evidence on the effectiveness of exercise therapy for athletic groin pain in order to aid clinicians in developing better treatment strategies.
Search of multiple databases turns out small but sufficient number of studies
A number of major databases were searched for pertinent studies and deemed relevant if they used exercise therapy as an intervention to treat groin pain in athletes. Out of the 468 studies initially identified, 12 were potentially relevant and five fulfilled the inclusion criteria and were used for the review. Each study was then appraised by two independent reviewers and given a quality score based on 12 criteria. The data was further divided into two categories: one encompassed the features of the exercise interventions such as type, intensity, frequency and duration, and the other encompassed how the intervention was delivered.
Exercise shown to definitively create positive outcomes for athletes
All five studies provided evidence that an exercise intervention can lead to favorable outcomes in terms of return to sport, and two studies additionally found it to result in symptom remission in soccer and Australian football players. Due to the diverse nature of the research used, there was major variability in the interventions and co-interventions reported, but one consistent finding across all studies was the use of strengthening exercises and the need for progression (from static contractions to functional positions) throughout the intervention period. Additionally, strengthening exercises for the hip and abdominal musculature were the most common throughout studies, which could mean they’re the most effective types to perform. Further analysis of the evidence suggested that interventions are most effective when administered in small groups (1-4 athletes), at a duration of 4-16 weeks, and in combination with co-interventions such as running, jogging or cycling. All programs were supervised by physical therapists, which is another important component that should be considered in determining who administers treatment. These findings support common clinical practice of exercise for groin pain in athletes, and should serve as further proof to implement these interventions to treat the condition.
-Summarized by Greg Gargiulo
-As reported in the March '09 edition of SMARTT
