At Bureta Physiotherapy we see a lot of people presenting with hip and groin pain. Individuals who play sports involving kicking, sprinting and change of direction are putting huge strains through their groin. Acute injuries are often see in these sports but a number of people also have long-standing groin pain.
The groin area has very complex anatomy with multiple structures in close relation to each other. People experiencing pain in their groin or hip should have a full physiotherapy assessment to explore a correct diagnosis and address any underlying factors in order to start on a road to recovery.
The source of groin or hip pain could be the
– bone : fracture, dislocation and stress fracture of the hip, pelvis or spine
– joint : osteoarthritis, impingement, cartilage tear
– muscle : quadriceps, hamstring, adductor, abductor, pelvic floor, hip flexor or abdominal
– other soft tissue : hernia, bursitis, ligaments
– referral from: lumbar spine, sacro-iliac joint, thoracic joint or abdominal organs
– other : developmental, tumour, infectious disease, vascular or nerve entrapment
The way our body is made up and how we have always been moving it can predispose us to different injuries. The hip joint can be loaded with 8 times our body weight whilst running so imbalances in muscles can lead to injury. People with long-standing hip impingement are more pre-disposed to requiring a total hip replacement in the future.
The Holmich protocol is an example of rehabilitation used as a basis for a management plan or appropriately diagnosed groin strains. This includes a progression of exercises which will be shown and personalised to your level of activity and grade of injury. Holmich conducted a study looking at two groups of patients with correctly diagnosed groin strains. The first group used the Holmich exercise protocol, the second group had a multi-modal approach to rehabilitation including manual therapy techniques performed by a physiotherapist, a stretching program and the Holmich protocol exercise program. Both groups had ‘successful’ outcomes at the 16 week mark. The group participating in the multi-modal rehabilitation plan returned to sports 4.5 weeks earlier than those only doing the exercises.
Rehabilitation from groin injuries is hugely important because it has been found that individuals with a previous groin injury have double the chance or re-injury to their groin, and individuals playing in high grades have triple the risk of injuring their groin.
The treatment plan changes for each individual to address their injury, activity level and goals. The exercises are important to strengthen structures around the hip, groin and core to ensure these muscles are in balance and transferring load to help prevent further ground injury. Treatment can also include education of how to safely return to sprinting, kicking, change of direction and sport to ensure best performance and low chance of re-injury. If conservative management is not successful, a specialist appointment can be arranged