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A New View on Adduction-Related Groin Pain

Mens, Jan MD, PhD; Inklaar, Han MD, PhD; Koes, Bart W PhD; Stam, Henk J MD, PhD

Clinical Journal of Sport Medicine: January 2006 - Volume 16 - Issue 1 - p 15-19
doi: 10.1097/01.jsm.0000180869.37673.7b
Original Research
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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.

From the Division Low Back Pain Research, Rehabilitation Medicine, Erasmus Medical Centre-Faculty, Rotterdam, The Netherlands.

Received for publication February 12, 2005; accepted July 13, 2005.

Reprints: Jan Mens, MD, PhD, Chief Investigator, Division Low Back Pain Research, Rehabilitation Medicine, Erasmus Medical Centre-Faculty, Dr. Molewaterplein 40, Rotterdam 3015 GD, Netherlands (e-mail: info@janmens.com).

© 2006 Lippincott Williams & Wilkins, Inc.