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Šuc A, Šarko P, Pleša J, Kozinc Ž. Resistance Exercise for Improving Running Economy and Running Biomechanics and Decreasing Running-Related Injury Risk: A Narrative Review. Sports (Basel) 2022; 10:sports10070098. [PMID: 35878109 PMCID: PMC9319953 DOI: 10.3390/sports10070098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 02/01/2023] Open
Abstract
It is well-accepted that at least a certain amount of resistance exercise (RE) is recommended for most endurance athletes. In this review, we aim to summarize the evidence regarding the effects of RE on running economy, running biomechanics, and running-related injury risk in endurance runners. The evidence robustly shows that lower limb RE is effective for improving running economy and performance, with a combination of strength and plyometric training being recommended to improve RE. Isometric training is also emerging as a possible alternative to implement during periods of high overall training load. Lower limb RE may change some aspects of joint kinematics during running; however, the evidence regarding the effects on kinetics is limited. Lower limb RE may help reduce running-related injury risk, but further evidence is needed.
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Affiliation(s)
- Anja Šuc
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (A.Š.); (P.Š.); (J.P.)
| | - Pija Šarko
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (A.Š.); (P.Š.); (J.P.)
| | - Jernej Pleša
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (A.Š.); (P.Š.); (J.P.)
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (A.Š.); (P.Š.); (J.P.)
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, SI-6000 Koper, Slovenia
- Correspondence:
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Requejo-Salinas N, Lewis J, Michener LA, La Touche R, Fernández-Matías R, Tercero-Lucas J, Camargo PR, Bateman M, Struyf F, Roy JS, Jaggi A, Uhl T, Bisset L, Wassinger CA, Donatelli R, Haik MN, Lluch-Girbés E. International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study. Braz J Phys Ther 2022; 26:100395. [PMID: 35366589 DOI: 10.1016/j.bjpt.2022.100395] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 01/12/2022] [Accepted: 02/08/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND There is a lack of standardized criteria for diagnosing rotator cuff related shoulder pain (RCRSP). OBJECTIVE To identify the most relevant clinical descriptors for diagnosing RCRSP. METHODS A Delphi study was conducted through use of an international physical therapists expert panel. A 3-round Delphi survey involving an international panel of physical therapists experts with extensive clinical, teaching, and research experience was conducted. A search query was performed in Web of Science, along with a manual search, to find the experts. The first round was composed of items obtained from a previous pilot Delphi study along with new items proposed by the experts. Participants were asked to rate items across six clinical domains using a five-point Likert scale. An Aiken's Validity Index ≥ 0.7 was considered indicative of group consensus. RESULTS Fifteen experts participated in the Delphi survey. After the three rounds, consensus was reached on 18 clinical descriptors: 10 items were included in the "subjective examination" domain, 1 item was included in the "patient-reported outcome measures" domain, 3 items in the "diagnostic examination" domain, 2 items in the "physical examination" domain", and 2 items in the "functional tests" domain. No items reached consensus within the "special tests" domain. The reproduction of symptoms in relation to the application of load, the performance of overhead activities, and the need of active and resisted movement assessment were some of the results with greatest consensus. CONCLUSION In this Delphi study, a total of 18 clinical descriptors across six clinical domains were agreed upon for diagnosing RCRSP.
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Affiliation(s)
- Néstor Requejo-Salinas
- Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV). Superior Center for University Studies La Salle. Autonomous University of Madrid, Madrid, Spain
| | - Jeremy Lewis
- School of Health and Social Work, University of Hertfordshire, Hertfordshire, United Kingdom; Therapy Department, Central London Community Healthcare National Health Service Trust, London, United Kingdom; Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
| | - Lori A Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, United States
| | - Roy La Touche
- Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV). Superior Center for University Studies La Salle. Autonomous University of Madrid, Madrid, Spain; Neuroscience and Craniofacial Pain Institute (INDCRAN), Madrid, Spain
| | - Rubén Fernández-Matías
- Research Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Research Institute of Physical Therapy and Pain, University of Alcala, Alcala de Henares, Madrid, Spain.
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Marcus Bateman
- Derby Shoulder Unit, Orthopaedic Outpatient Department, Royal Derby Hospital, Derby, United Kingdom
| | - Filip Struyf
- Department Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute, Quebec City, Quebec, Canada
| | - Anju Jaggi
- Royal National Orthopaedic Hospital NHS Trust, London Borough of Harrow, London, United Kingdom
| | - Timothy Uhl
- Department of Physical Therapy, University of Kentucky, Lexington, United States
| | - Leanne Bisset
- School of Allied Health Sciences, Griffith University, South East Queensland, Australia
| | - Craig A Wassinger
- Department of Physical Therapy, East Tennessee State University, Johnson City, Tennessee, United States
| | | | - Melina Nevoeiro Haik
- Department of Physical Therapy, Center of Health and Sport Science, Universidade do Estado de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Enrique Lluch-Girbés
- Department of Physical Therapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group, University of Valencia, Valencia, Spain
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Chaari F, Rebai H, Boyas S, Rahmani A, Fendri T, Harrabi MA, Sahli S. Postural balance impairment in Tunisian second division soccer players with groin pain: A case-control study. Phys Ther Sport 2021; 51:85-91. [PMID: 34303123 DOI: 10.1016/j.ptsp.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare postural balance outcomes between soccer players with and without groin pain (GP). DESIGN Case-control study. SETTING Laboratory. PARTICIPANTS Fifty-four soccer players, 27 with GP (GP group: GPG) and 27 healthy ones (control group: CG). MAIN OUTCOME MEASURES Static and dynamic postural balance were assessed with a force platform and Y-balance test (Y-BT), respectively. Hip abduction, internal rotation (IR), external rotation (ER) and total rotation (TR) of both limbs were evaluated. RESULTS The GPG exhibited significant higher centre of pressure values in the bipedal posture only on the foam surface in eyes opened and closed compared to controls. Besides, they had lower anterior, posteromedial and posterolateral reach distances and composite Y-BT score on the injured limb (IL) compared to non-injured limb (NIL) and dominant-limb (DL) of the CG. Moreover, they showed lower abduction, IR, ER, and TR on the IL compared to NIL and DL. CONCLUSIONS Dynamic unipedal postural balance disorder could be one of the limiting factors of performance in soccer players with non-time loss GP. Hence, postural balance data in these players could enable sport coaches and physical therapists to better understand the mechanisms contributing for performance decrease.
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Affiliation(s)
- Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sébastien Boyas
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Abderrahmane Rahmani
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Mohammed A Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
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Harmath DM, Lejkowski PM. Pubic and adductor related groin pain in an athlete: A case report linking pathology to conservative care. J Bodyw Mov Ther 2021; 27:344-351. [PMID: 34391256 DOI: 10.1016/j.jbmt.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/06/2020] [Accepted: 03/13/2021] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Case Report. BACKGROUND Groin pain in athletes is considered a common condition among males participating in sports that require sprinting, twisting, pivoting and kicking activities. While the condition is considered self-limiting, it often keeps athletes away from sport for a prolonged period of time. Much controversy exists regarding the pathogenesis of groin pain. This conflict translates to disagreement regarding diagnostic criteria, reporting and management strategies. CASE PRESENTATION a 28-year old recreational soccer player presented with a five-month history of groin pain that was resistant to passive care. With reference to the current conservative management literature, the athlete was progressed through an individualized multimodal program of care. OUTCOMES Following 10-weeks of care, the athlete was able to return to sport participation pain-free. CONCLUSION It is suggested that groin pain in athletes is likely multifactorial and therefore the management should reflect its multifactorial nature. Conservative therapy can evidently reduce the time to return to play however the benefits of incorporating plyometrics into the rehabilitation program should be investigated.
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Affiliation(s)
- Dominique M Harmath
- Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
| | - Peter M Lejkowski
- Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
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HIP AND PELVIC STABILITY AND GAIT RETRAINING IN THE MANAGEMENT OF ATHLETIC PUBALGIA AND HIP LABRAL PATHOLOGY IN A FEMALE RUNNER: A CASE REPORT. Int J Sports Phys Ther 2020; 15:1174-1183. [PMID: 33344033 DOI: 10.26603/ijspt20201174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Athletic pubalgia is a prevalent injury in athletes who kick, pivot, and cut, however it is poorly described in the literature. Many athletes with this diagnosis fail conservative management secondary to continued pain with activity and require surgical intervention for return to sport. Purpose The purpose of this case report is to describe an intervention strategy focusing on gait retraining and hip and lumbopelvic stability for a female runner diagnosed with athletic pubalgia and a labral tear of the hip. Case Description This case report involved a 45-year-old female runner who was seen for 14 visits, from examination to return to sport, with a follow up at 12 months post discharge. Interventions included hip, pelvic, and lumbar stability exercises, and gait retraining. Outcomes measurements included: pain on the numeric pain rating scale, the Lower Extremity Functional Scale (LEFS), gait mechanics, strength, and participation in sport. Outcomes At discharge the subject demonstrated improved strength of all muscle groups and changes in lower extremity running biomechanics. Changes in running mechanics included increased cadence, decreased pelvic drop, diminished over striding, and improved knee control with less valgus movement during the stance phase of gait. The subject reported no pain with running or recreational activities at discharge and follow up at 12 months post discharge. Discussion/Conclusion Most of the literature on conservative rehabilitation for athletic pubalgia focuses on athletes whose sports require pivoting and kicking. The literature provides little information on gait analysis and retraining for runners with a diagnosis of athletic pubalgia and/or hip labrum tears. The program used in this case report including gait retraining and hip, pelvic, and lumbar stability training allowed for full return to running in a 45-year-old female with a diagnosis of hip labrum tear and athletic pubalgia. Further research is needed to discern best conservative treatment for runners with athletic pubalgia and/or hip labral tears. Level of evidence 4.
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Nasrallah K, Jammal M, Khoury A, Liebergall M. Adult female patient with osteitis pubis and pelvic instability requiring surgery: A case report. Trauma Case Rep 2020; 30:100357. [PMID: 33163608 PMCID: PMC7610045 DOI: 10.1016/j.tcr.2020.100357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2020] [Indexed: 12/03/2022] Open
Abstract
Background Osteitis pubis (OP) is an inflammatory condition of the symphysis pubis (SP) characterized by focal pain and local tenderness. Pelvic instability (PI) is commonly associated with this condition. It is still not clear if OP leads to PI or it is PI that leads to OP. The exact cause of osteitis pubis is not yet known, although several predisposing factors have been suggested to contribute to this condition. In most cases, it is self-remitting and rarely needs surgical intervention. Case presentation A 63-year old woman presented with a 12-month history of persistent pain at the symphysis pubis and non-responsive to analgesics. The pain was aggravated by physical activity such as standing and walking. Physical examination showed focal tenderness at the symphysis pubis with no tenderness over the sacroiliac joints or lumbar region. The diagnosis was confirmed by characteristic findings on radiographs, CT and MRI. Surgery was considered after all conservative measures failed. The patient underwent a wedge-shaped resection of the symphysis pubis; the bone defect was filled autologous tri-cortical bone and fixed with dual plating. The outcome was satisfactory with radiologic union and symptom resolution postoperatively. Conclusions Osteitis pubis due to pelvic instability can cause chronic and persistent pain. In cases where conservative treatment fails, surgery should be considered. We recommend wide surgical resection of all non-viable bone at the symphysis pubis with the addition of tri-cortical iliac bone graft. Double plating should be considered in order to maximize the rate of fusion and further stabilize the fixation.
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Affiliation(s)
- Khalil Nasrallah
- Western Galilee Medical Center, 9 Nahariya-Cabri, Nahariya 22100, Israel
| | - Mahmoud Jammal
- Hadassah Medical Center of the Hebrew University, Kiryat Hadassah, POB 12000, Jerusalem 91120, Israel
- Corresponding author.
| | - Amal Khoury
- Hadassah Medical Center of the Hebrew University, Kiryat Hadassah, POB 12000, Jerusalem 91120, Israel
| | - Meir Liebergall
- Hadassah Medical Center of the Hebrew University, Kiryat Hadassah, POB 12000, Jerusalem 91120, Israel
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Via AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N. Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature. Open Access J Sports Med 2019; 10:1-10. [PMID: 30613167 PMCID: PMC6307487 DOI: 10.2147/oajsm.s155077] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Osteitis pubis is a common cause of chronic groin pain, especially in athletes. Although a precise etiology is not defined, it seems to be related to muscular imbalance and pelvic instability. Diagnosis is based on detailed history, clinical evaluation, and imaging, which are crucial for a correct diagnosis and proper management. Many different therapeutic approaches have been proposed for osteitis pubis; conservative treatment represents the first-line approach and provides good results in most patients, especially if based on an individualized multimodal rehabilitative management. Different surgical options have been also described, but they should be reserved to recalcitrant cases. In this review, a critical analysis of the literature about athletic osteitis pubis is performed, especially focusing on its diagnostic and therapeutic management.
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Affiliation(s)
- Alessio Giai Via
- Department of Orthopaedic Surgery and Traumatology, Hip Surgery Center, IRCCS Policlinico San Donato, Milano, Italy
| | - Antonio Frizziero
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - Paolo Finotti
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - Francesco Oliva
- Department of Orthopaedics and Traumatology, Tor Vergata Hospital, University of Rome "Tor Vergata", Rome, Italy,
| | - Filippo Randelli
- Department of Orthopaedic Surgery and Traumatology, Hip Surgery Center, IRCCS Policlinico San Donato, Milano, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy.,Centre for Sport and Exercise Medicine, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England
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Ramazzina I, Bernazzoli B, Braghieri V, Costantino C. Groin pain in athletes and non-interventional rehabilitative treatment: a systematic review. J Sports Med Phys Fitness 2018; 59:1001-1010. [PMID: 30160087 DOI: 10.23736/s0022-4707.18.08879-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Groin pain is a common complaint both in high-performance and recreational athletes. Diagnosis is based on the patient's history and physical examination. Imaging assessments are often considered to exclude other pathologies. To date there is no strong evidence to support conservative or surgical treatment options. The purpose of this study is to shed light on the more effective non-interventional rehabilitative treatments for the management of groin pain in athletes and, if possible, provide guidelines useful for clinical practice. EVIDENCE ACQUISITION The following electronic databases were searched: PubMed, Physiotherapy Evidence Database (PEDro), Scopus, Web of Science, Google and Google Scholar. Databases were investigated from January 1997 until March 2017. EVIDENCE SYNTHESIS The results reported in the randomized clinical trial studies highlight that active treatment is better than passive treatment to improve clinical signs of groin pain. Comparing the active strategy with multi-modal treatment the latter allows a faster return to sport activity. Although the evidence remains poor, all the included literature highlights that an integrated strategy which combines active and passive treatment, the assessment of perceived pain, a return to running program and specific-sport exercises is an effective strategy for management of groin pain in athletes. CONCLUSIONS Although we shed some light on common key aspects able to improve the typical signs of groin pain, on the basis of available data we were unable to provide practice guidelines. Further studies are necessary to set the best treatment algorithm for the management of groin pain in athletes.
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Affiliation(s)
- Ileana Ramazzina
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Benedetta Bernazzoli
- Graduate School of Physical Medicine and Rehabilitation, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, Parma, Italy - .,Graduate School of Physical Medicine and Rehabilitation, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Feldman K, Franck C, Schauerte C. Management of a nonathlete with a traumatic groin strain and osteitis pubis using manual therapy and therapeutic exercise: A case report. Physiother Theory Pract 2018; 36:753-760. [PMID: 29979902 DOI: 10.1080/09593985.2018.1492658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Without a definitive single pathoanatomical origin for groin pain, management is difficult. The purpose of this case report is to describe the differential diagnosis and management of an individual with a traumatic groin strain. Case Description: A 47-year-old sedentary male truck driver presented to physical therapy with a 2-month history of right medial groin pain. Pushing the gas pedal and sitting were painful activities. Pain was 3-8/10 on the Numeric Pain Rating Scale (NPRS). The patient reported 46/80 on the Lower Extremity Functional Scale. Examination: Tenderness was noted along the adductor longus muscle belly, right pubic ramus and hip range of motion was limited. Special tests directed at the hip and pelvic region indicated intraarticular and pelvic dysfunction. Treatment included hip and pubic symphysis joint mobilizations, lumbopelvic manipulation, adductor longus soft-tissue mobilization, and core strengthening. Outcome: 12 sessions of physical therapy resulted in LEFS to 80/80, Global Rating of Change (GROC) + 7, and NPRS 0/10 at worst. The patient returned to full work without restriction. Discussion: Groin pain has many pathoanatomical drivers. Management of a traumatic groin injury requires a thorough evaluation and a global treatment approach, in order to improve outcomes and reduce the risk of the pathology becoming chronic.
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Affiliation(s)
- Kyle Feldman
- Physical Therapy Specialists of Winchester , Winchester, VA, USA
| | - Carla Franck
- Kepros Physical Therapy and Performance , Cedar Rapids, IA, USA
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A new clinical test for measurement of lower limb specific range of motion in football players: Design, reliability and reference findings in non-injured players and those with long-standing adductor-related groin pain. Phys Ther Sport 2017; 23:67-74. [DOI: 10.1016/j.ptsp.2016.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 11/18/2022]
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Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls. Knee Surg Sports Traumatol Arthrosc 2017; 25:101-107. [PMID: 27056690 DOI: 10.1007/s00167-016-4101-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/22/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to evaluate patient-reported outcomes as well as lower extremity and trunk muscle function in patients with long-standing hip and groin pain, in comparison with matched, healthy controls. It was hypothesized that patients with long-standing hip and groin pain would report more deficiency on the Copenhagen Hip and Groin Outcome Score (HAGOS) and have worse outcomes on performance-based measures than healthy controls. METHODS Nineteen patients with long-standing hip and groin pain and 19 healthy, activity level-, age-, gender-, and weight-matched controls were assessed with the HAGOS for self-reported outcomes, and a parallel squat (w/kg), single-leg triple jump (cm), single-leg rise (n), barbell roll-out (% of height), and plank test (s) for performance-based measures. Independent sample t test was performed to assess between-group differences. The paired t test was used to analyse between-limb differences in unilateral performance tasks. RESULTS The patients had worse scores than the controls in all HAGOS subscales (p ≤ 0.001), while no statistically significant differences were observed for any performance measure between groups or between symptomatic and non-symptomatic limbs. CONCLUSIONS Despite significant self-reported functional limitations on the HAGOS, there were no significant differences between groups in performance-based strength or power measures. The results of this study highlight the need to identify performance-based measures, sensitive to functional deficiencies in patients with long-standing hip and groin pain in order to complement the clinical picture obtained by patient-reported outcomes such as the HAGOS. LEVEL OF EVIDENCE III.
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Coppack RJ, Bilzon JL, Wills AK, McCurdie IM, Partridge L, Nicol AM, Bennett AN. A comparison of multidisciplinary team residential rehabilitation with conventional outpatient care for the treatment of non-arthritic intra-articular hip pain in UK Military personnel - a protocol for a randomised controlled trial. BMC Musculoskelet Disord 2016; 17:459. [PMID: 27821103 PMCID: PMC5100075 DOI: 10.1186/s12891-016-1309-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/26/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment. With no available data, the sustainability of this care pathway has been questioned. The purpose of this randomised controlled trial is to compare the effects of a residential multidisciplinary intervention, to usual outpatient care, on the clinical outcomes of young active adults undergoing treatment for non-arthritic intra-articular hip pain. METHODS/DESIGN The trial will be conducted at the Defence Medical Rehabilitation Centre, Headley Court, UK. One hundred military male participants with clinical indicators of non-arthritic intra-articular hip pain will be randomly allocated to either: (1) 7-day residential multidisciplinary team intervention, n = 50; (2) 6-week physiotherapist-led outpatient intervention (conventional care), n = 50. Measurements will be taken at baseline, post-treatment (1-week MDT group; 6-weeks physiotherapy group), and 12-weeks. The primary outcome measures are the function in daily living sub-scale of the Copenhagen Hip and Groin Outcome Score (HAGOS), the physical function subscale of the Non-arthritic Hip Score (NAHS), and VAS pain scale. Secondary outcomes include objective measures of physical capacity and general health. An intention-to-treat analysis will be performed using linear and mixed models. DISCUSSION This study will be the first to assess the efficacy of intensive MDT rehabilitation, versus conventional outpatient care, for the management of non-arthritic hip pain. The results from this study will add to the evidence-base and inform clinical practice for the management of intra-articular non-arthritic hip pain and femoroacetabular impingement in young active adults. TRIAL REGISTRATION ISRCTN Reference: ISRCTN 59255714 dated 11-Nov-2015.
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Affiliation(s)
- Russell J. Coppack
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Andrew K. Wills
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Ian M. McCurdie
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
| | - Laura Partridge
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
| | - Alastair M. Nicol
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
| | - Alexander N. Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Oliveira ALD, Andreoli CV, Ejnisman B, Queiroz RD, Pires OGN, Falótico GG. Perfil epidemiológico dos pacientes com diagnóstico de pubalgia do atleta. Rev Bras Ortop 2016. [DOI: 10.1016/j.rbo.2016.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Oliveira ALD, Andreoli CV, Ejnisman B, Queiroz RD, Pires OGN, Falótico GG. Epidemiological profile of patients diagnosed with athletic pubalgia. Rev Bras Ortop 2016; 51:692-696. [PMID: 28050542 PMCID: PMC5198137 DOI: 10.1016/j.rboe.2016.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/07/2016] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To evaluate the clinical and epidemiological characteristics of pubalgia in patients from a Sports Medicine Center. METHODS Data analysis from medical records of patients with athletic pubalgia attended to from January 2007 to January 2015. The diagnosis was made by an experienced hip surgeon, complemented with pelvic X-ray, abdominal wall ultrasound, and magnetic resonance imaging of the pelvis. RESULTS Among 43 patients, 42 were men, with mean age of 33 years. As for sports, 25 (58.1%) athletes were soccer players and 13 (30.2%) were runners; 37.2% were professional athletes. Inguinal hernia was diagnosed in 20.9% of patients, showing the importance of its routine search in these patients. Treatment duration ranged from 1 to 12 months and 95.2% of the patients returned to sport. CONCLUSION This study presented the epidemiological characteristics of patients diagnosed with athletic pubalgia attended to in a reference medical center and demonstrated the prevalence of this lesion in male patients, soccer players and runners. It also disclosed a high success rate of the nonoperative treatment, and high rate of return to sport after treatment.
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Affiliation(s)
- Anderson Luiz de Oliveira
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
| | - Carlos Vicente Andreoli
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
| | - Benno Ejnisman
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
| | - Roberto Dantas Queiroz
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
| | - Osvaldo Guilherme Nunes Pires
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
| | - Guilherme Guadagnini Falótico
- Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil
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15
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Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report. J Orthop Sports Phys Ther 2016; 46:697-706. [PMID: 27374014 DOI: 10.2519/jospt.2016.6352] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.
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Coppack RJ, Bilzon JL, Wills AK, McCurdie IM, Partridge LK, Nicol AM, Bennett AN. Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel. BMJ Open Sport Exerc Med 2016; 2:e000107. [PMID: 27900174 PMCID: PMC5117069 DOI: 10.1136/bmjsem-2015-000107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 12/26/2022] Open
Abstract
Background There are no studies describing the clinical outcomes of a residential, multidisciplinary team (MDT) rehabilitation intervention for patients with prearthritic hip pain. The aim of this cohort study was to describe the functional and physical outcomes of multidisciplinary residential rehabilitation for UK military personnel with prearthritic hip pain. Methods Participants (N=40) with a mean age of 33 years referred to a specialist residential rehabilitation centre completed a comprehensive multidisciplinary residential intervention. The main outcome measures were mean pain, physical function (modified shuttle test (MST) and Y-balance test), hip range of motion (HROM) and a patient-reported outcome measure (The Copenhagen Hip and Groin Outcome Score, HAGOS). All scores for symptomatic hips were taken at baseline and post-treatment. Results There were improvements in the Y-balance test and HROM following rehabilitation. There were significant improvements in mean difference (T1-to-T2) for Y-balance scores (15.8 cm, 95% CI 10.7 to 20.9, p<0.001), HROM (6.5° increase in hip flexion, 95% CI 4.6 to 9.4, p<0.001) and hip internal rotation (4.6°, 95% CI 2.7 to 6.6, p<0.001). Scores for HAGOS, pain, MST and functional activity assessment showed no improvement. Conclusions Among UK military personnel with prearthritic hip pain, MDT residential rehabilitation resulted in improvements in a functional Y-balance test, hip flexion and internal rotation. The study suggests short-term benefits across some outcomes for the current UK military approach to MDT residential rehabilitation.
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Affiliation(s)
- Russell J Coppack
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK; Department for Health, University of Bath, Bath, UK
| | | | - Andrew K Wills
- School of Clinical Sciences, University of Bristol , Bristol , UK
| | - Ian M McCurdie
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) , Epsom , UK
| | - Laura K Partridge
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) , Epsom , UK
| | - Alastair M Nicol
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) , Epsom , UK
| | - Alexander N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Mosler AB, Agricola R, Weir A, Hölmich P, Crossley KM. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 2016; 49:810. [PMID: 26031646 PMCID: PMC4484362 DOI: 10.1136/bjsports-2015-094602] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Hip and groin injuries are common in many sports. Understanding the factors differentiating athletes with hip/groin pain from those without these injuries could facilitate management and prevention. Objective Conduct a systematic review and meta-analysis of the literature on factors differentiating athletes with and without hip/groin pain. Methods The review was registered as PROSPERO CRD42014007416 and a comprehensive, systematic search was conducted in June 2014. Inclusion criteria were: cross-sectional, cohort or case–control study designs of n>10 that examined outcome measures differentiating athletes with and without hip/groin pain. Two authors independently screened search results, assessed study quality, and performed data extraction. Methodological heterogeneity was determined and data pooled for meta-analysis when appropriate. A best evidence synthesis was performed on the remaining outcome measures. Results Of 2251 titles identified, 17 articles were included of which 10 were high quality. Sixty two different outcome measures were examined, 8 underwent meta-analysis. Pooled data showed strong evidence that athletes with hip/groin pain demonstrated: pain and lower strength on the adductor squeeze test, reduced range of motion in hip internal rotation and bent knee fall out; however, hip external rotation range was equivalent to controls. Strong evidence was found that lower patient-reported outcome (PRO) scores, altered trunk muscle function, and moderate evidence of bone oedema and secondary cleft sign were associated with hip/groin pain. Conclusions PROs, pain and reduced strength on the adductor squeeze test, reduced range of motion in internal rotation and bent knee fall out are the outcome measures that best differentiate athletes with hip/groin pain from those without this pain.
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Affiliation(s)
- Andrea B Mosler
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Rintje Agricola
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Adam Weir
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Per Hölmich
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Kay M Crossley
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia School of Allied Health, La Trobe University, Victoria, Australia
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Ultrasound-guided Corticosteroid Injection for the Treatment of Athletic Pubalgia: A Series of 12 Cases. J Med Ultrasound 2015. [DOI: 10.1016/j.jmu.2014.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain. J Sci Med Sport 2013; 17:155-9. [PMID: 23684372 DOI: 10.1016/j.jsams.2013.04.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 03/27/2013] [Accepted: 04/05/2013] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The objective of the present study was to investigate whether differences exist in adductor squeeze test values and hip joint range of motion between athletes with longstanding groin pain and injury-free controls. DESIGN Observational study with a case control design. METHODS Eighteen Gaelic football players with current longstanding groin pain and 18 matched injury-free controls were assessed on their performance of the adductor squeeze test. Adductor squeeze test values were quantified using a sphygmomanometer. A fluid-filled inclinometer was used to assess hip joint internal and external rotation range of motion. A bent knee fall-out test was also utilised to examine hip joint range of motion. RESULTS A significant difference in adductor squeeze test values was observed between the control group (269 ± 25 mmHg) and longstanding groin pain group (202 ± 36 mmHg; p<0.01). Furthermore the longstanding groin pain group had a decreased bent knee fall-out (p<0.01) bilaterally, as well as decreased hip joint internal rotation (p<0.05) and hip joint external rotation (p<0.05) range of motion bilaterally when compared to the control group. CONCLUSIONS Gaelic football players with longstanding groin pain exhibit decreased adductor squeeze test values and hip joint range of motion when compared to non-injured players. These findings have implications for assessment and rehabilitation practices, as well as return to play criteria.
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