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Dinis J, Oliveira JR, Choupina B, Seabra Marques P, Sá D, Sarmento A. Athletes With Adductor-Related Groin Pain: A Narrative Review. Cureus 2024; 16:e68625. [PMID: 39371738 PMCID: PMC11451080 DOI: 10.7759/cureus.68625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2024] [Indexed: 10/08/2024] Open
Abstract
Adductor-related groin pain is extremely common among athletes, and despite its high prevalence and impact, there is no consensus regarding taxonomy, anatomy, physiopathology, or treatment. We performed a comprehensive literature review and tried to demystify this pathology and its treatment. The Doha agreement classification and its impact are scrutinized as well as the complexity of the proximal adductor longus (AL) insertion and its relationship with the pyramidalis-anterior pubic ligament-AL complex. The stress-shielding and compression theories for the origin of AL tendon pathology are exploited along with how this knowledge translates into injury prevention protocols and surgical techniques. The importance of active rehabilitation protocols and intersegmental control-focused programs is highlighted. The role of an enthesis injection in the treatment algorithm is discussed along with when to perform a tenotomy. The differences between selective and complete tenotomy are highlighted.
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Affiliation(s)
- João Dinis
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - José Ricardo Oliveira
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Bárbara Choupina
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Pedro Seabra Marques
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - David Sá
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Andre Sarmento
- Orthopaedics and Traumatology, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, PRT
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Borszcz FK, de Aguiar RA, Costa VP, Denadai BS, de Lucas RD. Agreement Between Maximal Lactate Steady State and Critical Power in Different Sports: A Systematic Review and Bayesian's Meta-Regression. J Strength Cond Res 2024; 38:e320-e339. [PMID: 38781475 DOI: 10.1519/jsc.0000000000004772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT Borszcz, FK, de Aguiar, RA, Costa, VP, Denadai, BS, and de Lucas, RD. Agreement between maximal lactate steady state and critical power in different sports: A systematic review and Bayesian's meta-regression. J Strength Cond Res 38(6): e320-e339, 2024-This study aimed to systematically review the literature and perform a meta-regression to determine the level of agreement between maximal lactate steady state (MLSS) and critical power (CP). Considered eligible to include were peer-reviewed and "gray literature" studies in English, Spanish, and Portuguese languages in cyclical exercises. The last search was made on March 24, 2022, on PubMed, ScienceDirect, SciELO, and Google Scholar. The study's quality was evaluated using 4 criteria adapted from the COSMIN tool. The level of agreement was examined by 2 separate meta-regressions modeled under Bayesian's methods, the first for the mean differences and the second for the SD of differences. The searches yielded 455 studies, of which 36 studies were included. Quality scale revealed detailed methods and small samples used and that some studies lacked inclusion/exclusion criteria reporting. For MLSS and CP comparison, likely (i.e., coefficients with high probabilities) covariates that change the mean difference were the MLSS time frame and delta criteria of blood lactate concentration, MLSS number and duration of pauses, CP longest predictive trial duration, CP type of predictive trials, CP model fitting parameters, and exercise modality. Covariates for SD of the differences were the subject's maximal oxygen uptake, CP's longest predictive trial duration, and exercise modality. Traditional MLSS protocol and CP from 2- to 15-minute trials do not reflect equivalent exercise intensity levels; the proximity between MLSS and CP measures can differ depending on test design, and both MLSS and CP have inherent limitations. Therefore, comparisons between them should always consider these aspects.
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Affiliation(s)
- Fernando Klitzke Borszcz
- Physical Effort Laboratory, Sports Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Human Performance Research Group, Center for Health and Sport Sciences, University of Santa Catarina State, Florianópolis, Santa Catarina, Brazil; and
| | - Rafael Alves de Aguiar
- Physical Effort Laboratory, Sports Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Human Performance Research Group, Center for Health and Sport Sciences, University of Santa Catarina State, Florianópolis, Santa Catarina, Brazil; and
| | - Vitor Pereira Costa
- Human Performance Research Group, Center for Health and Sport Sciences, University of Santa Catarina State, Florianópolis, Santa Catarina, Brazil; and
| | - Benedito Sérgio Denadai
- Physical Effort Laboratory, Sports Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- Human Performance Laboratory, Paulista State University, Rio Claro, São Paulo, Brazil
| | - Ricardo Dantas de Lucas
- Physical Effort Laboratory, Sports Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Drake JP, Finke A, Ferguson RA. Modelling human endurance: power laws vs critical power. Eur J Appl Physiol 2024; 124:507-526. [PMID: 37563307 PMCID: PMC10858092 DOI: 10.1007/s00421-023-05274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023]
Abstract
The power-duration relationship describes the time to exhaustion for exercise at different intensities. It is believed to be a "fundamental bioenergetic property of living systems" that this relationship is hyperbolic. Indeed, the hyperbolic (a.k.a. critical-power) model which formalises this belief is the dominant tool for describing and predicting high-intensity exercise performance, e.g. in cycling, running, rowing or swimming. However, the hyperbolic model is now the focus of a heated debate in the literature because it unrealistically represents efforts that are short (< 2 min) or long (> 15 min). We contribute to this debate by demonstrating that the power-duration relationship is more adequately represented by an alternative, power-law model. In particular, we show that the often-observed good fit of the hyperbolic model between 2 and 15 min should not be taken as proof that the power-duration relationship is hyperbolic. Rather, in this range, a hyperbolic function just happens to approximate a power law fairly well. We also prove mathematical results which suggest that the power-law model is a safer tool for pace selection than the hyperbolic model and that the former more naturally models fatigue than the latter.
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Affiliation(s)
- Jonah P Drake
- Department of Mathematical Sciences, School of Science, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Axel Finke
- Department of Mathematical Sciences, School of Science, Loughborough University, Loughborough, LE11 3TU, UK
| | - Richard A Ferguson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
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Gorostiaga EM, Garcia-Tabar I, Sánchez-Medina L. Critical power: Artifact-based weaknesses. Scand J Med Sci Sports 2023; 33:101-103. [PMID: 36465056 DOI: 10.1111/sms.14260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Esteban M Gorostiaga
- Studies, Research and Sports Medicine Centre (CEIMD), Government of Navarre, Pamplona, Spain
| | - Ibai Garcia-Tabar
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Bioaraba GIKAFIT, Vitoria-Gasteiz, Spain
| | - Luis Sánchez-Medina
- Studies, Research and Sports Medicine Centre (CEIMD), Government of Navarre, Pamplona, Spain
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