Skip to main content

Rehabilitation from Hip and Groin Surgery

  • Chapter
  • First Online:
The Young Adult Hip in Sport

Abstract

Assessment of groin pain in the young adult population is complex and requires a systematic and integrated approach to create a marriage between the history, the investigations used and the physical examination. Through this process it is possible to ascertain the relationships between the primary and secondary conditions or clinical entities, and accurately identify the source of pain verses the source of dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Renstrom P, Petersen L. In: Renstrom P, editor. Sports injuries: their prevention and treatment. London: Martin Dunitz; 2002.

    Google Scholar 

  2. Puig P, Trouve P, Savalli L. Pubalgia: from diagnosis to return to the sports field. Ann Readapt Med Phys. 2004;47(6):356–64.

    Article  PubMed  CAS  Google Scholar 

  3. Cowan SM, Schache AG, Brukner P, Bennell KL, Hodges PW, Coburn P, et al. Delayed onset of transversus abdominus in long-standing groin pain. Am Coll Sports Med. 2004;36:2040–5.

    Google Scholar 

  4. Bradshaw CJ, Bundy M, Falvey E. The diagnosis of longstanding groin pain: a prospective clinical cohort study. Br J Sports Med. 2008;42:551–4.

    Article  Google Scholar 

  5. Holmich P, Holmich LR, Berg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med. 2004;38:446–51.

    Article  PubMed  CAS  Google Scholar 

  6. Holmich P. Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 206 patients. Br J Sports Med. 2007;41:247–52.

    Article  PubMed  Google Scholar 

  7. Malycha P, Lovell G. Inguinal surgery in athletes with chronic groin pain: the sportsman’s hernia. Aust N Z J Surg. 1992;62:123–5.

    Article  PubMed  CAS  Google Scholar 

  8. Falvey E, Franklyn-Miller A, McCrory P. A 3G approach to a 3-dimensional problem. Br J Sports Med. 2009;43:145.

    Article  PubMed  CAS  Google Scholar 

  9. Mitchell EC. The area of pain of patients undergoing Hip arthroscopic surgery. J Am Coll Sports Med. 2006;38(5 S11):627.

    Google Scholar 

  10. Orchard J, Best TM, Verrall GM. Return to play following muscle strains. Clin J Sports Med. 2005;15(6):436–41.

    Article  Google Scholar 

  11. Lloyd-Smith R, Clement DB, McKenzie DC, Taunton JE. A survey of overuse and traumatic hip adn pelvic injuries in athletes. Phys Sports Med. 1985;13(10):131–7, 141.

    Google Scholar 

  12. Verrall GM, Slavotinek JP, Barnes PG, Fon GT. Description of pain provocation tests used for the diagnosis of sports-related chronic groin pain: relationship of tests to defined clinical (pain and tenderness) and MRI (pubic bone marrow oedema) criteria. Scand J Med Sci Sports. 2005;15:36–42.

    Article  PubMed  Google Scholar 

  13. Verrall G, Hamilton I, Slavotinek J, Oakeshott J, Spriggins A. Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury. J Sci Med Sport. 2005;8(1):77–84.

    Article  PubMed  CAS  Google Scholar 

  14. Ekstrand J, Gillquist J, Liljedahl S-O. Prevention of soccer injuries supervision by doctor and physiotherapist. Am J Sports Med. 1983;11(3):116–20.

    Article  PubMed  CAS  Google Scholar 

  15. O’Connor DM. Groin injuries in professional rugby league players: a prospective study. J Sports Sci. 2004;22:629–36.

    Article  PubMed  Google Scholar 

  16. Molsa J, Airaksinen O, Nasman O, Torstila I. Ice hockey injuries in Finland. A prospective epidemiologic study. Am J Sports Med. 1997;25(4):495–9.

    Article  PubMed  CAS  Google Scholar 

  17. Torry ML. Neuromuscular hip biomechanics and pathology in the athlete. Clin Sports Med. 2006;25:179–97.

    Article  PubMed  Google Scholar 

  18. Schilders E, Bismil Q, Robinson P, O’connor PJ, Gibbon WW, Talbot CJ. Adductor-related groin pain in competitive athletes. Role of adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. J Bone Joint Surg. 2007;89:2173–8.

    Article  PubMed  Google Scholar 

  19. Lovell G, Galloway H, Hopkins W, Harvery A. Osteitis pubis and assessment of bone marrow edema at the pubic symphysis with MRI in an elite junior male soccer squad. Clin J Sports Med. 2006;16(2):117–22.

    Article  Google Scholar 

  20. Orchard JW, Read JW, Neophyton J, Garlick D. Groin pain associated with ultrasound findings of inguinal canal posterior wall deficiency in Australian Rules footballers. Br J Sports Med. 1998;32:134–9.

    Article  PubMed  CAS  Google Scholar 

  21. Orchard J, Wood T, Seward H, Broad A. Comparison of injuries in elite senior and junior Australian football. J Sci Med Sport. 1998;1(2):82–8.

    Article  Google Scholar 

  22. Tyler TF, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The effectiveness of a Preseason exercise program to prevent adductor muscle strains in professional ice hockey players. Am J Sports Med. 2002;30:680–3.

    PubMed  Google Scholar 

  23. Mens J, Inklaar H, Koes BW, Stam HJ. A new view on adduction-related groin pain. Clin J Sports Med. 2006;16(1):15–9.

    Article  Google Scholar 

  24. Verrall GM, Slavotinek JP, Fon GT, Barnes PG. Outcome of conservative management of athletic chronic groin injury diagnosed as pubic bone stress injury. Am J Sports Med. 2007;35:467–74.

    Article  PubMed  Google Scholar 

  25. Fricker P. Osteitis pubis – infection, inflammation or injury. Sports Med. 1991;12(4):266–79.

    Article  PubMed  CAS  Google Scholar 

  26. Verrall GM, Henry L, Fazzalari NL, Slavotinek JP, Oakeshott RD. Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury. Am J Sports Med. 2008;36(12):2425–31.

    Article  PubMed  Google Scholar 

  27. Bialosky J, Bishop M, Price D, Robinson M, George S. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14:531–8.

    Article  PubMed  Google Scholar 

  28. Holmich P, Uhrskou P, Ulnits L, Kanstrup I-L, Nielsen MB, Bjerg AM, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. The Lancet. 1999;353(9151):439–43.

    Article  CAS  Google Scholar 

  29. Thorborg K, Serner A, Petersen J, Madsen TM, Magnusson P, Holmich P. Hip adduction adn abduction strength profile in elite soccer players – implications for clinical evaluation of hip adductor muscle recovery after injury. Am J Sports Med. 2010;20(10):1–6.

    Google Scholar 

  30. Wollin MGL. Osteitis pubis in four young football players: a case series demonstrating successful rehabilitation. Phys Ther Sport. 2006;7:153–60.

    Article  Google Scholar 

  31. Klein-Nulend J, Bacabac RG, Mullender MG. Mechanobiology of bone tissue. Pathol Biol. 2005;53(10):576–80.

    Article  PubMed  CAS  Google Scholar 

  32. Rubin J, Rubin C, Jacobs C. Molecular pathways mediating mechanical signaling in bone. Gene. 2006;367:1–16.

    Article  PubMed  CAS  Google Scholar 

  33. Fritton S, McLeaod K, Rubin C. Quantifying the strain history of bone: spatial uniformity and self-similarity of low-magnitude strains. J Biomech. 2000;33:317–25.

    Article  PubMed  CAS  Google Scholar 

  34. Bacabac RG, Smit TH, Mullender MG, Dijcks SJ, Van Loon JJ, Klein-Nulend J. Nitric oxide reproduction by bone cells is fluid shear stress rate dependent. Biochem Biophys Res Commun. 2004;315:823–9.

    Article  PubMed  CAS  Google Scholar 

  35. Burr D, Milgrom C, Fyhrie D, Forwood M, Nyska M, Finestone A, et al. In vivo measurement of human tibial strains during vigorous activity. Bone. 1996;18(5):405–10.

    Article  PubMed  CAS  Google Scholar 

  36. Judex S, Zhong N, Squire M, Ye K, Donahue L-R, Hardjiargyrou M, et al. Mechanical modulation of molecular signals which regulate anabolic and catabolic activity in bone tissue. J Cell Biochem. 2005;94:982–94.

    Article  PubMed  CAS  Google Scholar 

  37. Smedberg S, Broome A, Gullmo A, Roos H. Herniorrhaphy in athletes with groin pain. Am J Surg. 1985;149(3):378–82.

    Article  PubMed  CAS  Google Scholar 

  38. Ekberg O, Persson N, Abrahamsson P-A, Westlin N, Lilija B. Longstanding groin pain in athletes a multidisciplinary approach. Sports Med. 1988;6(1):56–61.

    Article  PubMed  CAS  Google Scholar 

  39. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995;27(3):76–9.

    PubMed  CAS  Google Scholar 

  40. Orchard J, Read JW, Verrall GM, Slavotinek JP. Pathophysiology of chronic groin pain in the athlete. Int Sports Med J FIMS. 2000;1(1):1–16.

    Google Scholar 

  41. Brown RA, Mascia A, Kinnear DG, Lacroix V, Feldman L, Mulder DS. An 18-year review of sports groin injuries in the elite hockey player: clinical presentation, new diagnostic imaging, treatment, and results. Clin J Sports Med. 2008;18(3):221–6.

    Article  Google Scholar 

  42. Schleip R, Klinger W, Lehmann-Horn F. Fascia is able to contract in a smooth muscle-like manner and thereby influence musculoskeletal mechanics. In: 5th world congress of biomechanics. Munich: Medimond; 2006. p. 51–4.

    Google Scholar 

  43. Gilmore J. Groin pain in the soccer athlete fact, fiction and treatment. Clin Sports Med. 1998;17(4):787–93.

    Article  PubMed  CAS  Google Scholar 

  44. Akita K, Niga S, Yamato Y, Muneta T, Sato T. Anatomic basic of chronic groin pain with special reference to sports hernia. Surg Radiol Anat. 1999;21:1–5.

    Article  PubMed  CAS  Google Scholar 

  45. Gunn CC. The Gunn approach to the treatment of chronic pain – intramuscular stimulation for myofascial pain of radiculopathic origin. Singapore: Churchill Livingstone; 1997.

    Google Scholar 

  46. Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, Spencer L, et al. Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall – a new approach for the management of chronic groin pain. Surg Laparosc Endosc Percutan Tech. 2008;18(4):363–8.

    Article  PubMed  Google Scholar 

  47. Hackney RG. The sports hernia: a cause of chronic groin pain. Br J Sports Med. 1993;27(1):58–62.

    Article  PubMed  CAS  Google Scholar 

  48. Simonet W, Saylor III H, Sim L. Abdominal wall muscle tears in hockey players. Int J Sports Med. 1995;16:126–8.

    Article  PubMed  CAS  Google Scholar 

  49. Polglase A, Frydman G, Farmer K. Inguinal surgery for debilitating chronic groin pain in athletes. Med J Aust. 1991;155(10):674–7.

    PubMed  CAS  Google Scholar 

  50. Karlin LI. Injuries to the hip and pelvis in the skeletally immature athlete. In: Nicholas JA, Hershman EB, editors. The lower extremity and spine in sports medicine. St. Louis: C V Mosby; 1986. p. 1292–332.

    Google Scholar 

  51. Irshad K, Feldman LS, Lavoie C, Lacroix VJ, Mulder DS, Brown RA. Operative management of “hockey groin syndrome”: 12 years of experience in National Hockey League players. Surgery. 2001;130(4):759–66.

    Article  PubMed  CAS  Google Scholar 

  52. Thumbe V, Evans DS. To repair or not to repair incidental defects found on laparoscopic repair of groin hernia. Surg Endosc. 2001;15:47–9.

    Article  PubMed  CAS  Google Scholar 

  53. Koulouris G. Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings. Am J Roentgen. 2008;191:962–72.

    Article  Google Scholar 

  54. Muschaweck E, Berger L. Minimal repair technique of sportsmen’s groin: an innovative open-suture repair to treat chronic inguinal pain. Hernia. 2010;14(1):27–33.

    Article  PubMed  Google Scholar 

  55. Wang JH. Mechanobiology of tendon. J Biomech. 2006;29:1563–82.

    Article  Google Scholar 

  56. Khan KM, Scott A. Mechanotherapy: how physical therapists prescription of exercise promotes tissue repair. Br J Sports Med. 2009;43:247–52.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James Moore .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Moore, J. (2014). Rehabilitation from Hip and Groin Surgery. In: Haddad, F. (eds) The Young Adult Hip in Sport. Springer, London. https://doi.org/10.1007/978-1-4471-5412-9_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5412-9_25

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5411-2

  • Online ISBN: 978-1-4471-5412-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics