Hip and Groin Seminars.

Hip and Groin Seminars.

Staff at Carbery Physiotherapy attended two seminars recently on Hip and Groin pain. The first was titled “Hip and Groin Pain-from research to practice”, presented by Dr. Helen French & Mr. Enda King. The second was “The 3rd Hip and Groin Sports Injury Symposium” held in the Whitfield Clinic in Waterford. The aim of both seminars was to improve the therapist’s knowledge on hip and groin pathologies, to improve knowledge on the variety of rehabilitation, diagnosis and non-operative treatment of hip/groin injuries and to link the theory with the current evidence surrounding hip strengthening and rehabilitation.

Hip and groin pain affects a wide range of people, from the amateur athlete with an acute groin strain to those at risk of osteoporosis or osteoarthritic complications of the hip joint, which could ultimately lead to a total hip replacement. There are many common causes of both groin pain and hip pain. However both can often present with similar signs and symptoms making it difficult for both the patient to identify the source of the pain but also for the health professional to diagnose. On occasion, pain in the hip/groin can be referred from the lower back or pelvic joints. It is also possible to have simultaneous problems in both lower back and hip or hip and groin at the same time. Often a problem in one area can lead to symptoms in the other over time.

Groin Pain
A groin strain is a partial tear of the small fibres of the adductor muscles. The adductors are a group of three muscles located on the inner aspect of the thigh. They start in the groin area and run down the inner thigh attaching to the inner side of the knee. Athletes competing in sports that require running, changes in direction, repetitive kicking and physical contact such as Soccer, GAA, rugby and hockey, are at a relatively higher risk of experiencing episodes of groin injury.

Some facts…
Groin injuries account of 5% to 18% of all sport-related injuries and can take up to 6/12+ to resolve.
Up to 25% may not return to their sport
The term “Groin Pain” is often used to describe multiple and commonly co-existing pathologies
Terminology now moving towards
– Adductor-related groin pain
– Exercise –related groin pain
– Long-standing (adductor-related) groin pain (chronic)

“94% of athletes with long standing adductor related groin pain had signs of FAI when x-rayed”. (Weir et al, 2011)

So what is Femoro-acetabular Impingement (FAI)?
Femoro-acetabular impingement (FAI) is a condition where the bones of the hip are abnormally shaped. Because they do not fit together perfectly, the hip bones rub against each other (head of femur and acetabulum) and cause damage to the joint. Up to 30% of healthy young adults show FAI when examined (Laborie et al, 2011), it most common in those aged between 20-50 and is more prevalent in males over females.

Types of FAI
There are three types of FAI: pincer, cam, and combined impingement.
Pincer. This type of impingement occurs because extra bone extends out over the normal rim of the acetabulum. The labrum can be crushed under the prominent rim of the acetabulum.
Cam. In cam impingement the femoral head is not round and cannot rotate smoothly inside the acetabulum. A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.
Combined. Combined impingement just means that both the pincer and cam types are present.

Some suggest FAI is a developmental hip abnormality, others believe it is caused by excessive friction due to cumulated repetitive movement?
What we do know is that FAI, while sourced at the HIP joint can often present as pain in the groin area. To complicate matters the pain sometimes may be more toward the outside of the hip, can cause sharp stabbing pain with turning, twisting, and squatting, or just present as a constant dull ache.

What can Physiotherapy do?
Physiotherapy can provide you with a thorough musculoskeletal examination determining the actual source of the symptoms in your hip and groin and ultimately tailoring an evidence-based treatment plan. Physiotherapy plays a very important role in the recovery from injury or surgery. It is vital you are assessed so that the appropriate diagnosis can be made and the correct advice regarding treatment may be provided. Some injuries, which require surgery will also benefit from both pre-operative and post-operative physiotherapy. Each patient who requires physiotherapy should be provided with a personal rehabilitation programme.

For those who conservative treatment may not be suitable surgical intervention may be an option. Further information about the procedures available can be found at the following Hip and Groin Clinic…

For further information please do not hesitate to contact us…Get in Touch

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