If you play at any level of football you will know that hip and groin pain is very common.
A recent study performed in Scandinavia highlighted its impact on football players. In a group of 695 semi-eilte football players who trained between 3-4 times a week, 49% of the players reported they had experienced hip or groin pain during the previous season (Thorborg, Rathleff, Petersen, Branci, & Holmich, 2015). Amongst this group who reported pain, 31% had pain for longer than six weeks and 46% missed games due to the pain they experienced (Thorborg et al., 2015).
In order to implement correct management for hip or groin pain, a correct diagnosis is firstly required. The hip and groin area has been labelled the Bermuda triangle of sports medicine due to the close proximity of muscle, tendon and nerve tissue within the area (Bizzini, 2011). One often forgotten cause of hip or groin pain in footballers is the hip joint. It has been shown on many occasions that the hip joint can be the primary cause of groin pain (Bradshaw, Bundy, & Falvey, 2008; Rankin, Bleakley, & Cullen, 2015).
I am currently undertaking my PhD at Latrobe University looking at the impact of hip and groin pain in footballers. In particular it is focused on a condition called “femoroacetabular impingement” or ‘’FAI’’.
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Tweet at @JHeerey, @LaTrobeSEM, @FAI_Cohort and @mattgmking1 for more info
What is FAI?
FAI is caused by abnormal bone formation in the hip joint. This abnormal bone formation develops either on the femur, acetabulum or both. It is this abnormal bone formation combined with the movements performed during sporting activity, that is thought to cause damage within the hip joint and in particular the acetabular labrum. It is thought that this damage may increase the likelihood that hip joint arthritis will develop later in life.
How is FAI diagnosed?
Commonly people will report pain within the hip or groin area with activities like squatting, kicking, changing direction or passing. Often “clicking” or “catching” is also felt within the hip joint. Pain can vary in intensity and frequency. In order to be diagnosed with FAI, a physiotherapist or sports doctor will need to perform a clinical examination to evaluate the hip joint. This will include placing the hip into positions known to be painful in FAI and also looking at the flexibility that the hip has. After this has been completed, a thorough examination is needed of the lower back, adductor and hip flexor muscles to evaluate if they are involved or causing the individuals pain. Often medical imaging is used to evaluate the hip, this will consist of x-rays and an MRI scan. Only when an individual has a positive clinical examination and findings on X-ray or MRI can FAI actually be diagnosed.
What happens if I have FAI?
The management of FAI depends on many factors. A good starting place is to firstly reduce the amount of training you are performing. This in combination with a well-structured exercise program and treatment from your physiotherapist is thought to be a good way at reducing the symptoms associated with FAI. In some circumstances you may be referred to an orthopaedic surgeon, this is often done if your symptoms are not settling and you have not had success with an exercise program. The orthopaedic surgeon will evaluate whether or not they feel surgery can help reduce your symptoms.
LaTrobe University is currently undertaking a large research project looking at FAI in football players. This project is aiming to determine if strength, flexibility and movement patterns play a role in the worsening of hip joint structure in soccer players with FAI.
We are aiming to recruit football players currently playing within Victoria who are experiencing hip or groin pain. You may be eligible if you meet the following criteria:
- Male or Female and aged between 18-50
- Have or have had groin or hip pain for longer than six months
- Currently playing football at any level within Victoria
If you feel that you may be eligible and would like to know more about his exciting project please click on the above banner. This will direct you to the website located on the Latrobe university website. Alternatively you can contact me at:
Email: J.Heerey@latrobe.edu.au
Phone: 0419508647
A former Premiership winning player at South Hobart FC, Josh is a physiotherapist with extensive experience dealing with hip and groin pain in football players. He is currently undertaking his PhD, looking at hip and groin pain in soccer players. He consults privately at Clifton Hill Physiotherapy in Clifton Hill.
References:
Bizzini, M. (2011). The groin area: the Bermuda triangle of sports medicine? Br J Sports Med, 45(1), 1.
Bradshaw, C. J., Bundy, M., & Falvey, E. (2008). The diagnosis of longstanding groin pain: a prospective clinical cohort study. British Journal of Sports Medicine, 42(10), 551-554.
Rankin, A. T., Bleakley, C. M., & Cullen, M. (2015). Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population: A 6-Year Review of 894 Cases. Am J Sports Med, 43(7), 1698-1703. doi:10.1177/0363546515582031
Thorborg, K., Rathleff, M. S., Petersen, P., Branci, S., & Holmich, P. (2015). Prevalence and severity of hip and groin pain in sub-elite male football: a cross-sectional cohort study of 695 players. Scand J Med Sci Sports. doi:10.1111/sms.12623
Feature image: Mark Avellino