Specialist areas.

ACL rEAbILITATION.

MRI including a sagittal view can rule out other causes and to get an idea of severity – this can help suggest whether this has been longstanding or acute, but some excellent work from Denmark suggests that the scan helps less than you might think , and other studies have shown that 60% of athletes have some change in the hip – without any pain – and as such those offering hip surgery as the answer to groin pain are way off the mark in most cases.

See the animation we have designed to show what happens when you change direction at speed. As you will see unless your posterior chain (Gluteals, Lumbar extensors and Hamstrings) all work in synchronous stability – your torso can tip forward, or your lumbar spine can become lordotic – i.e.  stick your butt out like a duck. This decreases hip range of motion and results in an increased load on the hip flexor and upper quad muscles. In fact some people move this way all the time – and certainly give themselves less room for error. This in turn is likely to mean an increase in bone load across the pubic bone and lower abdominal muscle. You can see the lower abs and adductors form a sling and if this is overloaded it hurts.

Cutting, turning, rotation under load all aggravate it, and kicking sometimes. As it worsens you can get pain when you wake up – sitting up in bed, putting on socks, standing on one leg, and coughing and sneezing. You will probably have had massage, strengthening, physiotherapy, and maybe injections to keep playing. Steroid injections to the adductor muscles, pubic bone and symphysis are commonly used, but do not ‘cure’ or fix, neither does rest – it is not treatment.