Groin injuries present a major problem in football codes due to their high incidence, chronic symptoms, and high of recurrence. Unfortunately, most studies have focused a single culprit underlying such cases, failing to appreciate the vast number and complexity of anatomical structures located within the region. An appreciation of these factors is crucial to our understanding of groin injuries, and subsequent management and prevention. The current study aims to describe the occurrence and clinical presentation of groin injuries amongst sub-elite soccer players in-season.
A large cohort of 998 male soccer players were followed prospectively over a 10-month season. Players sustaining groin injuries were further examined clinically in an attempt to identify the injured anatomical structure(s). Both the exposure time and injury time were also documented.
The results suggested that adductor-related groin injury, followed by iliopsoas-related and abdominal-related was the most prevalent. Both age and previous history were identified as significant risk factors. Furthermore, both the player’s dominant and previously injured side were more vulnerable to injury. In comparison to abdominal-related groin injuries, the time-frame for recovery from adductor-related injury was significantly greater.
These findings provide further insight into understanding the clinical characteristics of groin injuries in soccer, allowing coaches and trainers to better plan their training approaches in order to prevent new and reoccurring injuries. > From: Holmich et al., Br J Sports Med (2013) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd. Image taken from:dailymail.co.uk
Non-operative treatment of acute hip adductor longus ruptures in athletes has been described in the literature. However, very limited information concerning the recovery of this type of injury exists. This case represented a unique possibility to study the recovery of two acute adductor longus ruptures, using novel, reliable and validated assessment methods.
Case presentation
A 22-year old male soccer player (Caucasian) sustained two subsequent acute adductor longus ruptures, one in each leg. The injuries occurred 10 months apart, and were treated non-surgically in both situations. He was evaluated using hip-strength assessments, self-report and ultrasonography until complete muscle-strength recovery of the hip adductors had occurred. The player was able to participate in a full soccer training session without experiencing pain 15 weeks after the first rupture, and 12 weeks after the second rupture. Full hip adductor muscle-strength recovery was obtained 52 weeks after the first rupture and 10 weeks after the second rupture. The adductor longus injuries, as verified by initial ultrasonography (10 days post-injury), showed evidence of a complete tendon rupture in both cases, with an almost identical imaging appearance. It was only at 6 and 10 weeks ultrasonographic follow-up that the first rupture was found to include a larger anatomical area than the second rupture.
Conclusion
From this case we can conclude that two apparently similar hip adductor longus ruptures, verified by initial ultrasonography (10 days post-injury), can have very different hip adductor strength recovery times. Assessment of adductor strength recovery may therefore in the future be a useful and important additional measure for determining when soccer players with hip adductor longus ruptures can return safely to play.
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