Acta Chir Orthop Traumatol Cech. 2019; 86(6):435-443 | DOI: 10.55095/achot2019/073

Combined Symptomatic Treatment of Groin Pain Syndrome in Professional Football Players - Prospective Study ResultsOriginal papers

M. MOHYLA1,2, H. TOMÁŠKOVÁ2, O. JELÍNEK3, M. STŘÍŽ1, R. FREI5, P. ZEMAN4,*
1 Ortopedické oddělení Fakultní nemocnice Ostrava
2 Ústav epidemiologie a ochrany veřejného zdraví Lékařské fakulty Ostravské Univerzity, Ostrava
3 Fyzioterapeut FC Baník Ostrava
4 Klinika ortopedie a traumatologie pohybového ústrojí Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Plzeň
5 Centrum pohybové medicíny Pavla Koláře, Praha

PURPOSE OF THE STUDY:
The results of the prospective study evaluating the outcomes of a combined therapeutic approach of non-operative therapy of Groin Pain Syndrome (GPS) in professional football players are presented.

MATERIAL AND METHODS:
The evaluated cohort consisted of a total of 31 football players of a professional football club divided into two groups. The Group 1 included 10 symptomatic patients suffering from GPS for at least 4 weeks, the Control Group 2 included 21 healthy football players not suffering from GPS. The symptomatic patients with GPS who had undergone any surgery or had sustained any major injury to their low back, groins, hip or knee joints were excluded from the study. It was a prospective non-randomized study. The results were evaluated using the HAGOS (Copenhagen Hip and Groin Outcome Score) questionnaire, which in Group 1 compared the results before the initiation of the new combined therapeutic approach of non-operative therapy developed by us and the results after the end of this treatment, i.e. after 6 weeks. Moreover, the HAGOS was used to compare the results of the Group 1 after the treatment and the Control Group 2, i.e. the healthy football players. The HAGOS evaluated six separate areas: Pain, Symptoms, Physical function in daily living, Physical function in sport and recreation, Participation in physical activities, and hip and/or groin-related Quality of Life. The resulting score for each domain ranges from 0 to 100 (100 = no problems, 0 = extreme problems). The results were statistically evaluated by an independent statistician.

RESULTS:
In Group 1, after the end of the treatment a statistically significant improvement was observed in all the parameters assessed by HAGOS. Pain (70 before the treatment, 95 after the treatment), Symptoms (58.9 before/85.7 after), Physical function in daily living (70 before/100 after), Physical function in sport (46.9 before/90.6 after), Participation in physical activities (43.8 before/100 after), Quality of Life (66.3 before/95 after). When comparing the two groups, before the treatment a statistically significant difference was found in all the six parameters assessed by HAGOS, while after the treatment no significant difference between Group 1 and Group 2 was detected.

DISCUSSION:
The most important result of our study is that by applying the new combined therapeutic approach of the GPS non-operative therapy developed by us better HAGOS score were achieved in our cohort than those achieved by other types of non-operative therapy presented in recent literature. The approach proposed by us is more successful in terms of the speed of return to sport (6 weeks) than the multimodal therapy programme (12 weeks) and Training programme (18 weeks).

CONCLUSIONS:
The results of this prospective study confirm that the Group 1 having undergone the 6-weeek long combined symptomatic non-operative therapy of GPS proposed by us showed a statistically significant improvement in all the parameters assessed by HAGOS and these values showed no statistically significant difference from those of the Control Group of healthy individuals.

Keywords: Groin Pain Syndrome (GPS), professional football player, HAGOS (Copenhagen Hip and Groin Outcome), symptomatic therapy

Published: December 1, 2019  Show citation

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MOHYLA M, TOMÁŠKOVÁ H, JELÍNEK O, STŘÍŽ M, FREI R, ZEMAN P. Combined Symptomatic Treatment of Groin Pain Syndrome in Professional Football Players - Prospective Study Results. Acta Chir Orthop Traumatol Cech. 2019;86(6):435-443. doi: 10.55095/achot2019/073. PubMed PMID: 31941572.
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References

  1. Bisciotti G N, Volpi P, Zini R, Auci A, Aprato A, Belli A, Bellistri G, Benelli P, Bona S, Bonaiuti D, Carimati G, Canata G L, Cassaghi G, Cerulli S, Delle Rose G, Di Benedetto P, Di Marzo F, Di Pietto F, Felicioni L, Ferrario L, Foglia A, Galli M, Gervasi E, Gia L, Giammattei C, Guglielmi A, Marioni A, Moretti B, Niccola R, Orgiani N, Pantalone A, Parra F, Quaglia A, Respizzi F, Ricciotti L, Pereira Ruiz M T, Russo A, Sebastiani E, Tancredi G, Tosi F, Vuckovic Z. Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport Exerc Med. 2016;29;2:e000142. Go to original source... Go to PubMed...
  2. Delahunt E, Fitzpatrick H, Blake C. Pre-season adduktor squeeze test and HAGOS fiction sport and recreation subscale score pregict groin Indry in Gaelic football players. Phys Ther Sport. 2017;23:1-6. Go to original source... Go to PubMed...
  3. Ekberg O, Persson NH, Abrahamsson PA, Westlin, NE, Lilja B. Longstanding groin pain in athletes. A multidisciplinary approach. Sports Med. 1988;6:56-61. Go to original source... Go to PubMed...
  4. Ekstrand J., Hilding J. The incidence and differential diagnosis of acute groin injuries in male soccer players. Scand J Med Sci Sports. 1999;9:98-103. Go to original source... Go to PubMed...
  5. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, Krogsgaard K. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999;353:439-443. Go to original source... Go to PubMed...
  6. Hölmich P. Long-standing groin pain in sportspeople falls into three primary patterns, a "clinical entity" approach: a prospective study of 207 patients. Br J Sports Med. 2007;41:247e52. Go to original source... Go to PubMed...
  7. Janda V a kol. Svalové funkční testy. Grada, Praha, 2004, pp.279-306.
  8. Kolář P. Rehabilitace v klinické praxi. 1. vyd., Galén, Praha, 2009.
  9. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport.1995;27:76-79.
  10. Mohyla M, Zeman P. Diferenciální diagnostika bolestí kyčle. In: Zeman P. a kol. Artroskopie kyčelního kloubu. Maxdorf, Praha, 2016, pp.97-107.
  11. Poděbradský J, Poděbradská R.. Fyzikální terapie. 1. vyd., Grada, Praha, 2009.
  12. Serner A, van Eijck CH, Beumer BR, Hölmich P, Weir A, de Vos RJ. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med. 2015;49:813. Go to original source... Go to PubMed...
  13. Tak I, Weir A, Langhout R, Waarsing JH, Stubbe J, Kerkhoffs G, Agricola R. The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players. Br J Sports Med. 2015;49:630-634. Go to original source... Go to PubMed...
  14. Tak I, Langhout R, Bertrand B, Barendrecht M, Stubbe J, Kerkhoffs G, Weir A. Manual therapy and early return to sport in football players with adductor-related groin pain: a prospective case series. Physiother Theory Pract. 2018;11:1-10. Go to original source... Go to PubMed...
  15. Thorborg K, Holmich P, Christensen R, Petersen J, Roos EM. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med. 2011;45:478-491. Go to original source... Go to PubMed...
  16. Thorborg K, Branci S, Stensbirk F, Jensen J, Hölmich P. Copenhagen hip and groin outcome score (HAGOS) in male soccer: reference values for hip and groin injury-free players. Br J Sports Med. 2014;48:557-559. Go to original source... Go to PubMed...
  17. Thorborg K, Tijssen M, Habets B, Bartels EM, Roos EM, Kemp J, Crossley KM, Hölmich P. Patient-reported outcome (PRO) questionnaires for young-aged to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence. Br J Sports Med. 2015;49:812. Go to original source... Go to PubMed...
  18. Travell J, Simons D. Myofascial pain and dysfunction. Volume 1., 2. vyd., Williams Wilkins, Philadelphia Pa, 1999.
  19. Waldén M, Hägglund M, Ekstrand J. The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med. 2015;49:792-797. Go to original source... Go to PubMed...
  20. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther. 2011;16:148-154. Go to original source... Go to PubMed...
  21. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, Lovell G, Meyers WC, Muschaweck U, Orchard J, Paajanen H, Philippon M, Reboul G, Robinson P, Schache AG, Schilders E, Serner A, Silvers H, Thorborg K, Tyler T, Verrall G, de Vos RJ, Vuckovic Z, Hölmich P. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015;49:768-774. Go to original source... Go to PubMed...
  22. Werner J, Hägglund M, Waldén M, Ekstrand J. UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med. 2009;43:1036-1040. Go to original source... Go to PubMed...
  23. Wörner T, Sigurðsson HB, Pålsson A, Kostogiannis I, Ageberg E. Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls. Knee Surg Sports Traumatol Arthrosc. 2017;25:101-107. Go to original source... Go to PubMed...