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- Issue 19
- CLINICAL AND BIOMECHANICAL OUTCOMES OF REHABILITATION…
CLINICAL AND BIOMECHANICAL OUTCOMES OF REHABILITATION TARGETTING INTERSEGMENTAL CONTROL IN ATHLETIC GROIN PAIN: PROSPECTIVE COHORT OF 205 PATIENTS
BACKGROUND & OBJECTIVE
This study reported on the outcome of a series of individuals with athletic groin pain (AGP) following a rehabilitation programme including inter-segmental control alongside isolated strength work. A basic premise of this paper was that, whilst high speed sprints and rapid changes of direction tend to be provocative activities for individuals with groin pain, most outcome measures tend to be uniplanar and involve isolated muscle groups. These functional activities are complex, involving a number of joints and directions of movement. Therefore, it is logical to consider that movement strategy and flow may be a risk factor in AGP in addition to the capacity of a muscle to produce force.
This paper supports the reasoning that successful return to sport following athletic groin pain should ideally include strength (capacity), good form (control through range and across body segments) plus efficient timing/co-ordination (movement flow).
The authors presented their findings from following 205 athletes through a rehabilitation programme that focused on inter-segmental control and re-education of running and cutting technique. They also used 3D motion analysis to assess movement strategies across the hip, knee and ankle during a cutting manoeuvre, before and after the rehabilitation intervention. The outcome measures were the HAGOS (Hip And Groin Outcome Score) questionnaire, return to play rates and the squeeze test for pain provocation. They included a variety of conditions causing AGP. An initial assessment excluded conditions that were not suitable for rehabilitation. The image below shows an outline of the programme progression.
HAGOS and squeeze tests both improved significantly and to normative levels post-rehab, but were still lower than typical values for those who have never experienced AGP.