Clinical examination for athletes with inguinal-related groin pain: interexaminer reliability and prevalence of positive tests

Review written by Dr Alison Grimaldi info

Key Points

  1. Combining abdominal wall palpation and abdominal resistance tests should identify 90% of patients with the clinical entity of inguinal-related groin pain.
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Groin pain is a prevalent and impactful condition in young, male athletes. The Doha Agreement aimed to address inconsistency in diagnosis by standardizing terminology and assessment around four main clinical entities – adductor-related groin pain, iliopsoas-related groin pain, pubic-related groin pain, and inguinal-related groin pain (IRGP) (1). Of all the entities, achieving clarity around diagnosis of IRGP has perhaps remained most challenging.

IRGP was defined in the Doha agreement as: pain in the inguinal canal region that worsened with exercise (history) and tenderness of the inguinal canal (clinical examination). Further, the diagnosis was more likely if the pain was aggravated by abdominal resistance tests or on Valsalva, cough or sneeze.

This study aimed to assess the interexaminer reliability of abdominal palpation and resistance tests in athletes with longstanding groin pain, and to report the prevalence of positive clinical tests in athletes classified with IRGP.

Groin pain is a prevalent and impactful condition in young, male athletes.
Full examination of the groin region will assist in exclusion of other clinical entities, hip-related groin pain and other causes.


  • This was a prospective study of male athletes (n=44; age:28.5±5.7) who presented to a sports medicine hospital with long standing groin pain.
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