About Hip & Groin Pain
Hip and groin pain, with resultant dysfunction, are common reasons for patients to attend a sports medicine clinic.
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Hip and groin pain, with resultant dysfunction, are common reasons for patients to attend a sports medicine clinic. The nature of problems around this region may be acute, such as a sudden onset after a sporting incident, or may be chronic with the apparently insidious onset of symptoms over many months or even years. Although there may be a variety of reasons for such presentations, a thorough examination by an experienced clinician will usually unearth the cause of the issue.
Regarding hip pain
We are often first line clinicians diagnosing conditions such as femoroacetabular impingement, labral tears, ischiofemoral impingement, instability, dysplasia, osteoarthritis, gluteal tendinopathy / trochanteric bursitis, Perthes disease, avascular necrosis and a few other weird and wonderful presentations. We also work closely with leading sports physicians and orthopaedic surgeons providing post diagnostic care or postoperative care following, but not limited to, hip arthroscopy, labral repair, labral reconstruction, periacetabular osteotomy, femoral osteotomy, total hip replacement and hip resurfacing surgery. Pain and dysfunction can usually be addressed with a combination of activity modification, appropriate, progressive strengthening, functional retraining of movement patterns, and finally graduated return to sport or activity of choice. Conditions such as impingement and dysplasia are recognised as leading causes of early onset hip osteoarthritis, and hence, early detection and appropriate management are essential. As such, in addition to the aforementioned management program, referral to an appropriate sports physician or orthopaedic surgeon may be warranted.
Regarding groin pain
We are often faced with the difficulty of demystifying chronic pain that has been present for an extended period. Patients are often diagnosed with the term “osteitis pubis” which is an umbrella term for centrally located groin pain. The issue with the term “osteitis pubis” is that it fails to clearly delineate what pathology (adductor tendon or attachment, rectus abdominis tendon or attachment, pubic instability, pubic irritation, bone stress, pubic apophysitis) is the main culprit and patients can be left confused regarding a clear management direction. Management should be respectful of the underlying pathology and in addition should address biomechanical deficits which either caused the initial problem or resulted as an adaptation to pain. The treatment plan may include restoration of hip and pelvic range, appropriate hip and pelvic stability, functional retraining of movement patterning and finally appropriately timed conditioning for return to sport or athletic pursuits.