Hip and groin pain are common complaints in sport. The anatomy of the two regions is complex and pathologies often co-exist. As a result, diagnoses and management plans can be difficult and are often multi-factorial.
Research: Early days
Until recently, hip joint disorders were not thought to have a significant impact on athletic populations, although their impact on paediatric and geriatric populations has long been recognized. With the introduction of MRI and hip arthroscopy surgery, the influence of hip pathology on athletes has received greater attention. The hip joint can be injured acutely during sport, or problems can develop more slowly secondary to underlying anatomical abnormalities. The biomechanical demands of a sport will have some effect, especially in sports requiring repetitive flexion, adduction and rotation. Although there has been a recent increase in hip and groin pain-related research, it is still early days and more research will help improve understanding in assessment, management strategies and return to sport.
Clinical assessment and management
With a greater awareness of groin pain and hip injuries in sport, clinical assessment and management of these conditions has also progressed. The new edition of the Clinical Sports Medicine textbook reflects this with a brand new chapter titled Hip-related pain, spanning over 30 pages. This chapter complements the updated Groin pain chapter. Features of the new and updated chapters include helpful hints for differentiating hip joint and thigh pain, discussion on common causes of hip and groin pain, a list of local factors that can contribute to the development of hip-related pain including femoroacetabular impingement and case scenarios.
The hip chapter is co-authored by world renowned physiotherapists and researchers Joanne Kemp, Kay Crossley and Anthony Schache and orthopaedic surgeon Mike Pritchard who has added his clinical insights to the chapter. The groin chapter is co-authored by sports physician Chris Bradshaw and orthopaedic surgeon and groin pain researcher Per Holmich.
With improved understanding of hip injuries and groin pain, management strategies and rehabilitation have progressed. The new edition of the textbook outlines evidence-based treatment protocols and examples of exercises that can provide increasingly greater challenges for sportspersons. Criteria for return to sport are discussed to help clinicians make that all important decision.