Injuries to the groin are not unusual to the professional footballer and the onset of a slight strain does not result in long-term absence from training. More chronic groin pain is a far more challenging condition that is becoming increasingly prevalent in
the modern player, with time lost to injury ranging from 2-3 months to 1-2 years.
In general, chronic groin pain usually comes on without specific injury. Pain develops over a prolonged period and the player can often suffer with this low-grade pain for weeks before getting to a stage where they feel they can no longer train.
• Reduced straight line running speed and pain after training.
• This progresses to an inability to change direction and weakness and pain when attempting to strike the ball with the instep.
• Pain in bed after training and difficulty sitting up, turning over and lying on one side are also common features.
DIAGNOSIS (see Fig.1)
When you look at the anatomy of the region there are so many joints, muscles and ligaments coming together leading to so many possible pain sources, a number of diagnoses may be made. But it is possible that all of these conditions are a result of poor pelvic control. Due to the amount of kicking and turning in football, the stresses placed on the pelvis are immense. If the pelvis is not stable during these movements it is likely that the groin region will take these stresses and overload.
The following simple tests will look to see if you have adequate pelvic control. If you are unable to complete them you will be at
higher risk to future groin injury and you should seek advice from a physiotherapist. Until you can control the pelvis you should
not attempt to return to sport.
Squeeze test (see Fig.2)
Place a ball between your knees. Now squeeze your knees together as hard as you can. Can you generate good power?
Can you do this without pain?
Single leg bridge (see Fig.3)
Perform a single leg bridge. Can you do this comfortably without any movement in your pelvis? If your pelvis moves it is a sign of limited stability in the groin.
Plank (see Fig.4)
Can you perform front, reverse, side and abduction plank exercises for 30 seconds each in perfect alignment? Do you develop pain or weakness? Do you start to compensate? All these would be a sign of a lack of pelvic control.
Athletic groin pain is a common problem in footballers, which has a wide pain source. Many of the diagnoses are likely to be due to the same cause – poor control of the pelvis (Pelvic Biomechanical Overload Syndrome). If the player can address this lack of control through rehabilitation, the risk of injury or length of time lost to injury can be significantly reduced.