Study Design Cross-sectional, case-control design. Background Pelvic movement has been considered a possible discriminating parameter associated with femoroacetabular impingement (FAI) symptom onset. Decreased pelvic rotation has been found during squatting in people with FAI when compared to people with healthy hips. However, it is possible that changes in pelvic movement may occur in other hip conditions because of pain and may not be specific to FAI. Objectives To compare sagittal pelvic rotation during hip flexion and in sitting between people with FAI and people with other symptomatic hip conditions. Methods Thirty people with symptomatic FAI, 30 people with other symptomatic hip conditions, and 20 people with healthy hips participated in the study. Sagittal pelvic rotation was calculated based on measures of pelvic alignment in standing, hip flexion to 45° and 90°, and sitting. Results There were significant differences in sagittal pelvic rotation among the 3 groups in all conditions (P<.05). Post hoc analyses revealed that participants in the symptomatic FAI group had less pelvic rotation during hip flexion to 45° and 90° compared to participants in the other symptomatic hip conditions group and the hip-healthy group (mean difference, 1.2°-1.9°). In sitting, participants in the other symptomatic hip conditions group had less posterior pelvic rotation compared to those in the hip-healthy group (mean difference, 3.9°). Conclusion People with symptomatic FAI have less posterior pelvic rotation during hip flexion when compared to people with other symptomatic hip conditions and those with healthy hips. Level of Evidence Diagnosis, level 4. J Orthop Sports Phys Ther 2016;46(11):957-964. Epub 29 Sep 2016. doi:10.2519/jospt.2016.6713.
A pubalgia tornou-se um problema comum no futebol, preocupando atletas, treinadores, ortopedistas e fisioterapeutas. A articulação do púbis é capaz de absorver parte das forças descendentes e ascendentes que são aplicadas ao corpo e seu comportamento depende diretamente dos movimentos da articulação sacroilíaca. Esses fatores tornam essa articulação extremamente importante, colocando-a algumas vezes em situações estressantes. Por ter como características tratamento difícil e de tempo prolongado, torna-se imprescindível o conhecimento da fisiopatologia relacionada à pubalgia. Embora não haja ainda um consenso entre os autores, vários mecanismos têm sido sugeridos na tentativa de explicar o desenvolvimento da pubalgia. A proposta deste artigo é discutir esses possíveis mecanismos, tentando correlacioná-los com a experiência dos autores junto a jogadores profissionais de futebol, mostrando possíveis caminhos relacionados à prevenção e reabilitação. Isso inclui boa flexibilidade dos músculos relacionados com o osso púbico, mobilização da articulação sacroilíaca, correção de desbalanceamentos de força, calçados e campos de treinamento adequados.
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