Groin injuries in professional rugby league players: a prospective study

Abstract

Altogether, 100 uninjured professional rugby league players were evaluated over a 2-year period. Their height, body mass, sum of skinfolds, girths and bone diameters were recorded. A Cybex 340 isokinetic dynamometer was used to determine peak torque, work, power, endurance ratios and peak torque ratios of the hip abductors and adductors (5 repetitions at 0.52 and 2.08 rad. s(- 1); 20 repetitions at 3.66 rad. s(- 1)) and knee flexors and extensors (4 repetitions at 1.04 and 3.14 rad. s(- 1); 30 repetitions at 5.22 rad. s(- 1)). Hip abduction and adduction were also assessed with the hip in external rotation. Discriminant function analysis was conducted on all predictor variables to develop a multivariate predictive model capable of classifying players with a high degree of accuracy into groups with and without a groin injury. The model consisted of eight variables and correctly classified 91.7% of the non-injured players and 90.5% of the injured players. The correct classification for the model as a whole was 91.4%. The aetiological factors identified as being related to injury of the groin musculotendinous unit included abduction and adduction-with-rotation peak torque, angle of adduction and abduction-with-rotation peak torque, strength ratio of hip muscle groups, bilateral difference in extension peak torque, femur diameter and body mass.

Rehabilitation from Hip and Groin Surgery

“…When analysed further they concluded that if the adduction strength was 80 % or less than that of the abductor strength then you were 17 times more likely to get a groin strain. This philosophy of hip muscle ratio balance being important versus peak strength has been echoed by O'Connor [ 15 ] who commented on an over focus on gluteals at the expense of the adductors, allows the ratio to become poor. He goes on to mention that the Hip fl exors should be incorporated into this and that the focus should be on total hip strength.…”

“…O'Connor [ 15 ] reported that 23 % of all injuries over two seasons (n = 100) in rugby union occurred in the adductor muscles. While Molsa et al [ 16 ] commented that in ice hockey adductor muscle injuries accounted for 43 % of all muscle strains over three seasons (n = 134).…”

“…Establishing a strength balance, applying the principles outlined from a total hip strength [ 15 ] and abductor to adductor ratio [ 22 ]. Looking at specifi c local strength in both a functional a non-functional manner, and applying the principles of loading appropriate for the tissues involved (bone, enthesis, tendon, muscle) will allow for effective adaption of the pathology and injured tissue to provide a good stable background where the athlete can move forward and incorporate specifi c skill acquisition.…”

Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy

“…Numerous authors have reported predisposing factors to groin and hip pathologies, most notably reduced total hip range of motion (ROM) (Malliaras, Hogan, Nawrocki, Crossley, & Schache, 2009;Tyler, Nicholas, Campbell, & McHugh, 2001;Verrall, Hamilton, et al, 2005;Verrall, Slavotinek, Barnes, et al, 2007;Williams, 1978) and hip strength profiles, particularly into abduction and adduction (Delahunt, McEntee, Kennedy, Green, & Coughlan, 2011;Emery & Meeuwisse, 2001;Malliaras et al, 2009;O'Connor, 2004;Thorborg et al, 2011;Tyler et al, 2001). Other factors mentioned include reduced trunk control seen in chronic 'groin pathologies (Bradshaw & Holmich, 2009;Cowan et al, 2004;McCarthy & Vicenzino, 2003).…”

“…Active rehabilitation involved the athlete commencing gentle transversus abdominus (TrA) (Cowan et al, 2004), internal and external oblique (IO/EO) activation, abductor strengthening (Malliaras et al, 2009;O'Connor, 2004;Thorborg et al, 2011;Tyler et al, 2001) and light cross-training via a stationary bike to maintain cardiovascular fitness.…”