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Purpose: The purpose of this research was to report isometric hip adduction and abduction strength reference values of men's and women's Gaelic football and rugby union players and compare values between sexes and between sports. Methods: This cross-sectional cohort study consisted of 331 club-level athletes. Maximum isometric hip adduction squeeze and abduction press strength values were measured with a ForceFrame across several testing positions. Results: Hip adduction squeeze and abduction press strength reference values for men's and women's Gaelic and rugby union footballers were provided with mean and 1 SD. A 2-way analysis of variance demonstrated significant sport × sex interaction main effects for hip adduction squeeze (η2 =.159–.228), abduction press (η2 =.099–.144), and adduction:abduction ratio (η2 =.120). Men demonstrated significantly greater relative (Newtons per kilogram) maximum isometric hip adduction squeeze (15.5%–26.4%, 0.48–1.00 N/kg) and hip abduction press (9.6%–19.6%, 0.20–0.67 N/kg) strength across all testing positions when compared with women of the same sport. Male Gaelic football players demonstrated significantly greater hip adduction (8.7%–14.0%, 0.30–0.52 N/kg) and abduction (6.1%–8.6%, 0.16–0.31 N/kg) strength (Newtons per kilogram) than their rugby counterparts, while no significant between-sports differences in strength were observed between female athletes. Conclusion: Reference values are provided with mean and 1 SD. Sport and sex interaction had significant main effects for hip adduction, abduction, and adduction:abduction ratio, with medium to large effect sizes. Male athletes demonstrate significantly greater hip strength than female athletes of the same sport, and male Gaelic players demonstrate greater hip strength than male rugby players. [ABSTRACT FROM AUTHOR]

Context: Adductor longus muscle strains are one of the most common injuries occurring in intermittent sports such as soccer. Objective: The purpose of this study was to know the effect of a specific rehabilitation and reconditioning program, which was previously validated, after adductor longus injury in professional soccer players. Methods: A specific rehabilitation and reconditioning program was applied to 11 injured male professional soccer players. Participants: Eleven male professional soccer players (age = 29.18 [4.45] y; height = 179.64 [4.97] cm; mass = 75.33 [3.84] kg). Interventions: In the first place, the days taken to return to full team training and to return to competition (RTP) was analyzed; second, the most important performance parameters were analyzed and compared in the preinjury match (PRE) and after the return to competition at 2 different points in time (RTP1–RTP2). Results: The return to full team training recorded was 11.91 (1.92) days and the RTP was 15.36 (3.04) days. Match performance parameters showed significant improvements after injury. Significant improvements were observed during RTP2, in the variables of high-speed running (P =.002), very high-speed running (P =.006), acceleration (>3 m/s2; P =.048), and high metabolic load distance (P =.009). Conclusion: The results allow us to conclude that this program was very effective, as it allowed the players to obtain similar and/or higher performance values in a reduced period of time after the injury. [ABSTRACT FROM AUTHOR]

Context: Osteitis pubis (OP), which occurs as a result of excessive use of the symphysis pubis and parasymphysis bones, is more common in long-distance runners and kicking athletes, especially football players. Due to the poor results of commonly used treatments for OP, there is a need for investigation of more effective treatments, such as ozone therapy. Ozone therapy is used to treat a variety of diseases, including musculoskeletal conditions. Case Presentation: A 30-year-old amateur soccer player diagnosed with OP received conservative treatment with traditional physiotherapy and analgesic medications. After 6 months and no resolution of symptoms, the patient presented to the sports medicine outpatient clinic seeking alternative therapy options. Management and Outcomes: The patient received ozone injections in 3 sessions administered at 10-day intervals. At 1, 3, 6 and 12 months after the treatment, the patient's complaints and pain levels were re-evaluated and examined. The patient was able to return to competition at the same level after the first injection. No recurrence was revealed at a minimum of 12 months of follow-up. Conclusion: In this article, we present a case in which OP was successfully treated with ozone injection. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Injuries that affect the groin region are among the most common in football players. To prevent this condition, studies have focused on strengthening the adductors, hip flexors, or abdominal muscles. Recent investigations have used an eccentric-biased exercise (Copenhagen Adduction Exercise [CAE]) that promotes functional and architectural adaptations in the muscle tissue, though its effect on injury risk reduction is unknown. Clinical Question: Can the Copenhagen Adduction Exercise prevent groin injuries in soccer players? Summary of Key Findings: The literature was searched for studies investigating the potential groin injury risk reduction effect of the CAE. (1) Three studies met the inclusion criteria and were used for this appraisal; (2) one study observed a significantly lower injury rate ratio favoring the group that used the CAE program; and (3) 2 studies found similar or higher injury rates in the intervention groups, not supporting the inclusion of the CAE as a preventative tool. Clinical Bottom Line: There is conflicting evidence that usage of the CAE is superior to not performing adductor strengthening exercises in mitigating the risk of sustaining groin injuries. Given the evidence supporting these findings, it is advisable to exercise caution when contemplating the incorporation of the CAE into training regimens aimed at preventing groin injuries. Strength of Recommendation: There is Grade B evidence to suggest that inclusion of the CAE may not be associated with reduced injury rates. [ABSTRACT FROM AUTHOR]

Groin injuries have one of the highest incidences in soccer and can be career threatening, especially for adolescents, due to their high recurrence rate. Quick accelerations have been connected to groin injuries along with kicking and change of directions. Purpose of this study was to examine the hip joint kinematics, kinetics and the muscle forces of adductor longus and gracilis during first ground contact of a linear sprint acceleration performed by adolescent soccer players. Twenty-two male participants were investigated with 3D motion capture and two force plates. Inverse dynamics were used to calculate the kinematics, kinetics and muscle forces. The kinematics show a constant extension during the stance phase and a quick transition from an abduction to an adduction movement at 90% stance, which coincides with the highest forces in adductor longus and gracilis. This indicates a high load on the adductor muscles due to eccentric contractions combined with high muscle forces in the adductors. Compared to previously investigated inside passing and change of direction movements, adductor muscle forces and angular velocities are higher in this study. Therefore, it is suggested that sprint accelerations are likely to be connected to the development of groin injuries in adolescent soccer players. [ABSTRACT FROM AUTHOR]

Context: There is limited information on the quantification of external load and reconditioning programs during adductor longus injuries in soccer. Case Presentation: This case report describes a male professional soccer player (LaLiga) returning to performance following an adductor longus muscle injury during the 2022/2023 season. The player suffered the injury during a change of direction in a match. The injury was confirmed by ultrasound after 48 h, and the previously validated rehabilitation and reconditioning program was applied to the injured player. This case report has focused on the development of the on-field reconditioning program and the quantification of the load during this phase. The goal of this case report was to return the player to pre-injury loads using global positioning systems (GPS). Variables such as total distance, distances covered at different speeds and metabolic load variables were quantified during the injury process, with the aim of increasing them through training and reaching at least 75% of the game load. Therefore, objective performance criteria for making return-to-play decisions based on the use of GPS was determined. In addition, the return to play (RTP) was on the 20th day after the injury, and then four RTPs were recorded in the following 6 weeks after the injury occurred, without re-injury. Conclusions: The approach to the competition performance profile, through the quantification of the external load during the rehabilitation process of the injured player, allowed us a safe return to competition and continued competition with a 6-week follow-up. [ABSTRACT FROM AUTHOR]

Hip strength has been shown to influence the incidence of injury in women's football. The first objective of our study was to examine the differences in isometric strength of the adductors and abductors between two test positions (0° vs. 45° hip angle). Our second objective was to verify the sensitivity of the two test positions in discriminating between women footballers with and without a history of groin pain in the last twelve months. One hundred and one elite players from the Slovenian women's football league were tested. The isometric strength of the adductors, abductors, and the ratio between hip abductor and adductor strength in two different test positions were assessed. We found statistically significant differences (p < 0.05; effect size range 0.12–0.13) between the two test positions in hip adduction, abduction strength, and abductor/adductor strength ratio. The ROC analysis showed that only the abductor/adductor strength ratio at the 0° hip angle position can differentiate between players with and without a history of groin pain, with an optimal cut-off point of ≤ 1.01 (p < 0.05; AUC = 0.734). The results should help practitioners plan hip strength training for returning to sport or preventing groin pain among women football players. [ABSTRACT FROM AUTHOR]

Introduction: Groin injuries are common in soccer players and often involve adductor muscle strains. The Copenhagen Adduction Exercise (CAE) is a targeted intervention whose effectiveness in rehabilitation for these injuries warrants investigation. Objective: To investigate the impact of a rehabilitation program, which includes the CAE, on eccentric hip adduction (EHAD) strength, hip joint range of motion (ROM), self-reported disability, and pain among soccer players with adductor-related groin pain. It was hypothesized that the addition of CAE to the rehabilitation program would yield greater improvements. Methods: Employing a randomized controlled trial with a two-group parallel design, thirty male soccer players with a mean age of 26.4 ± 3.9 years were randomized into an intervention group (IG) including CAE (n = 15) and a control group (CG) without CAE (n = 15), based on a power analysis to ensure 80% power to detect significant differences. Both groups engaged in their respective rehabilitation programs twice a week for eight weeks. The primary outcome measured was EHAD strength, while secondary outcomes included hip joint ROM, self-reported disability measured by the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain levels. Results: Significant improvements within groups were observed across all measures (p < 0.001). The IG demonstrated a greater increase in EHAD strength (Mean Difference [MD] = 0.49 Nm/kg, 95% Confidence Interval [CI] [0.31, 0.66]), a more pronounced reduction in pain (MD = -1.60, 95% CI [−2.18, −1.02]), and betterment in all HAGOS subscale scores compared to the CG. There were no significant between-group differences in hip joint ROM. Conclusion: Incorporating the CAE into rehabilitation programs significantly improves EHAD strength, decreases pain scores, and reduces self-reported disability in soccer players with adductor-related groin pain. Registration: ClinicalTrials.gov identifier: NCT05589623 [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence, incidence, and burden of groin injuries in the Norwegian women's premier football league and to describe their clinical and imaging characteristics. Methods: During the 2020 and 2021 seasons, players in the Norwegian women's premier league reported groin injuries weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC‐H2). We calculated weekly prevalence, incidence, and burden of groin injuries. The team physical therapists classified the player‐reported injuries based on the Doha classification system. Injuries with more than 3 days' time loss or reported in 2 consecutive weeks were eligible for magnetic resonance imaging (MRI). Results: On average, 3.9% (95% CI: 3.4–4.4) of players reported a groin injury at any time; of which 78% caused time loss. The incidence rate was 1.6 injuries/1000 h (95% CI: 1.3–2.0) and their burden was 11 days lost/1000 h. The physical therapists examined 67 of 124 player‐reported groin injuries (53%). Adductor‐related injury was most common (55%) followed by iliopsoas (15%) and rectus femoris‐related (12%). Pubic‐related injuries caused most time loss (median: 24 days, IQR: 5–133). In this study, 42 injuries were investigated with MRI; 8 (19%) showed no changes, 6 (14%) an acute musculotendinous lesion, and 32 (76%) a nonacute finding (e.g., central symphyseal disc protrusion, tendinopathies). Conclusion: The incidence rate and burden of groin injuries were high. Adductor‐related injuries were most common, but pubic‐related injuries caused most time loss. Most MRI examinations demonstrated nonacute findings. [ABSTRACT FROM AUTHOR]

Context: There is limited information on the quantification of external load and reconditioning programs during adductor longus injuries in soccer. Case Presentation: This case report describes a male professional soccer player (LaLiga) returning to performance following an adductor longus muscle injury during the 2022/2023 season. The player suffered the injury during a change of direction in a match. The injury was confirmed by ultrasound after 48 h, and the previously validated rehabilitation and reconditioning program was applied to the injured player. This case report has focused on the development of the on-field reconditioning program and the quantification of the load during this phase. The goal of this case report was to return the player to pre-injury loads using global positioning systems (GPS). Variables such as total distance, distances covered at different speeds and metabolic load variables were quantified during the injury process, with the aim of increasing them through training and reaching at least 75% of the game load. Therefore, objective performance criteria for making return-to-play decisions based on the use of GPS was determined. In addition, the return to play (RTP) was on the 20th day after the injury, and then four RTPs were recorded in the following 6 weeks after the injury occurred, without re-injury. Conclusions: The approach to the competition performance profile, through the quantification of the external load during the rehabilitation process of the injured player, allowed us a safe return to competition and continued competition with a 6-week follow-up.

Context: The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport. Objective: The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer. Design: A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players. Setting: Soccer pitch and indoor gym. Participants: Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga). Interventions: The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury. Main Outcome Measures: Aiken V for each item of the program and number of days taken by the players to return to full team training. Results: The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61–0.98) for all drills, and the return to training was in 13.08 (±1.42) days. Conclusion: This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training. [ABSTRACT FROM AUTHOR]

Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury—A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician. This statement was developed by the Team Physician Consensus Conference, an annual project-based alliance of six major professional associations. The goal of this document is to help the team physician improve the care and treatment of the athlete by understanding the initial assessment and management of selected musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

Background Research is limited investigating injuries/illness incidence among National Hockey League (NHL) players. This study sought to establish injury/illness incidence, initial versus subsequent injury risk among NHL players, and determine temporal trends of injury and illness incidence. Hypothesis Variations in injury incidence by body region, and initial versus subsequent injury would be observed among positions. Study Design Retrospective cohort study Methods Publicly available data were utilized. NHL players 18 years or older between 2007-2008 to 2018-2019 were included. Injury and illness was stratified by position and body segment. Incidence rate (IR), and initial versus subsequent injury and illness risk ratios were calculated. Temporal trends were reported. Results Nine thousand, seven-hundred and thirty four injuries and illnesses were recorded. Centers had the highest overall IR at 15.14 per 1000 athlete game exposures (AGEs) (95%CI:15.12-15.15) and were 1.4 times more likely to sustain a subsequent injury compared to other positions. The groin/hip/thigh was the most commonly injured body region with an IR of 1.14 per 1000 AGEs (95%CI:1.06-1.21), followed by the head/neck (0.72 per 1000 AGEs, 95%CI:0.66-0.78). Combined injury and illness IR peaked in 2009-2010 season at 12.01 (95%CI: 11.22-12.79). The groin/hip/thigh demonstrated peak incidence during the 2007-2008 season (2.53, 95%CI:2.17-2.90); head/neck demonstrated a peak incidence in 2010-2011 season (Overall: 1.03, 95%CI:0.81-1.26). Injuries reported as 'lower body' increased over time. Conclusions Positional differences were observed; centers demonstrated the highest overall IR, and subsequent injury risk. Injury by body region was similar to previous literature. Head/neck and concussion decreased over time supporting rule changes in body checking and visor wear. Clinicians should be aware that 'lower body' injuries increased over time; therefore, injuries to the groin/hip/thigh or knee are likely underreported. Level of Evidence Level 3 [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the relationship between haemoglobin A1c (HbA1c) values and operative wound infection Method: During the period from 2013–2016, consecutive patients with type 2 diabetes were prospectively evaluated. Data were retrospectively analysed. All included patients were admitted for an elective surgical procedure, requiring the use of prosthetic graft in a groin wound. The patients were divided into two groups according to their preoperative HbA1c values. The main outcome was groin wound infection. The association between preoperative long-term glycoregulation and wound infection was evaluated, as well as the impact of postoperative glycaemic values, regardless of the level of HbA1c. Results: Of the 93 participating patients, wound infection occurred in 20 (21.5%). Wound infection occurred in 28.2% of patients with uncontrolled diabetes (HbA1c >7%) and 16.7% of patients with controlled diabetes (HbA1c <7%); however, the difference did not reach statistical significance (p=0.181). In regression modelling, operative time (p=0.042) was a significant predictor of wound infection, while patients' age (p=0.056) was on the borderline of statistical significance. Females had a higher probability for wound infection (odds ratio (OR): 1.739; 95% confidence interval (CI):0.483–6.265), but there was no statistical significance (p=0.397). Patients with elevated levels of HbA1c had a higher chance of wound infection compared with patients with controlled diabetes (OR: 2.243; 95% CI: 0.749–6.716), nevertheless, this was not statistically significant (p=0.149). Conclusion: We found no statistically significant correlation between elevated values of preoperative HbA1c and postoperative groin wound infection. [ABSTRACT FROM AUTHOR]

Groin injuries are common in basketball. Reduced adductor strength is a risk factor for injury, so monitoring strength can be important for injury prevention. This research assessed the reliability of an adductor strength test in male professional basketballers in preseason. Strength was tested using a sphygmomanometer between the knees at 0°, 45°, and 90° of hip flexion, in two trials. There was no difference in mean scores between trials. All conditions had moderate or higher intrarater reliability, with 45° hip flexion the most reliable. This test can be used to identify and monitor players with increased adductor injury risk. [ABSTRACT FROM AUTHOR]

Because of the COVID-19 pandemic, the National Football League (NFL) made changes to its operations for the 2020 season. We hypothesize an increase in the rate of injuries during the 2020 season. Publicly available data were reviewed to identify NFL injuries from the 2015-2020 seasons. Player position, description of injury, date of injury, and injury setting were recorded. p#0.05 was considered statistically significant. For the 2020 season, compared with the 2015-2019 seasons, there was an increased risk of injury during the regular season overall relative risk (RR) 5 1.308 (p, 0.05), week (W)1 RR 5 7.33 (p, 0.05), W1-6 RR 5 1.964 (p, 0.05), W7-12 RR 5 1.8909 (p, 0.05), and during the postseason overall RR 5 1.1444 (p, 0.05), calculated using analysis of variance. There was an overall increased risk of abdominal or core injuries RR51.248 (p < 0.05), groin or hip injuries RR52.534 (p < 0.05), and hamstring injuries RR 5 3.644 (p, 0.05). There was an increased risk of hamstring injuries in cornerbacks RR 5 3.219 (p, 0.05) and running backs RR 5 1.1394 (p, 0.05), hip or groin injuries in guards RR 5 1.105 (p, 0.05), Achilles tendon injuries in safeties RR51.6976 (p < 0.05), quadriceps injuries in running backs RR51.6191 (p < 0.05), and arm injuries in defensive tackles RR 5 1.221 (p, 0.05). There was an increase in the overall rate of injuries in the 2020 NFL season, both in the regular season and postseason, compared with the 2015-2019 seasons. The overall rate of abdominal or core, groin or hip, and hamstring injuries increased. Specific player positions saw unique increases in rates of injuries. These findings may be due to numerous operational changes implemented, such as reduced in-person training and the elimination of the preseason, leading to suboptimal, sportsspecific conditioning and increased risk of musculoskeletal injury. [ABSTRACT FROM AUTHOR]

Background: A 2015 study of platelet-rich plasma (PRP) for groin injuries in National Football League (NFL) players alerted the authors to the possibility that PRP is associated with heterotopic ossification (HO). The current study of athletes seen between 2014 and 2019 provides a more comprehensive analysis of that observation. Purpose/Hypothesis: This report describes the early results of groin surgery for athletes who had experienced failed PRP therapy performed by different practitioners and with an assortment of PRP techniques. The primary goal of this cohort study was to determine short-term clinical outcomes after surgery of PRP-treated patients. It was hypothesized that previous PRP treatment would be associated with the presence of HO among patients with core muscle injuries (CMIs). Study Design: Cohort study; Level of evidence, 3. Methods: All athletes seen at 1 institution and identified at their first visit as having received PRP for a CMI were followed and compared with patients with a CMI who had not previously received PRP. Although in many cases HO was observed on clinical examination or imaging, HO was identified intraoperatively in all surgical cases and confirmed pathologically. Successful surgery was defined as return to play at previously high levels of performance or greater as determined by the athletes' own assessments. All patients who had received PRP were followed for ≥2 years. Results: Among 3642 patients with a new CMI seen between 2014 and 2019, 68 (1.9%) patients developed HO within the core muscles and/or adjacent soft tissues. Of the 68 patients, 60 (88.2%) were men, and the mean age was 34.5 years. Of the 68 patients, 62 (91.2%) were athletes and 44 (64.7%) had been treated previously with PRP. HO was observed in 24 (0.7%) patients without previous PRP treatment. Three athletes who received PRP retired early from sports because of HO and scar issues. In total, 22 of 28 (78.6%) NFL players who received PRP developed HO, compared with 0 (0%) of 28 randomly selected, age-, position-, and injury-matched NFL players. After surgical repair, 3-month success rates were 67.9% and 96.4%, respectively, in the PRP and non-PRP groups (P =.006). By 6 months postoperatively, PRP-treated patients were back to similarly high success rates compared with the non-PRP cohort. Scar tissue issues played a prominent role in the relative delay in definitive success. Conclusion: The present, more comprehensive study confirms the previous preliminary analysis that treating CMIs with PRP may be associated with HO. [ABSTRACT FROM AUTHOR]

Background: Controversies remain regarding the diagnosis, imaging, and treatment of acute adductor injuries in athletes. Purpose: To investigate the diagnostic imaging, treatment, and prevention of acute adductor injuries based on the most recent and relevant scientific evidence. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed and Web of Science databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify articles studying acute adductor injury in athletes. Inclusion criteria were original publication on acute adductor injury in amateur or professional athletes, level 1 to 4 evidence, mean patient age >15 years, and results presented as return-to-sport, pain, or functional outcomes. Quality assessment was performed with the CONSORT (Consolidated Standards of Reporting Trials) statement or the methodological index for non-randomized studies criteria. Articles were grouped as imaging, treatment, prevention focused, or mixed. Results: A total of 30 studies published between 2001 and 2021 were selected, involving 594 male patients with a mean age 26.2 years (range, 16-68 years). The most frequent sports were soccer (62%), basketball (14%), futsal (6%), American football (3%), and ice hockey and handball (2%). Risk factors for acute adductor injury were previous acute groin injury, adductor weakness compared with the uninjured side, any injury in the previous season, and reduced rotational hip range of motion. The frequency of complete adductor muscle tears on magnetic resonance imaging was 21% to 25%. For complete adductor tears, the average time to return to play was 8.9 weeks in patients treated nonoperatively and 14.2 weeks for patients treated surgically. Greater stump retraction was observed in individuals treated surgically. Partial acute adductor tears were treated nonoperatively with physical therapy in all studies in the present systematic review. The average time to return to play was 1 to 6.9 weeks depending on the injury grade. The efficacy of adductor strengthening on preventing acute adductor tears has controversial results in the literature. Conclusion: Athletes with partial adductor injuries returned to play 1 to 7 weeks after injury with physical therapy treatment. Nonoperative or surgical treatment is an acceptable option for complete adductor longus tendon tear. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe and characterize injuries sustained by elite male futsal players in Portugal. Design: Prospective cohort study. Setting: Top-tier Portuguese league in the 2019 to 2020 season. Participants: One hundred sixtyseven players from 9 elite/international-level (tier 4) futsal teams. Independent variables: The location, type, body side, body part, mechanism of injury, severity, occurrence, days lost, training, and match exposure were collected. Main Outcome Measures: Injury incidence, prevalence, and burden. Results: The study was conducted during an 8-month season. A total of 133 injuries were recorded, and 92 (67.6%) players sustained injuries. The overall time-loss injury incidence was 4.5 injuries per 1000 hours of exposure. Injury incidence during matches was higher than during training sessions (25.9 vs 3.0 per 1000 hours of exposure, respectively). Average time loss was 9 days, and moderate injuries were the most frequent (44%), followed by mild injuries (24%). Injury burden was 73.8 days lost per 1000 hours of total player exposure. Sprains/ligament (29%) and muscle rupture/tear/strains (32%) were the most common injuries. The groin (19%), thigh (17%), knee (19%), and ankle (15%) were the most affected body areas. Noncontact injuries were the most reported mechanism (65%), and 24% were overuse injuries. Conclusions: This study showed that elite/international-level (tier 4) male futsal players are more prone to noncontact injuries, primarily affecting the lower limbs. The incidence during match play increased by 9-fold compared with training sessions. [ABSTRACT FROM AUTHOR]

Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to midseason. A questionnaire and two pain provocation tests were used for the evaluation. Mild GPS required positive results in at least two evaluations, while severe GPS was associated with pain incompatible with engagement in any activity confirmed by diagnostic ultrasound. Forty-two elite male athletes (aged 16.9 ± 0.7 years) participated in the study, with half of them assigned to the usual training (control group) and the remaining athletes undergoing the preventive protocol (treatment group) for 24 weeks. GPS rates were 14.3% (three diagnoses: two mild, one severe) in the treatment group and 28.6% (six diagnoses: three mild, three severe) in the control group. Toward the end of the season, three players, one from the treatment group and two from the control group had to stop playing due to severe GPS problems. In addition, one player in the control group stopped midseason. Even though the reduction in the risk of developing GPS was not significant (relative risk of 0.50 ([95%CI 0.14 to 1.74], p = 0.2759), the halved incidence of severe GPS and the increased muscle strength related to the treatment (p = 0.0277) are encouraging data for future studies. [ABSTRACT FROM AUTHOR]

The purpose of this research was to compare the hip adduction and abduction relative strength, adduction-to-abduction strength ratio (ADD:ABD), and interlimb asymmetries of ice hockey athletes between the typically used bilateral position and 3 unilateral positions in joint-specific angles (0°, 25°, and 50° of hip abduction) relevant to an ice hockey stride. A secondary purpose was to explore any relationships between these measures and hip and groin noncontact injuries, and self-reported pain and disability. Twenty-five semiprofessional male ice hockey athletes (26.7 ± 6.7 years) were assessed for hip abduction range of motion (ROM), hip adduction and abduction relative strength, and completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire. Within-subjects repeated-measures analysis of variance revealed a significant effect for the assessment position for adduction (F1,24 = 52.4, p < 0.01) and abduction relative strength (F1,24 = 152.1, p < 0.01), ADD:ABD (F1,24 = 38.9, p < 0.01), and the interlimb asymmetries for each of these variables (F1,24 = 9.8-12.3; p < 0.01), with large strength differences observed between the bilateral assessment and all unilateral assessment positions for adduction and abduction relative strength. In addition, 4 athletes experienced a noncontact hip or groin injury within 1 month after testing, and when compared with the rest of the cohort (n = 21) with Welch's t-tests, demonstrated significantly reduced hip abduction ROM (mean difference [MD] = -8.4 ± 2.5°; p < 0.01), sport subscale score for the HAGOS questionnaire (MD = -33.9 ± 7.1; p < 0.01), and a decline in hip adduction relative strength in the unilateral position of 50° compared with the position of 25° hip abduction (MD = -13.4 ± 3.8; p = 0.04). These results suggest that practitioners working with ice hockey athletes may benefit from profiling hip strength in these unilateral joint-specific angle positions because they provide an evidence base to determine the hip strength needs of ice hockey athletes in positions associated with skating performance and noncontact hip and groin injury mechanisms (between 25° and 50° of hip abduction). [ABSTRACT FROM AUTHOR]

Clinical Scenario: Ice hockey and soccer are both dynamic sports that involve continuous, unpredictable play. These athletes consistently demonstrate higher rates of groin strains compared with other contact sports. Measuring the hip adductor/ abductor ratio has the potential to expose at-risk players, reduce injury rales, and preserve groin health in players with chronic strains. Focused Clinical Question: What is the clinical utility of measuring the hip adductor/abductor ratio for preseason and in-season ice hockey and soccer players? Summary o f Key Findings: Three studies, all of which were prospective cohort designs, were included. One study involved assessing preseason strength and flexibility as a risk factor for adductor strains in professional ice hockey players. Another study performed with the same professional hockey team used preseason hip adductor/abductor strength ratios to screen for those players who would benefit from a strengthening intervention aimed at reducing the incidence of adductor strains. The final study, which was performed in elite Ul7 soccer players, assessed the effectiveness of monthly in-season strength monitoring as a guide to trigger in-season interventions to decrease injury incidence. Clinical Bottom Line: Measuring the hip adductor/abductor strength ratio in hockey and soccer players can be a beneficial preseason and in-season tool to predict future groin strain risk and screen for athletes who might benefit from a strengthening intervention. Strength o f Recommendation: Level 3 evidence exists to support monitoring the hip adductor/abductor strength ratio to assess and reduce the risk of adductor strains in ice hockey and soccer players. [ABSTRACT FROM AUTHOR]

Introduction: Groin pain is one of the prevalent injuries in soccer players.1 Since groin pain takes time to heal and affects the performance of the players, it is necessary to monitor the groin condition regularly to prevent its onset and reccurence. The Groin Injury Screening Questionnaire (GISQ) was developed in Norway to evaluate the groin condition for soccer players.2 GISQ has already been translated in several language, but not into Japanese. Objectives: To develop the Japanese version of the GISQ (GISQ-J), and to examine its validity and reliability. Moreover, to investigate the relationship between a history of groin pain and GISQ-J scores. Study design: Cross-sectional study Methods: The GISQ-J, translated with permission from the original author, was distributed twice to 114 Japanese high school and university soccer players by Google Forms. The second response was given within 72 hours of the first 79 80 response, recalling the condition of the groin at the time of the first response. The GISQ-J is a 100-point scale, with a higher score indicating better groin conditions. Cronbach's α was calculated to assess the validity of each GISQ-J scale, and the intraclass correlation coefficient (ICC) was calculated to evaluate the reliability. In addition, an unpaired t-test was used to compare GISQ-J scores by the presence or absence of a history of groin pain. Results: A total of 60 soccer players (52.6%) responded. Cronbach's α for each scale ranged from 0.71 to 0.97, and the ICC from 0.72 to 0.86. Those with a history of groin pain (n=14) had significantly lower GISQ-J scores than those without (n=46)(p<0.05). Conclusions: The GISQ-J showed good validity and reliability on each scale. The GISQ-J scores were poor with a history of groin pain, suggesting that the GISQ-J may be useful in the evaluation of groin conditions in Japanese soccer players. [ABSTRACT FROM AUTHOR]

Objective: To evaluate for associations between concussion history or lower extremity (LE) injury and computerized sensory organization testing (SOT) performance in professional soccer players. Design: Cross-sectional study. Setting: Tertiary care center. Participants: Thirty-three, professional, male soccer players on an American club, between the years 2019 and 2021. Assessment of Risk Factors: Player age, history of reported LE injury (gluteal, hamstring, ankle, knee, hip, groin, and sports hernia), history of diagnosed concussion, and the number of prior concussions were documented for each player. Main Outcome Measures: Baseline SOT of postural sway was conducted in 6 sensory conditions for all players. Results: Eleven athletes (33%) reported a previous concussion, and 15 (45%) reported a previous LE injury. There were no significant differences in SOT scores between those with and without a previous diagnosis of concussion (P > 0.05). Those reporting a previous LE injury performed better on condition 3 (eyes open, unstable visual surround) than those who did not (P = 0.03). Athletes aged 25 years or younger performed worse on condition 3 (P = 0.01) and had worse, although not statistically significant, median performance on all other balance measures than those older than 25 years. Intraclass correlation coefficient for repeat SOT assessment was 0.58, indicating moderate reliability, without an evident practice effect. Conclusions: Professional soccer players with a previous concussion or history of LE injury did not demonstrate long-term deficits in postural control, as assessed by multiyear computerized SOT baseline testing. The SOT was reliable over time with younger athletes exhibiting greater postural sway than older athletes. [ABSTRACT FROM AUTHOR]

We performed a meta‐analysis to evaluate the effect of prophylactic negative pressure treatment for post‐surgery groin wounds management in vascular surgery. A systematic literature search up to April 2022 was performed and 1537 total number of groin vascular surgery incisions at the baseline of the studies; 729 of them were using the prophylactic negative pressure treatment, and 808 were using control. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of prophylactic negative pressure treatment for post‐surgery groin wounds management in vascular surgery using the dichotomous, and contentious methods with a random or fixed‐effect model. The prophylactic negative pressure treatment subjects had a significantly lower surgical site wound infection (OR, 0.26; 95% CI, 0.16‐0.42, P <.001) in subjects after vascular surgery compared with control. However, prophylactic negative pressure treatment did not show any significant difference in revision surgery (OR, 0.73; 95% CI, 0.52‐1.00, P =.05), readmission (OR, 0.93; 95% CI, 0.66‐1.32, P =.69), mortality in hospital (OR, 0.54; 95% CI, 0.29‐1.01, P =.05), and length of hospital stay (MD, −0.24; 95% CI, −0.91‐0.44, P =.49) compared with control in subjects after vascular surgery. The prophylactic negative pressure treatment subjects had a significantly lower surgical site wound infection and no significant difference in revision surgery, readmission, mortality in hospital, and length of hospital stay compared with control in subjects after vascular surgery. The analysis of outcomes should be with caution because of the low sample size of 2 out of 10 studies in the meta‐analysis and a low number of studies in certain comparisons. [ABSTRACT FROM AUTHOR]

The criterion validity of the sphygmomanometer was evaluated, relative to the Force Frame strength testing system. Test-retest reliability was assessed for both hip adduction and abduction strength. Test-retest reliability study and criterion validity study. 50 asymptomatic, field-sport athletes. Maximal isometric hip adduction and abduction strength were measured. Interclass correlation coefficient(ICC 2,1) with confidence intervals were calculated to evaluate reliability of peak strength values. A Pearson product-moment correlation coefficient(r) was calculated to examine criterion validity of the sphygmomanometer as a measure of force when compared to the ForceFrame. Intra-rater reliability for bilateral adduction testing using both ForceFrame and sphygmomanometer values revealed good-excellent reliability for both the 0° (ICC 2.1 = 0.87–0.90) and 45° (ICC 2.1 = 0.81–0.91) positions. ForceFrame values revealed good-excellent reliability for 0° abduction position and 45° abduction position. A good-moderate relationship (Pearson's r = 0.63) for 0° adduction position, and poor relationship (Pearson's r = 0.40) for 45° adduction position, were found between adduction squeeze values on ForceFrame and sphygmomanometer. Excellent reliability in hip adduction squeeze strength testing for both modes. However, there exists a 'good to moderate'-'fair' relationship between the Force Frame and sphygmomanometer. • Sphygmomanometer is reliable when used for measuring hip adduction strength. • ForceFrame is reliable and valid when used for measuring hip strength. • Sphygmomanometer displays ceiling effects. • Sphygmomanometer may not be the most valid method of measuring hip strength. [ABSTRACT FROM AUTHOR]

Context: Agility is crucial for soccer players, and core training can improve it. One study showed significant agility improvements after an intervention including core training for athletes with groin pain. However, it is unclear if these improvements resulted specifically from the core exercises or the entire program. Additionally, the study lacked a control group, making the findings inconclusive., Purpose: The current study aimed to explore the effect of core training, previously reported in the context of groin-pain rehabilitation, on agility performance in soccer players with groin pain., Methods: Twenty soccer players with groin pain volunteered to participate. They were randomly assigned to a core training group (n = 10) and a control group (n = 10). Before and immediately after that period, agility performance (T test and Edgren Side Step Test) and self-reported outcomes (Copenhagen Hip and Groin Outcome Score) were assessed in both groups., Results: No significant session × group interaction was observed in agility T test (F = 2.55; P = .12; ηp2=.12) and Edgren Side Step Test (F = 3.18; P = .09; ηp2=.15) performances. Besides, Copenhagen Hip and Groin Outcome scores showed significant improvements (P = .007 to <.001) in the core training group following the 12 weeks of core training and compared with the control group., Conclusion: The results showed that soccer players with groin pain who received or did not receive core training showed similar agility performance. However, significant improvements in self-reported outcomes were observed in soccer players compared with the control group. Clinicians and coaches should therefore consider core training when designing training and rehabilitation programs for this population to enhance recovery.

Objectives: To provide normative values for between-limb asymmetry of hip strength and range of motion (ROM) in professional male soccer players and evaluate the relationship between these asymmetries and groin injury., Design: Secondary analysis of a prospective cohort study., Methods: A total of 438 professional male soccer players underwent musculoskeletal screening, injury and exposure surveillance over two consecutive seasons. Between-limb asymmetry for two hip strength (eccentric adduction and abduction) and six ROM measures were calculated, and normal asymmetry considered within 1 standard deviation (SD) of the mean. Cox proportional hazard regression analysis estimated the association between asymmetry and time-loss groin injury., Results: Normal asymmetry ranged between 0.3% and 27.3% across strength and ROM variables. No association was found between groin injuries and asymmetry in eccentric hip adduction (HR = 0.99, 95%CI = 0.98-1.00; p = 0.167) or abduction strength (HR = 1.00, 95%CI = 0.99-1.01; p = 0.745). For five of the six ROM measures, no association with groin injuries were determined. A statistically significant, though likely clinically irrelevant, association was found between groin injury and dominant leg total hip rotation ROM (HR = 1.03, 95% CI = 1.00-1.05; p = 0.040)., Conclusion: Normal hip strength and ROM asymmetry ranged between -27 and +20%. No clinically relevant associations were found between asymmetry in hip strength or ROM and time-loss groin injuries., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

To assess the relationship between history of past season groin pain and current pain during the five-second squeeze test (5SST) with groin function and adductor strength in rink hockey players. Cross-sectional. First (Ok Liga), Second (Plata) and third division (Bronce) clubs. Participants: Sixty-eight female and 183 male hockey players. Seasonal prevalence of groin pain (time/non-time-loss). Adductor strength and pain during the 5SST. Function was evaluated with the Hip and Groin Outcome Score (HAGOS). Seasonal time-loss groin pain prevalence was 21%. Male players had 3.5 higher odds of having had an episode of time-loss groin pain during the previous season compared to female players. The adductor relative strength was no different between players with and without previous season groin injury (p = 0.53-0.55), while the HAGOS results differed between groups, with past season groin injury players obtaining lower values in all subscales. HAGOS scores differed between the 5SST pain intensity groups (p < 0.01). Male players had higher odds of having had a groin injury in the previous season compared to female players. Players with pain during 5SST and previous season groin injury reported functional deficits, while strength remains identical to their healthy counterparts. • Groin injury seasonal prevalence is high among rink hockey players. • Current pain on 5-s squeeze does not affect adductor strength. • Players with current pain or previous episode of groin injury reported worse sporting function. [ABSTRACT FROM AUTHOR]

Gonçalves, BM, Mesquita, RNO, Tavares, F, Brito, J, Correia, P, Santos, P, and Mil-Homens, P. A new portable device to reliably measure maximal strength and rate of force development of hip adduction and abduction. J Strength Cond Res 36(9): 2465–2471, 2022—Groin injuries are a major issue in sports involving kicking or quick changes of direction. Decreased hip adduction and abduction strength have been indicated as one of the main risk factors for groin injury. The methods currently available to measure hip adduction and abduction strength are reliable but highly dependent on the evaluator skills. Furthermore, several studies have reported the reliability of maximal strength (MVIC), but very few studies investigated the reliability of explosive strength (RFD), a parameter that has been previously shown to have a higher functional value. The aim of the current investigation was to assess the reliability of a user-independent portable dynamometer that concurrently measures MVIC and RFD. Twenty-five healthy young subjects performed maximal isometric hip adduction and abduction in both sitting and supine positions. Measurements occurred in 2 different days separated by 48–72 hours. Test-retest reliability was calculated for both MVIC and RFD. Both MVIC and RFD showed good relative reliability (intraclass correlation coefficient = 0.77–0.98) with no differences between positions or muscle actions. Measurement error was similar between positions for MVIC in both hip adduction and abduction. Measurements of RFD showed higher reliability using a time window of at least 0–100 milliseconds, and lower measurement error was observed in sitting for adduction and in supine for abduction. This study shows that portable dynamometry can be used to concurrently measure hip adduction and abduction maximal and explosive strength, with levels of reliability that are similar to previously described methods. [ABSTRACT FROM AUTHOR]

Background: There are few data on injuries suffered by collegiate water polo athletes. Purpose: To describe the epidemiology of injuries suffered by National College Athletic Association (NCAA) male and female water polo players by using injury surveillance data over a 5-year period. Study Design: Descriptive epidemiology study. Methods: Deidentified data on all water polo injuries and illnesses recorded in the Pac-12 Sports Injury Research Archive from July 2016 through June 2021 were obtained and analyzed. Three men's and 4 women's teams were observed for the entire 5-year period, and 1 men's and 1 women's team was observed from July 2018 through June 2021. Results: During the observation period, 729 injuries were recorded in the database, with no differences in overall injury rates between male and female athletes (relative risk [RR] = 1.0; 95% CI, 0.9-1.2); 33.7% of injuries required a physician encounter, and 3.6% required surgery. The shoulder was the most injured body part, making up 20.6% of all injuries, followed by the head/face (18.8%) and hand/wrist/forearm (11.7%). Shoulder tendinopathy was the most common shoulder injury diagnosis (4.5% of all injuries). Concussion was the most common injury diagnosis overall, making up 11.4% of injuries, and 81.9% of concussions occurred outside of competition. Male athletes were significantly more likely than female athletes to have a concussion in an off-season practice (RR, 3.25; 95% CI, 1.2-8.8) and via contact with another player (RR, 2.9; 95% CI, 1.3-6.4). Half of the 26 surgical procedures occurring over the observation period were for chronic joint trauma of the groin/hip/pelvis/buttock, with 9 of those 13 being for femoroacetabular impingement specifically. Conclusion: Among NCAA water polo athletes, the shoulder was the most injured body part; however, shoulder injuries rarely required missed time from sport or necessitated surgical intervention. Concussions were the most common injury diagnosis, had the worst return-to-play outcomes among common diagnoses, and were mostly sustained outside of competition. Femoroacetabular impingement was found to be the dominant diagnosis for which surgical intervention was required. [ABSTRACT FROM AUTHOR]

Background: In professional sports, injuries resulting in loss of playing time have serious implications for both the athlete and the organization. Efforts to quantify injury probability utilizing machine learning have been met with renewed interest, and the development of effective models has the potential to supplement the decision-making process of team physicians. Purpose/Hypothesis: The purpose of this study was to (1) characterize the epidemiology of time-loss lower extremity muscle strains (LEMSs) in the National Basketball Association (NBA) from 1999 to 2019 and (2) determine the validity of a machine-learning model in predicting injury risk. It was hypothesized that time-loss LEMSs would be infrequent in this cohort and that a machine-learning model would outperform conventional methods in the prediction of injury risk. Study Design: Case-control study; Level of evidence, 3. Methods: Performance data and rates of the 4 major muscle strain injury types (hamstring, quadriceps, calf, and groin) were compiled from the 1999 to 2019 NBA seasons. Injuries included all publicly reported injuries that resulted in lost playing time. Models to predict the occurrence of a LEMS were generated using random forest, extreme gradient boosting (XGBoost), neural network, support vector machines, elastic net penalized logistic regression, and generalized logistic regression. Performance was compared utilizing discrimination, calibration, decision curve analysis, and the Brier score. Results: A total of 736 LEMSs resulting in lost playing time occurred among 2103 athletes. Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis. Conclusion: Machine learning algorithms such as XGBoost outperformed logistic regression in the prediction of a LEMS that will result in lost time. Several variables increased the risk of LEMS, including a history of various lower extremity injuries, recent concussion, and total number of previous injuries. [ABSTRACT FROM AUTHOR]

Objective: To determine differences in prevalence and diagnostic accuracy of MRI findings between asymptomatic athletes and athletes with longstanding groin pain., Materials and Methods: One hundred twenty-three adult male athletes were approached with 85 consecutive athletes recruited. Group 1 (symptomatic, n = 34) athletes referred for longstanding groin pain (insidious onset, > 3 weeks duration). Group 2 (control, n = 51) athletes referred for injuries remote from the pelvis and no groin pain in the last 12 weeks. All referrers completed a clinical examination proforma documenting absence or presence of pelvis and hip abnormality. All patients completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire and underwent a 3T MRI groin and hip protocol. MRIs were scored independently by two musculoskeletal radiologists blinded to clinical details. Statistical analysis was performed to evaluate associations between MRI findings, inter-reader reliability, clinical examination and HAGOS scores., Results: Pubic body subchondral bone oedema, capsule/aponeurosis junction tear and soft tissue oedema were more prevalent in the symptomatic group (p = 0.0003, 0.0273 and 0.0005, respectively) and in athletes with clinical abnormality at symphysis pubis, adductor insertion, rectus abdominis, psoas and inguinal canal (p = 0.0002, 0.0459 and 0.00002, respectively). Pubic body and subchondral oedema and capsule/aponeurosis tear and oedema significantly correlated with lower (worse) HAGOS scores (p = 0.004, 0.00009, 0.0004 and 0.002, respectively). Inter-reader reliability was excellent, 0.87 (range 0.58-1). Symphyseal bone spurring, disc protrusion and labral tears were highly prevalent in both groups., Conclusion: Clinical assessment and MRI findings of pubic subchondral bone oedema and capsule/aponeurosis abnormality appear to be the strongest correlators with longstanding groin pain., Competing Interests: Declarations. Competing interests: No competing interests declared., (© 2024. The Author(s).)

The article titled "Remote endovascular treatment of femoral pseudoaneurysms in hostile groins: technical note" describes an alternative technique for the treatment of femoral pseudoaneurysms. Pseudoaneurysms are false aneurysms that can occur as a complication of endovascular procedures. Conventional treatment includes open surgical repair, but in patients with hostile groins or obesity, the KERBI technique is proposed. This technique uses a left brachial approach to place an endovascular balloon and perform ultrasound-guided thrombin injection. It is suggested that this technique may be an alternative in selected patients, thus avoiding open surgery and its possible complications. [Extracted from the article]

* OBJECTIVE: To investigate the relationship between training/match-play duration and time-loss groin injury in professional male soccer players, and to determine whether previously identified intrinsic risk factors influenced this relationship. * DESIGN: Prospective cohort study. * METHODS: A total of 579 professional male soccer players were prospectively followed from July 2013 to June 2015. Time-loss groin injuries and individual training and match-play duration were recorded using standardized surveillance methods. Acute training/ match-play duration and chronic training/match-play duration were considered as interacting variables. Nonlinear Cox regression analysis (modeled using restricted cubic splines), clustered by player identification number, examined the relationship between training/match-play duration and groin injury. Previously identified intrinsic risk factors of previous groin injury and eccentric adduction strength were included in the multivariable regression analysis. * RESULTS: There was no clinically meaningful relationship between training/match-play duration and groin injury risk. Team played for had the strongest influence on groin injury risk (relative log hazard ratio -2.28 to 0.97). Groin injury risk was highest when accumulated chronic and acute training duration was also highest, but large confidence intervals indicate considerable uncertainty around this finding. Previous groin injury and eccentric adduction strength were not associated with groin injury risk when training/match-play duration and team were included in the model. * CONCLUSION: In professional male soccer players, there was no clinically meaningful relationship between groin injury risk and training/ match-play duration. Team played for either protected against or increased groin injury risk, indicating that team-related factors not measured in this study had greater effect on groin injury risk than training/match-play duration. [ABSTRACT FROM AUTHOR]

Groin pain is a common cause of disability in athletes. Imaging is crucial in a clinical diagnosis, given the multiple associated etiologies. The main sites of groin pain are the adductors, iliopsoas muscles, inguinal ring, hip joint, and pubic symphysis. Although magnetic resonance imaging is the gold standard to image groin pain, ultrasound (US) offers excellent accuracy in pinpointing muscle injuries, inguinal disruption, and hernias. US requires a detailed knowledge of anatomical landmarks; imaging pitfalls, and pathologic patterns. We review the complex anatomy of the groin region, the sonographic appearance of the involved structures, and the strengths and weaknesses of US., Competing Interests: None declared., (Thieme. All rights reserved.)

Objectives: This study aimed to assess the effectiveness of a systems-based secondary injury prevention intervention aimed at early detection and management of hamstring strain injury (HSI) and time-loss groin injury in an Australian male professional football club., Design: Prospective cohort study., Setting: Australian male professional football club., Participants: Data were collected from male professional football players (n = 73) from a single football club., Main Outcome Measures: Unilateral knee flexion and side-lying hip adduction maximum voluntary isometric contractions were monitored routinely in-season, two days post-match (≥40 h [h]) during a three-season intervention period. Strength reductions greater than the tests' minimal detectable change percentage prompted intervention. HSI and time-loss groin injury burdens were calculated per 1000 player hours and compared with those from an immediately preceding two-season control period, to assess the effectiveness of the intervention., Results: Across the intervention period, there was a decrease in HSI (4.98 days absence/1000 h (19.8%) decrease) and time-loss groin injury burdens (0.57 days absence/1000 h (49.1%) decrease) when compared with the control period., Conclusions: A systems-based secondary injury prevention intervention shows preliminary positive findings in reducing HSI and time-loss groin injury burdens within a male professional football club, compared with usual care only., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Context: Athletic pelvic and groin injuries are a common yet challenging problem. Pelvic belts have been successfully used to reduce pain and improve function but are not a practical solution for athletes. Therefore, there is scope to explore the use of a more dynamic intervention developed to aid in the management of this type of injury. Objectives: To undertake a preliminary investigation into the effectiveness of a dynamic elastomeric fabric orthosis (DEFO) in supporting the management of athletic pelvic and groin injury. Design: A case series with an AB design. Daily assessments were undertaken over 15 days; the onset of intervention was randomized with a minimum baseline period of 6 d. Follow-up assessment was undertaken after 1 mo. Settings: Community and university. Participants: 8 athletes presenting with pelvic or groin injury confirmed through clinical screening. Intervention: A bespoke DEFO. Main Outcome Measures: Force produced on bilateral resisted hip adduction and self-scored pain (using a numerical rating scale of 0-10) at rest and during an active straight-leg raise and a broad jump. Results: In 7 cases a significant improvement was observed on at least 1 measure (2-SD method, celeration line, and/or the point of nonoverlapping data). The remaining case showed minimal symptoms during testing. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate inter-tester and intra-tester reliability of a novel clam test (CLAMT) for the measurement of gluteal muscle strength and to detect possible differences between CLAMT values in football players with and without a history of groin injuries. Twenty male football players participated in the test-retest and sixty-two male professional football players participated in the case–control study. Hip abductor maximal muscle strength was evaluated either using CLAMT or in a supine position with the hip in a neutral pose. For CLAMT, intraclass correlation coefficient (ICC) for inter-tester-intra-day reliability was 0.80 (95% CI: 0.60–0.90), with a standard error of measurement of 34.2 N. The intra-tester-intra-day ICC was 0.92 (95% CI: 0.87–0.95), with a standard error of measurement of 23.6 N. The inter-week ICC was 0.96 (95% CI: 0.92–0.98), with a standard error of measurement of 18.9 N. CLAMT showed lower (but not significant) strength values in football players with a history of groin injuries to non-injured players. CLAMT showed good to excellent levels of reliability, intraday and inter-week, with low standard errors of measurement while it was effective (possible) to identify residual weakness in players with previous groin injuries. [ABSTRACT FROM AUTHOR]

Background Core injuries in professional baseball pitchers have been linked to both diminished performance and time missed during the season injury was sustained. It is currently unclear how a history of a core injury may affect the future pitching performance and mechanics of professional baseball pitchers. Purpose To compare kinetic and kinematic variables between professional baseball pitchers with prior core/groin injuries and those without prior injury. Study design Descriptive laboratory study. Methods Professional baseball pitchers with a history of core injury pitched 8--12 fastball pitches while evaluated with 3D-motion capture (480 Hz). Inclusion criteria necessitated that the core injury occurred within one to four-years prior to biomechanical evaluation and that the core injury required time off from professional play for a minimum of 2 weeks and maximum of 3 months. These pitchers were 4:1 propensity-scored matched by age, height, weight, and handedness to pitchers with no prior injury history (control). Twenty kinematic and eleven normalized and non-normalized kinetic parameters were compared between groups using appropriate parametric testing. Sub-analysis of pitchers with distinct core muscle and spinal injuries were also analyzed. Results The No Prior Injury (NPI) subgroup (n = 76) had significantly less elbow flexion at ball release (31 ± 5° vs. 35 ± 6° respectfully, p = 0.044) compared to the Core Musculature/Soft Tissue subgroup (CM/ST, n = 10), with no significant difference in kinematics for other injury groups (p > 0.05). The General Core/Groin injury group (GCG, n = 19) had significantly greater normalized elbow anterior force (43.9 ± 4.7 vs. 40.0 ± 5.2 %BodyWeight[BW], p = 0.006) and elbow flexion torque (4.3 ± 0.5 vs. 3.8 ± 0.5 %BWxBodyHeight[BH], p = 0.001) than the NPI pitchers. CM/ST had significantly greater normalized elbow anterior force (p = 0.031), elbow flexion torque (p = 0.002), and shoulder adduction torque (p = 0.007) than NPI pitchers. Conclusion Professional baseball pitchers with prior core/groin injuries demonstrated increased elbow anterior force and elbow flexion torque compared to pitchers with no prior core injuries. One possible explanation for this finding includes inadequate recruitment and utilization of the lower extremities as a component of the kinetic chain leading to compensation at the level of the throwing arm. Whether these kinetic differences arise as a consequence of injury or present a risk for such warrants additional investigation. [ABSTRACT FROM AUTHOR]

The article provides information on various research, cases, and proposals of interest to physical and massage therapists in 2022. Topics discussed include an American College of Rheumatology study of the clinical effect of end-range Maitland mobilization in the management of knee osteoarthritis, research on adductor muscle injuries among Union of European Football Associations (UEFA) soccer athletes, and a proposal for the classification of the coracobrachialis longus.

Background: Aortoenteric fistula (AEF) is uncommon condition but may be one of a fatal causes of bleeding from gastrointestinal tract and Operative management of aortoenteric fistula is associated with high incidence of mortality and morbidity. Objectives: To assess the different methods of management of patients presented with primary or secondary aortoenteric fistulas and the outcomes of management. Patients and Methods: This study was conducted to patients presented to Kasralainy teaching hospital with upper gastrointestinal bleeding with history of aortic aneurysm or aortic graft in which two different methods of treatment either open surgery or endovascular intervention was done for these patients with assessment of outcomes and postoperative complications. Results: This study included 9 patients 7 of them were males and 2 females with mean age (±51.6 years). Hematemesis was the main presentation in 6 patients, bleeding per tectum in 3 cases, shock in 2 patients and groin infection in 2 patients. According to type of fistula, three patients presented with primary AEF and the other 6 patients presented with secondary aortoenteric fistula Conclusion: Patients with AEFs have high incidence of mortality. Endovascular management gives an alternative to open surgery and associated with low perioperative mortality and morbidity and a short hospital stay with accepted survival rate. [ABSTRACT FROM AUTHOR]

In recent years, there has been increased awareness and treatment of groin injuries in athletes. These injuries have been associated with various terminologies including sports hernia, core muscle injury (CMI), athletic pubalgia and inguinal disruption, among others. Treatment of these injuries has been performed by both orthopaedic and general surgeons and may include a variety of procedures such as rectus abdominis repair, adductor lengthening, abdominal wall repair with or without mesh, and hip arthroscopy for the treatment of concomitant femoroacetabular impingement. Despite our increased knowledge of these injuries, there is still no universal terminology, diagnostic methodology or treatment for a CMI. The purpose of this review is to present a detailed treatment algorithm for physicians treating patients with signs and symptoms of a CMI. In doing so, we aim to clarify the various pathologies involved in CMI, eliminate vague terminology, and present a clear, stepwise approach for both diagnosis and treatment of these injuries. [ABSTRACT FROM AUTHOR]

Background: Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain.Methods: Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club's youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play.Results: A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players.Conclusions: Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence.Trial Registration: The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021. [ABSTRACT FROM AUTHOR]

Background Groin strains are one of the most common time-loss injuries in athletes. The Copenhagen Adductor Exercise (CAE) eccentrically strengthens the adductors and may function to prevent adductor strains, similar to the eccentric mechanism in which the Nordic Hamstrings exercise acts to prevent hamstring strains. Objective The purpose of this study was to systematically review the literature on the CAE and its effects on adductor muscle strength and muscle activity in athletes. Study Design Systematic Review Methods A systematic search of the literature was performed in the following databases: Pubmed; Medline (EBSCO); Sportdiscus; Scopus; Web of Science; CINAHL; Proquest; Cochrane Library; Physiotherapy Evidence Database (PEDro). Inclusion criteria consisted of 1) implements CAE, 2) includes athletes of any age participating in at least one sport, 3) study type is a cohort study or randomized control trial. Studies were excluded if they were not written in English or did not measure strength as an outcome. Data were extracted on eccentric hip adductor strength (EHAD), eccentric hip abductor strength (EHAB), EHAD:EHAB ratio, and electromyography (EMG) activity of the adductor muscles. Quality assessment was performed on all included studies using Quality Assessment Tool for Quantitative Studies. Results Five articles were identified for inclusion, four of which received a strong rating, and one a moderate rating on the Quality Assessment Tool for Quantitative Studies. The CAE significantly increased EHAD in four of the four studies that examined it; significantly increased EHAB and EHAD:EHAB in three of the three studies that examined them, and increased the EMG activity of the adductors in the dominant leg 108%. Conclusion Overall, the CAE increases EHAD, EHAB, EHAD:EHAB, and EMG activity in the hip adductors in male soccer players. The increase in strength may reduce adductor muscle injuries, although more research needs to be done in this area to identify a clear relationship between the CAE and groin injury prevention. [ABSTRACT FROM AUTHOR]

This study investigated the weekly prevalence of groin problems over a 3-week football pre-season, compared to a 39-week competitive in-season. We registered time-loss groin injuries, and self-reported weekly groin-pain in 17 amateur male football teams (386 players). The average weekly prevalence of groin problems (prevalence ratio (PR)) was 1.8 times higher (95% CI 1.6 to 2.0) during pre-season (21%) compared to in-season (12%). We found a higher weekly prevalence (PR 1.8; 95% CI 1.6 to 2.1) of groin problems without time loss, during the pre-season (19%) compared to the in-season (10%), but no significant difference in the weekly prevalence of groin problems with time loss (PR 1.5; 95% CI 1.0 to 2.4). Attention should be given to optimal load progression, and early implementation of preventive measures during the football pre-season to reduce the prevalence of groin problems in both pre- and in-season. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between hamstring strength, age and lower limb soft tissue injury history and subsequent hamstring injury among Australian Football League (AFL) players. This prospective cohort study recruited 125 players from three professional AFL teams. Eccentric knee flexor strength was assessed while performing the Nordic hamstring exercise in pre-season, and injury data were collected retrospectively (hamstring, groin, calf, quadriceps and knee), and prospectively (hamstring injuries) for one AFL playing season. Fourteen players (11%) sustained a hamstring injury in the subsequent playing season. Nordic strength was not significantly associated with future hamstring injury (Odds Ratio (OR) 1.9, p = 0.36), whereas player age greater than 25 years (OR = 2.9, p < 0.05), report of a hamstring injury within the previous year (OR = 3.7, p = 0.01), or greater than 1-year (OR = 3.6, p = 0.01), a previous groin (OR = 8.6, p < 0.01) or calf injury (OR = 4.6, p = 0.01) were factors significantly associated with subsequent hamstring injury. Based on these findings, increasing age and previous hamstring, groin and calf injury are all associated with an elevated risk of subsequent hamstring injury in AFL players. [ABSTRACT FROM AUTHOR]

Background: Athletic pubalgia, commonly referred to as a "sports hernia," is a disease process characterized by groin pain produced by physical exertion often occurring in patients whose athletic activities require them to make rapid changes in direction. The groin pain is due to the traction-countertraction relationship between the adductor muscles and the weaker abdominal muscles. Hence, a few studies have shown inguinal hernia repair with adductor tenotomy to be an effective treatment for this pathology (Brody in Hernia 21:139-147, 2016, https://doi.org/10.1007/s10029-016-1520-8 ; Rossidis et al. in Surg Endosc 29:381-386, 2015, https://doi.org/10.1007/s00464-0143679-3 ). However, these studies are small and few in quantity but have demonstrated promising results. Thus, we sought to further study this combined surgical approach as a treatment for this multifactorial disease to improve our understanding and outcomes.Methods: With IRB approval, we retrospectively reviewed the charts of all patients who underwent adductor tenotomy and inguinal hernia repair for the treatment of athletic pubalgia at Mount Sinai Medical Center, Miami Beach FL. Parameters gathered included basic demographics, past medical and surgical history, athletic activity, length of surgery, length of time between surgery and follow-up, intraoperative and postoperative complications, and time to return to athletic activities.Results: A total of 93 patients underwent inguinal hernia repair with adductor tenotomy. These procedures were all performed by a single surgeon at two academic institutions. The average age of patients was 23.4 years. Athletic activities reported by the patients were as follows: American football (n = 36), soccer (n = 18), triathlon (n  = 11), track and field (n = 8), and baseball (n = 5). Less-represented activities included swimming (n = 3), tennis (n = 2), lacrosse (n = 1), golf (n = 1), and other (n = 8). Mean operative time was 72.4 min. Most patients were found to return to athletic activity in 28 days following a standardized physical therapy regimen (92.5%). Postoperative complications included recurrence of pain/symptoms (7.5%, n = 7), urinary retention (2.2%, n = 2), pain along the adductor magnus/brevis muscle group with more extraneous activity (1.1%,  n = 1), and adductor brevis hematoma 3 months following surgery and rehabilitation (1.1%, n = 1). Of the patients with recurrent pain, 2/7 reported contralateral pain.Conclusions: Total extraperitoneal laparoscopic inguinal hernia repair with adductor tenotomy appears to be a relatively quick and safe procedure with few postoperative complications. The majority of treated athletes are able to return to full athletic activities within 28 days of operation. While a return of symptoms has been seen in some patients, it is frequently observed on the contralateral side. [ABSTRACT FROM AUTHOR]