By Helen McElroy (@helenmcelroy) Physiotherapist and Northern Ireland Rep for ACPSEM
Hip and Groin pain in kicking sports will be the focus of the 2019 ACPSEM Autumn Study day. This two-day event will be held in Riddell Hall, Belfast on 22/23rd November. We’ve pulled together experts from several kicking sports including international rugby and premiership football to join us and discuss the complexities of hip and groin pain in this population. The event is open to physiotherapists, sports medicine doctors, strength and conditioning coaches working with athletes across the spectrum of kicking sports.
Hip and groin pain in men’s football has a high incidence (1.1/1000 Hours) (Walden et al, 2015). Each season a club can expect to see 6-7 hip/ groin injuries (Mosler et al 2017). On average there are 10 days lost per injury with 85 days lost per club per season (Mosler et al, 2017). With this in mind, if you are looking after these athletes in a team setting, clinicians need to look at the demands of these sports, the biomechanics of the tasks they are asked to complete and how to build effective rehab strategies to enable us to manage these athletes effectively.
In the recent BJSM Warm up, the complexities of monitoring individual factors for athletes and how the complex interaction of these factors can greatly influence outcome is discussed by the issue editors Philip Glasgow and Stephen Mutch. This is further explored in the BJSM Editorial by Taberner et al. where they describe the control-chaos continuum of injury. Through the rehab process the athlete needs to progress from the controlled environment of the gym/ rehab facility back to the chaos of the playing field. This dynamic process can be hard to navigate for both athlete and clinician. The discussion of when to add chaos and how to apply greater reactive neurocognitive challenges will be a major talking point of the ACPSEM Autumn Study day. We plan to break this process down looking at the forces across the pelvis and the actions and biomechanical demands placed on these athletes. This excellent infographic from @sportsmedicineni shows how complex this area is and how the demands across the pelvis will vary from athlete to athlete and injury to injury.
Once we have ascertained the demands on the athlete, we will discuss the building blocks of assessing and monitoring these athletes. Across the three practical breakout sessions speakers will be outlining the rehab strategies employed in premiership football. The first session will focus on the influence of the stance leg, the second on control of the pelvis in these multidirectional movements and the third on how the specifics of the kick should be addressed in both injury prevention and injury management strategies.
The expert panel will then present a difficult case and talk through its management before rounding off the day with a panel discussion focusing on rehab progression/ milestones on the return to play continuum/ reintegration back into play and how to keep the player pain free on their return to the chaos of their sport.
This study day is designed with the ‘in the field’ clinician in mind. The overall aim is to provide access to experts working at the top of their game and how clinicians can apply the pillar priniciples of rehab to a complex population to enhance performance, allow for efficiency in movement and build resilient athletes on their return to play.
For more information on this exciting event check out www.physiosinsportevents.co.uk or follow @physiosinsport or @acpsemni on twitter.
A note of thanks to Alan Rankin @sportsmedicineni for the use of their infographic in this blog post.
References
Mosler AB, Weir A, Eirale C, et al. Epidemiology of time loss groin injuries in a men’s professional football league: a 2-year prospective study of 17 clubs and 606 players
British Journal of Sports Medicine 2018;52:292-297.
Waldén M , Hägglund M , Ekstrand J . The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med 2015;49:792–7.
Taberner M, Allen T, Cohen DD. Progressing rehabilitation after injury: consider the ‘control-chaos continuum’. British Journal of Sports Medicine 2019;53:1132-1136.