Why does screening fail to identify injuries? What actually works?
Groin and hip injuries wreak havoc in the sporting population, with significant time loss to the athlete, and financial implications to clubs and organisations. In this BJSM podcast, Dr Liam West talks with Dr Andrea Mosler PhD (specialist sports physiotherapist and research fellow at LaTrobe University) about how to best approach the prevention and management of hip and groin pain in athletes. The podcast is full of clinical pearls to add to your “hip and groin” treatment toolbox – let us know what you’ll be building into your practice!
What do we think are some of the biggest lessons from this podcast?
It is often easy to do a barrage of pre-season screening tests to identify abnormalities and aim to “correct” them – but maybe you should think twice! This ties in nicely with Prof Roald Bahr’s critical review on why screening tests to predict injury do not work—and probably never will #OpenAccess https://bjsm.bmj.com/content/50/13/776
Use evidence-based injury prevention programmes!
- The Adductor Strengthening Programme
If there was a tablet for athletes to take that reduced their risk of groin problems by 40%, they would all be on it, no? If you would be putting all of your players on this pill, shouldn’t you make sure they’re all on an adductor strengthening programme (such as the one from Joar Haroy’s now famous RCT)? You can find the link to said RCT here! https://bjsm.bmj.com/content/53/3/150
- The FIFA11+ (though evidence-based alternatives exist!)
If you want a quick, effective resource designed to prevent non-contact injuries in sport, look no further! It has been estimated to have a risk reduction of hip and groin injuries by 41% The large UEFA injury audit shows that almost one in seven injuries in football are hip and groin related – so it would be hard to fathom why you wouldn’t think about implementing it in your setting! You can find links to the injury study and evaluating the implementation model here! (https://bjsm.bmj.com/content/53/9/539 & https://bjsm.bmj.com/content/47/12/803.short)
Want more resources on hip & groin pain?
We are fortunate that the BJSM is home to many hugely popular and relevant hip & groin papers & collections – below is a list of some relevant resources that have shaped thinking and practice over the last few years:
Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport – grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF) #OpenAccess https://bjsm.bmj.com/content/54/9/528
Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain #OpenAccess https://bjsm.bmj.com/content/early/2020/06/15/bjsports-2019-101690
Athletic groin pain: a systematic review and meta-analysis of surgical versus physical therapy rehabilitation outcomes (free for those with BJSM member society access!) https://bjsm.bmj.com/content/49/22/1447
Podcast: Treating hip pain including FAI syndrome. Arthroscopy or focused physio? #PerfectForTheCommute
Thanks to Dr Tej Pandya for helping to collate this collection of