Groin Pain 101: Screen/Assessment Review

At this point I thought it would be a good idea to recap all the things we’ve discussed over the last week.  Below is a summary of the process I take when an athlete comes to me reporting groin pain.

1. Question about the nature of the pain

  • When did the pain/discomfort start? Was there a specific incidence that caused it?
  • Where is your pain located?
  • What does the pain feel like? Dull aching, sharp, radiating, etc. 
  • What types of exercises/movements cause pain?  Is the pain immediate or does it come afterwards? 
  • Describe the intensity of the pain.  On a scale from 0-10, 10 being unbearable excruciating pain, where would you rate your pain when it first comes, a couple hours later, the next day, etc?
  • How long does the pain last?

2. Posture Analysis

  • Hip Position: Anterior/Posterior Pelvic Tilt, Lateral Pelvic Tilt, Rotation
  • Knee Position: Knee caps pointing in? Relatively in line with femur and tibia?
  • Foot Position: In-/Out-Toed? Flat footed? Check shoes-Note uneven wear on inner (excessive pronation-usually excessive hip internal rotation )or outer borders (excessive supination)

3. Range of Motion Analysis

  • Thomas Test: Extensibility of hip flexors. Note compensatory rotations with lengthening
  • Hip Internal/External Rotation ROM: Test with hips flexed to 90 degrees and with hips extended
  • Quadruped Rocking: Note maximum hip flexion before lumbar rounding

4. Muscle Function Test

  • Seated Psoas Test: Note ROM, strength, and compensatory motion on each side
  • Side Lying Hip Abduction: Note ROM, strength, and compensatory motion on each side
  • Front Plank: Endurance test for time
  • Side Plank: Endurance test for time on each side

5. Movement Analysis

  • Double-Leg Movements: Squat, Deadlift, and Stiff-Legged Deadlift Patterns
  • Single-Leg Movements: 1-Leg Squat, 1-Leg Deadlift, 1-Leg Stiff-Legged Deadlift, and Reverse Lunge Patterns
  • In all movements, note movements of the knee, hip, and lumbar spine, keeping the whole body movement in mind.

By completing the above screen/analysis, I have a better idea of any predisposing factors or resulting functional impairments related to the athletes groin or hip pain.  This will allow me to communicate more effectively with an athletic trainer, physical therapist, or sports physician (if the athlete is lucky enough to have access to any of these professionals).  At a minimum, it will give me an idea of areas the athlete’s abilities and areas that need improvement or areas to avoid.

Next up: How to get back on track following a groin injury…

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