Author Names
Tak, I., Langhout, R., Bertrand, B., Barendrecht, M., Stubbe, J., Kerkhoffs, G., Weir, A.
Reviewer Name
Jasmin Flores, SPT
Reviewer Affiliations
Duke University School of Medicine, Doctor of Physical Therapy Division
Paper Abstract
Objectives: To study the clinical course including return to sport success rates of football players with adductor-related groin pain (ARGP) after manual therapy of the adductor muscles. Design: Prospective case series.
Methods: Thirty-four football players with ARGP with median pre-injury Tegner scores of 9 (IQR 25–75: 9–9) were treated with manual therapy of the adductor muscles. Main outcome measures were numeric pain rating scale (NPRS), Hip and Groin Outcome Score (HAGOS) and global perceived effect (GPE) for treatment and patient satisfaction at 2, 6 and 12 weeks. Return to sport was documented.
Results: Pain during (NPRS 7 (6–8) and after (NPRS 8 (6–8) sports decreased to NPRS 1 (0.2–3) and 1 (0.8–3), respectively (p < 0.001). Within 2 weeks 82% of the players returned to pre-injury playing levels with improved (p < 0.001) HAGOS subscale scores. Eighty-five percent reported clinically relevant improvement, 82% reported to be satisfied. At 12 weeks, 88% had returned to pre-injury playing levels. HAGOS showed symptoms were still present.
Conclusion: Early return to sport seems possible and safe after manual therapy of the adductor muscles in football players with ARGP in the short term. While the majority of injured football players return to sport within two weeks, caution is advised regarding effectiveness as hip and groin symptoms were still present and no control groups were available.
NIH Risk of Bias Tool
Quality Assessment Tool for Case Series Studies
- Was the study question or objective clearly stated?
- Yes
- Was the study population clearly and fully described, including a case definition?
- Yes
- Were the cases consecutive?
- Yes
- Were the subjects comparable?
- Yes
- Was the intervention clearly described?
- Yes
- Were the outcome measures clearly defined, valid, reliable, and implemented consistently across all study participants?
- Yes
- Was the length of follow-up adequate?
- Yes
- Were the statistical methods well-described?
- Yes
- Were the results well-described?
- Yes
Key Finding #1
There was clinical improvement and a reduction of pain with the use of adductor muscle manual manipulation for football players with long-standing adductor-related groin pain.
Key Finding #2
Even though the football players did return to sport, it was noted that most players still experienced hip and groin related problems.
Key Finding #3
After just 6 weeks of adductor muscle manual manipulation, 27 (79%) of the patients reported being able to return to football at their pre-injury level.
Please provide your summary of the paper
Based on the results of this study, manual manipulation of the adductor muscles improved return to sport for football players with groin injuries. However, there still isn’t enough information on whether or not this treatment method is reliable for long-term benefits. Additionally, even though the participant’s were able to return to sport and perform at a pre-injury level, they still experienced some hip and groin related problems.
Please provide your clinical interpretation of this paper. Include how this study may impact clinical practice and how the results can be implemented.
Depending on how long a football player, or athlete in general, have had an adductor-related groin pain, this manual manipulation technique may be beneficial for them in returning to sport sooner. Many of the football players seemed to respond very well to the manual manipulation, even getting them back to sport at their pre-injury level at just 6 weeks. This study also measured pain level and it was recorded that between 6 to 12 weeks there was a significant improvement in pain. A limitation in this study would be that they did not highlight any possible long-term benefits and some football players still continued to have some pain.
