Today we will tackle groin pain with Fisiorunning, an annoying and usually prolonged pathology of runners that is often misdiagnosed precisely for its multifactorial causes.
Among sports injuries we often hear about groin pain which can prevent the normal course of training and competitions. Groin pain is often associated with adductor muscle problems; as we have seen in the past few weeks. The causes are almost always identified in the problems of the tendons of this muscle group but we will see how it is imbalance between adductors and abdominals plays an essential role in the development of this pathology.
It must be emphasized that the groin is statistically more frequently in sports involving kicks, twists and lateral movements that stress the pubic symphysis. THE runners most affected are those who travel many kilometers, especially on rough terrain. They are predominantly male under 40. The the fairer sex is less affected because it has a much wider and more robust attachment of the rectus abdominis on the pubic symphysis. Furthermore, the female pelvis, being wider and having a greater sububic angle, better distributes the incident forces on the pubic region.
What are the symptoms of groin pain? –
Pubalgia usually presents with a groin pain unilateral which is reduced with rest and returns with activity. It is a pain that in the 70% of cases it manifests itself as a gradual discomfort that becomes a sharp pain when stopping the race. At the palpation pain persists in the lower abdomen, adductors and pubic symphysis. Coughing and sneezing they can sometimes reproduce the painful symptom. In cases of entrapment of the nerves we can see alterations of the epithelial sensitivity of the area. Movements such as opening out, flexing, and internally rotating the leg can cause pain.
What are the most common causes of groin pain? –
Pubalgia has a broad spectrum of causes that generate it. Scholars have counted further 70 causes of Pubalgia which include pathologies muscular (adductors, abdominals, lumbar paravetrebrals and iliopsoas) tendon, articular (diseases of the hip, pubic symphysis, sacroiliac and pelvis), biomechanics (lumbar hyperlordosis and asymmetries of the pelvis or lower limbs), bone (fractures), inflammation of the bags serous, by compression of the nerves, genitourinary, hernia, tumors and infectious. With this broad spectrum we understand as one correct and early diagnosi is essential for speeding up recovery and healing.
How do adductors and abdominals work biomechanically? –
To understand the onset and resolution of groin pain, it is necessary to specifically analyze what happens on the pubic symphysis and on the muscles that are inserted into it (Abdominals and Adductors) during the race. In monopodalic support phase we have the total load that weighs on the adductors stabilizing the hip and pelvis by acting with forces incident on the pubic symphysis and on the contralateral abdominals. Thus preventing the leg from opening outward and into the subsequent extension help the iliopsoas to advance the femur. During the leg rise the whole system has a stabilization phase of the femur.
The anatomical component rectus abdominis-pubic symphysis-adductor long it must be well balanced to avoid imbalances. A weak and loose rectus abdominis allows the adductors to go too short and hypertonic, causing Pubalgia over time. Furthermore, the weakness and elongation of the rectus abdominis cause hypertonus in the lumbar area, facilitating hyperlordosis. This is why a correct physiotherapy approach to these compartments very often resolves groin pain.
How can physiotherapy for groin pain help us? –
In addition to treating groin pain in classic way through massages, manual therapy, stretching, kinesiotaping, instrumental therapies on the anatomical adductor area we should consider the peripheral areas that influence the muscle chain. Including the abdominal and lumbar area.
In Fisorunning we have developed a specific treatment of postural rebalancing of the lumbar / abdominal / adductor area. Through manual and osteopathic therapy techniques these areas are passively treated and then specific exercises are carried out to restore the weak and stretched muscles to a physiological tone that releases adductor tensions. The goal is to normalize lumbar hyperlordosis as well.
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