070. How to treat adductor related groin pain and complex cases with Dr Adam Weir

Athletes with groin pain will commonly play with pain until the end of the season, and rest during the off-season in the hopes this will aid in their recovery. Unfortunately this offseason rest period rarely results in recovery, and athletes head into the preseason with long-standing groin pain and an extended recovery period.

In this episode of the Physio Edge podcast with Dr Adam Weir , you will discover how to treat adductor related groin pain (ARGP) and complex patient presentations with multiple areas of pathology or pain.

This podcast follows on from the Physio Edge podcast episode 69, where Dr Adam Weir and I discussed in detail how to assess and diagnose adductor related groin pain, identify or exclude differential diagnosis including stress fractures, hip joint involvement, inguinal related groin pain and nerve entrapment.

You will explore:

• Treatment of acute adductor strains
• Long term adductor related groin pain (ARGP)
• Is rest during the off season helpful or harmful for groin pain
• What pain level is ok during rehab exercises
• How can you describe ARGP to decrease patient fear
• Is ARGP a tendinopathy or different pathology?
• How to answer your patients when they ask how long until they can return to training (RTT) or return to play (RTP)?
• What is and how can you incorporate the Copenhagen Adductor exercise?
• Is there a role for passive treatment?
• Is hand held dynamometry useful during recovery?
• Treatment for adductor related groin pain (ARGP)
• Starting treatment
• Exercise progressions
• What criteria can you utilise for treatment progressions?
• What criteria can you use prior to allowing your patients to return to running, change of direction and RTP
• How to progress running and change of direction training
• Adductor to abductor strength ratios your athletes can achieve prior to RTP

Complex presentations

• How can you make a diagnosis and tailor your rehab when a patient has multiple areas of pain and positive tests eg ARGP plus Psoas related groin pain or Inguinal related groin pain?
• How your treatment program may evolve as your patient progresses through their rehab

Dr Adam Weir will be presenting at the upcoming Sports Injuries virtual conference on the assessment and treatment of Inguinal related groin pain. You can access his free preconference presentation, along with other free sports injury assessment and treatment videos AT THIS LINK

Links associated with this episode:

• Download your free podcast handout
• Dr Adam Weir on Twitter - @adamweirsports
• Aspetar – Sports groin pain centre
• Get your free trial Clinical Edge membership
• David Pope on Twitter
• Clinical Edge on Facebook
• Adductor protocol on Mobile devices
• Adductor protocol videos on Youtube

Articles associated with this episode:

• Branci et al. 2014. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls.

• Drew et al. 2017. Experimental pain in the groin may refer into the lower abdomen: implications to clinical assessment.

• Drew. 2017. PhD Thesis - Beyond the pathoanatomical explanation of long-standing groin pain in athletes

• Mosler et al. 2015. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis.

• Weir et al. 2015. Doha agreement meeting on terminology and definitions in groin pain in athletes.

• Whittaker et al. 2015. Risk factors for groin injury in sport: an updated systematic review.