We need to Address the Problem of Hip & Groin Pain in Athletes!
In last week’s article I wrote about the increasing frequency of Hip Labral tear injuries in athletes. This week I will discuss further reasons why the Labral fibrocartilage becomes torn in young athletes from the age of 16 years upwards. We know that that excessive abnormal positioning of the ball of femur head against the frontal aspect of the acetabulum Hip socket leads to wearing of the Labral. Lets first recap over the symptoms of the Injury and the reasons for its occurrence!
Most Common Symptoms of torn Hip Labral Cartilage:
Ongoing Groin Pain for 3-6 months in duration
Occurred gradually without a trauma injury
Groin Pain becoming progressively worse during & after matches
Notable clicking or catching sensation or noise in the Hip or groin area
Reasons for Hip Labral Occurrence
Overactive Hamstrings versus Underactive Glutes
Increased reliance or over activity on the hamstring to work when swinging the leg backwards during running and walking causing excessive movement into the front sector of the Hip Joint. This is due to poorly working Glute Maximus (buttock Muscle) and Erector Spinae muscles (of the lower spine). The role of these muscles involves helping to control and initiate the Leg when swinging backwards, if the gluteal and lower back muscles are weak and tight they fail to perform this essential role and hence the hamstring becomes dominant. Athletes with groin pain should be assessed for weak gluteal and lumbar spine muscles and tight hamstring muscles that cause further excess straightening (hyper-extension) of the Knee Joint. Furthermore this can commonly lead to problems with the Sacro-iliac Joint of the Lower Spine.
Lower Back Pain
It is so common for a Young GAA or Rugby player to enter my clinic presenting groin pain and yet have ongoing achy lower back pain during and after games. Are the two conditions related? Yes! Lower Back Pain commonly causes the glute medius muscle of the Hip and Pelvic to work when standing when in fact, it should be in a relaxed position. Hence when we need to run, twist and turn and even walk the essential glute medius activation that we need to stabilize the hip and pelvis is not happening, simply because the muscle is fatigued due it being switched on when standing. This is the reason why we have tight glutes and unequal firing of the muscles that control both Hip Joints. This needs to be assessed in Athletes with Groin pain!
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Clonmel & Thurles. Contact Number: 0504 26672. Email: tomaspryan@gmail.com
