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Athletic Groin Pain Assessment

Updated: Jan 31


Special Tests for the Groin


Athletic Groin Pain is a common and complex problem which can be caused by numerous anatomical structures. The 'Doha agreement 2015' is a recent consensus for definition's and terminology that will be used for groin pain in athletic populations.


Defined clinical entities for groin pain


Adductor related-groin pain

​Adductor tenderness AND pain on resisted adduction testing


Iliopsoas related-groin pain

​Iliopsoas tenderness and more likely if pain on resisted hip flexion AND/OR pain on hip flexor stretching


Inguinal related-groin pain

Pain in inguinal canal region AND tenderness of the inguinal canal. No palpable inguinal hernia is present. More likely if aggravated with abdominal resistance OR Valsalva/cough/sneeze


Pubic related-groin pain

Local tenderness of the pubic symphysis and the immediately adjacent bone


Hip related-groin pain

Physical examination including a passive range of motion and hip special tests Flexion-abduction-external rotation (FABER) and Flexion-adduction-internal rotation (FADDIR) test


Other conditions

Other conditions causing groin pain, especially when the symptoms cannot be easily classified into one of the commonly defined clinical entities


Assessments

There remains scarce evidence for use of stand alone clinical tests, therefore clinical assessments should be taken in conjunction with a clear subjective history and current symptoms to assist in making a diagnosis.


Clockface Palpation

  • Identification of pain generating area

  • Positive for pain reproduced within specific area

  • 3 O'clock - Pubic Symphysis

  • 6 O'clock - Adductor Longus

  • 9 O'clock - Inguinal Ligament

  • 12 O'clock - Superficial Inguinal Ring / Rectus Abdominus


Isometric Groin Squeeze Test

  • Adductor Related Groin Pain

  • Pubic Related Groin Pain

  • Positive for reproduction of patients pain





Isometric Hip Flexor Test & Modified Thomas test

  • Iliopsoas Related Groin pain

  • Positive for reproduction of patients symptoms







Isometric Abdominal Test

  • Inguinal Related groin Pain

  • Positive for reproduction of patients symptoms







Hip Related Groin Pain

  • Hip Passive Range of Motion

  • FABER - Flexion Abduction External Rotation

  • FADDIR - Flexion Adduction Internal Rotation

  • Flex-IR - Flexion Internal Rotation

  • Positive for reproduction of patients symptoms




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