DOCTOR’S CORNER with JOSEPH KABUNGO
GROIN injuries are very common among football players and hardly a week passes without anyone being affected.
A groin problem when severe can limit someone’s participation in football, thus it is important for a good recovery and rehabilitation programme to be put in place.
Groin injuries are common in many sports disciplines, which involve explosive movements.
In football groin injuries account for about 7-11 percent according to the studies by FIFA.
Groin injuries are a very common occurrence in football players with 60 percent of these injuries present with acute pain while 40 percent come with chronic groin pain.
Majority of the footballers will complain of groin pain.
The groin area can be defined as the area where the thigh meets the pelvis.
It is clearly formed by the muscles of the thigh, muscles of the abdominal wall from the top and also the muscles of the pelvis.
Pain which is acute or pain of sudden onset can arise from the groin area and it can involve the muscles, ligaments, tendons or it can arise from nerve entrapment.
It is also important to remember that pain in the hip joint must not be overlooked when evaluating groin injuries.
There is one important group of muscle which is referred to as the adductor group in the inner aspect of the thigh and this is commonly the origin of acute groin pain or pain of sudden onset.
Groin pain of sudden onset is one of the important and agonising conditions, which keep the player out of training.
This is the reason why we need to understand what the predisposing factors for this condition are, and how to treat these injuries.
In conditions like sports hernia there is a typical recurrent groin pain, which results from a tear to the muscle of the abdominal wall.
my focus will be the pain as a result of the problem with the inner muscles of the thigh (Adductor group of muscles).
The inner muscles of the thigh are a source of sudden groin pain because of the work, which these muscles have to do in order to cope with resisting forces of varying intensities.
A player or sports man who suffers sudden groin pain will either immediately stop performing his usual activity, the running becomes slower, he can not kick the ball effectively without pain and will in most cases demand that he rests from the usual activity.
The factors which are responsible for a player or athlete to experience sudden groin pain involve explosive sprinting, excessive opening of the leg when trying to stop a ball, massive turning and twisting movements, sudden resistance when trying to kick the ball and also when the player attempts to kick a ball and then accidentally hits the ground.
The other mechanism involves a player who is tackled whilst in motion.
This will result in sudden muscle strain, strain at the junction of the muscle and the tendon or at the point were the tendon attaches to the bone.
Muscle strains are very common and are mainly the origin of acute (sudden) groin pain in a sports man.
Inadequate warm up and stretching of the respective groups of muscles also predispose a player to groin injuries.
The crucial part is how to treat or manage an injured groin so that the player gets relief.
Many will tell you that the best mode of treatment of groin injuries is rest and a good rehabilitation programme.
In our case, I will describe what has to be done when faced with a condition like this one.
It always has to be remembered that when soft tissues like muscles, ligaments, tendons get injured there is some element of bleeding.
It is very important that the bleeding is limited and this in itself becomes crucial in the management of these injuries.
Pain also has to be dealt with so that the player can have recovery time which is pain-free.
The problem which is identified in many players is that they return to action prematurely and this will lead to a prolonged period for the groin injury to heal.
When an athlete complains of sudden groin pain, it is safer to immediately stop them from the intense activity and the Rest, Ice, Compression and elevation (RICE) method used.
The rest will improve on the blood circulation to the injured part and also provides the much-needed time for recovery to occur.
The ice will provide pain relief and also limit the bleeding around the injured part of the groin.
The ice should be administered repeatedly especially in the first 48 hours to 72 hours.
This is the reason why ice becomes one of the important basic requirements whenever a team is training or during actual competition because it can provide relief and limit the inflammatory process.
It is important that players are taught basic management of injuries because ice application is what they can do on their own and they do not need qualified staff.
The use of the available pain killers like brufen, indocid and Diclofenac is also commonly used to relieve the pain.
Acute groin injuries can take few days to heel.
The other important aspect is the rehabilitation process from an injured groin. Rehabilitation is important so that the player returns to action without putting them at risk of injuring the groin again.
In the rehabilitation phase the goal is to normalise movement and reduce pain so that the player is fit again to return to competition.
The main areas of the rehabilitation phase have to focus on good exercise, massage and stretching.
Functional exercises which are sport specific have to be encouraged in the rehabilitation phase so that the physical conditioning of the player is improved.
In certain cases surgery becomes the available option if the conservative treatment fails or the injury takes longer than usual to heal.
Even after undergoing surgery, rehabilitation is a must for the injured groin and it is thus important to have a physiotherapist who will fully understand the rehabilitation for groin injuries.
Acute groin injuries must be treated fully for the player or sportsman to get back to normal activity.
Good warm up is vital to prevent many injuries from occurring and these should be accompanied by a good stretching session.
Apart from the acute groin injuries, we should also look out for the chronic overuse groin injuries and sports hernia as major causes of groin pain.
The important thing is for players to seek early medical attention when they experience sudden groin pain so that treatment is begun early.
For questions and comments write to: Dr Kabungo Joseph
Email:: zengajk@yahoo.com or kateulejk@gmail.com