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What is the relationship between groin pain in athletes and femoroacetabular impingement?
  1. M Ferguson1,
  2. J Patricios2,3,4
  1. 1 The Centre for Sports Medicine and Orthopaedics, Johannesburg, South Africa
  2. 2 Morningside Sports Medicine, Johannesburg, South Africa
  3. 3 Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  4. 4 Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  1. Correspondence to Dr Jon Patricios, PO Box 1267, Parklands 2121, South Africa; jpat{at}mweb.co.za

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Groin symptoms in athletes have been likened to the Bermuda Triangle as sports physicians, orthopaedists, surgeons and therapists alike are easily sucked into a sea of confusing suppositions and assumptions.1 Possibly the greatest advance in the understanding and appreciation of ‘sports hernia’ has been the recent acknowledgment by a multidisciplinary panel of experts that there is in fact no hernia associated with the condition and they have coined the term ‘inguinal disruption’.2 Unfortunately, although the authors describe a constellation of symptoms, the label again suggests a localised pathology rather than a syndrome.

A broader focus required

As much as we concentrate our collective efforts on repairing a defect in an anatomical area or treating what we consider to be the primary area of injury, perhaps we should explore and investigate the concept that symptoms are a result of a structural failure of tissue to compensate for abnormal loads created by an imbalance of forces across the groin area. Single or multiple areas of groin injury may represent a failure of the same functional unit. The proposal of a ‘pubic joint’, distinct from the symphysis pubis, which involves numerous anatomical structures and their resultant forces at different contact sites can explain the multiple pathologies that exist in this condition. …

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