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Anatomical and morphological characteristics may explain why groin pain is more common in male than female athletes
  1. Anthony G Schache1,
  2. Stephanie J Woodley2,
  3. Ernest Schilders3,4,5,
  4. John W Orchard6,
  5. Kay M Crossley7
  1. 1Department of Mechanical Engineering, University of Melbourne, Melbourne, Victoria, Australia
  2. 2Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand
  3. 3The London Hip Arthroscopy Centre, The Wellington Hospital, London, UK
  4. 4Fortius Clinic, London, UK
  5. 5School of Sport, Leeds Beckett University, Leeds, UK
  6. 6School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  7. 7La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Anthony G Schache, Department of Mechanical Engineering, University of Melbourne, Melbourne, VIC 3010 Australia; anthonys{at}unimelb.edu.au

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Groin pain is prevalent in athletes who play field sports that involve repetitive agility and kicking (eg, soccer, rugby and Australian Rules football). It is prone to recurrence and chronicity, thus can be challenging to overcome. A recent review found that men are 2.5 times more likely to sustain a groin injury than women when participating in the same sport.1 This observation is probably attributable to various factors. Contrasting training and/or match workloads could potentially exist between male and female athletes. Hormonal differences may be relevant too. While acknowledging these factors, we suggest that the higher risk of groin injury for male compared with female athletes may also be attributable to sex-related differences in groin anatomy as well as pelvic and hip joint morphology.

Pubic-related anatomy

The confluence of aponeurotic tissues across the anterior surface of the pubic symphysis, comprising fibres from the adductor and abdominal musculature, is a potential site of pathology in athletes with groin pain. Schilders2 dissected 16 embalmed cadavers (8 males and 8 females) and observed a sex-related difference in the …

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