Objective: To evaluate the hypothesis that groin pain at isometric hip adduction may not be caused by adductor tendinitis.
Design: Symptoms and signs in a cross-sectional analysis.
Setting: Multicenter primary care institutes.
Subjects: Athletes with pain in the groin(s), provoked by playing sports, with a duration of complaints for at least 1 month and pain provocation on isometric adduction of the hips.
Interventions: Data on medical history and symptoms were collected. Pain provocation tests and strength measurements were performed. A pelvic belt was used to investigate its influence on pain provocation and strength.
Main outcome measurements: Site of the pain, duration of the complaints, severity of the pain, hip adduction force, pain at isometric hip adduction, restriction to perform active straight leg raising, influence of a pelvic belt on pain and strength of isometric hip adduction and straight leg raising.
Results: Groin pain was bilateral in 41%; pain was also located at the posterior aspect of the pelvis in 32%; Active Straight Leg Raise (ASLR) test was positive in 39%. When tested with a pelvic belt, the weakness of ASLR improved in all with a positive ASLR, hip adduction force increased significantly in 39% and pain at forceful isometric hip adduction decreased in 68%.
Conclusions: Groin pain at isometric hip adduction may not be caused by adductor tendinitis in a large proportion of athletes with adduction-related groin pain. The results suggest that adduction-related groin pain with a positive belt test may be treated by stabilization of the pelvis.