Skip to main content

Advertisement

SpringerLink
Log in

Treatment of longstanding groin pain: a systematic review

  • Review
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

The most effective treatment for longstanding groin pain with no hernia present has not been designated. The aim of this systematic review was to assess whether surgical or conservative treatment are the most effective in reducing pain and thereby returning patients to habitual activity.

Methods

PubMed, Embase, and Cochrane were searched. We included adults diagnosed with longstanding groin pain with no hernia. Treatment included inguinal hernia repair, tenotomy, and nonsurgical management. Outcomes included return to habitual activity, pain, patient satisfaction, re-operations for the operated patients, and shift to surgery for the non-operated patients. We included randomized controlled trials and observational studies with more than 10 participants.

Results

In total, 72 studies with 3629 patients were included. Only five studies used a comparison group. After inguinal hernia repair, 94% returned to habitual activity after median 10 weeks, 92% became pain free, and 92% were satisfied with their treatment. After adductor tenotomy, 90% returned to habitual activity after median 12 weeks, 90% became pain free, and 84% were satisfied. After combined inguinal hernia repair and adductor tenotomy, 97% returned to habitual activity after median 10 weeks, 92% became pain free, and 91% were satisfied with their treatment. After nonsurgical management, 80% returned to habitual activity after median 12 weeks, 67% became pain free, 56% were satisfied, and 21% shifted to surgery.

Conclusion

We found that surgery seems to be more efficient in return the patients to habitual activity, reduce their pain, and satisfy them than conservative treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sheen AJ, Stephenson BM, Lloyd DM, Robinson P, Fevre D, Paajanen H et al (2014) Treatment of the sportsman’s groin: British Hernia Society’s 2014 position statement based on the Manchester Consensus Conference. Br J Sports Med 48:1079–1087. https://doi.org/10.1136/bjsports-2013-092872

    Article  PubMed  Google Scholar 

  2. Jansen CJ, Yielder PC (2018) Evaluation of hernia of the male inguinal canal: sonographic method. J Med Radiat Sci 65:163–168. https://doi.org/10.1002/jmrs.275

    Article  PubMed  PubMed Central  Google Scholar 

  3. Weir A, Brukner P, Delahunt E et al (2015) Doha agreement on terminology and definitions in groin pain in athletes. Br J Sports Med 49:768–774

    Article  Google Scholar 

  4. Hopkins JN, Brown W, Lee CA (2017) Sports hernia: definition, evaluation, and treatment. JBJS Rev 5:e6. https://doi.org/10.2106/JBJS.RVW.17.00022

    Article  PubMed  Google Scholar 

  5. Bernhardt GA, Gruber G, Molderings BS, Cerwenka H, Glehr M, Giessauf C et al (2014) Health-related quality of life after TAPP repair for the sportsmen’s groin. Surg Endosc 28:439–446. https://doi.org/10.1007/s00464-013-3190-2

    Article  PubMed  Google Scholar 

  6. Cavalli M, Bombini G, Campanelli G (2014) Pubic inguinal pain syndrome: the so-called sports hernia. Surg Technol Int 24:189–194. https://doi.org/10.1007/s10029-009-0610-2

    Article  PubMed  Google Scholar 

  7. Eames NW, Deans GT, Lawson JT, Irwin ST (1994) Herniography for occult hernia and groin pain. Br J Surg 81:1529–1530. https://doi.org/10.1002/bjs.1800811044

    Article  CAS  PubMed  Google Scholar 

  8. Gwanmesia II, Walsh S, Bury R, Bowyer K, Walker S (2001) Unexplained groin pain: safety and reliability of herniography for the diagnosis of occult hernias. Postgrad Med J 77:250–251. https://doi.org/10.1136/pmj.77.906.250

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Macarthur DC, Grieve DC, Thompson AM, Greig JD, Nixon SJ (1997) Herniography for groin pain of uncertain origin. Br J Surg 84:684–685. https://doi.org/10.1002/bjs.1800841229

    Article  CAS  PubMed  Google Scholar 

  10. Martens MA, Hansen L, Mulier JC (1987) Adductor tendinitis and musculus rectus abdominis tendopathy. Am J Sports Med 15:353–356. https://doi.org/10.1177/036354658701500410

    Article  CAS  PubMed  Google Scholar 

  11. Muschaweck U, Berger L (2010) Minimal Repair technique of sportsmen’s groin: an innovative open-suture repair to treat chronic inguinal pain. Hernia 14:27–33. https://doi.org/10.1007/s10029-009-0614-y

    Article  PubMed  Google Scholar 

  12. Jose J, Buller LT, Fokin AJ et al (2015) Ultrasound-guided corticosteroid injection for the treatment of athletic pubalgia: a series of 12 cases. J Med Ultrasound 23:71–75. https://doi.org/10.1016/j.jmu.2014.11.003

    Article  Google Scholar 

  13. Dellon AL, Williams EH, Rosson GD, Hashemi SS, Tollestrup T, Hagen RR et al (2011) Denervation of the periosteal origin of the adductor muscles in conjunction with adductor fasciotomy in the surgical treatment of refractory groin pull. Plast Reconstr Surg 128:926–932. https://doi.org/10.1097/PRS.0b013e3182268cbf

    Article  CAS  PubMed  Google Scholar 

  14. Hussain A, Mahmood H, Singhal T, Balakrishnan S, Nicholls J, Grandy-Smith S et al (2008) Laparoscopic surgery for chronic groin pain in the general population: a prospective study. J Laparoendosc Adv Surg Tech A 18:809–813. https://doi.org/10.1089/lap.2007.0167

    Article  PubMed  Google Scholar 

  15. Caudill P, Nyland J, Smith C, Yerasimides J, Lach J (2008) Sports hernias: a systematic literature review. Br J Sports Med 42:954–964. https://doi.org/10.1136/bjsm.2008.047373

    Article  CAS  PubMed  Google Scholar 

  16. King E, Ward J, Small L, Falvey E, Franklyn-Miller A (2015) Athletic groin pain: a systematic review and meta-analysis of surgical versus physical therapy rehabilitation outcomes. Br J Sports Med 49:1447–1451. https://doi.org/10.1136/bjsports-2014-093715

    Article  CAS  PubMed  Google Scholar 

  17. Paajanen H, Montgomery A, Simon T, Sheen AJ (2015) Systematic review: laparoscopic treatment of long-standing groin pain in athletes. Br J Sports Med 49:814–818. https://doi.org/10.1136/bjsports-2014-094544

    Article  PubMed  Google Scholar 

  18. Swan KGJ, Wolcott M (2007) The athletic hernia: a systematic review. Clin Orthop Relat Res 455:78–87. https://doi.org/10.1097/BLO.0b013e31802eb3ea

    Article  PubMed  Google Scholar 

  19. De Sa D, Hölmich P, Phillips M, Heaven S, Simunovic N, Philippon MJ et al (2016) Athletic groin pain: a systematic review of surgical diagnoses, investigations and treatment. Br J Sports Med 50:1181–1186. https://doi.org/10.1136/bjsports-2015-095137

    Article  PubMed  Google Scholar 

  20. Serner A, van Eijck CH, Beumer BR, Holmich P, Weir A, de Vos R-J et al (2015) Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 49:813. https://doi.org/10.1136/bjsports-2014-094256

    Article  PubMed  PubMed Central  Google Scholar 

  21. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647

    Article  Google Scholar 

  22. Newcastle-ottawa quality assessment scale case control studies (2018) http://www.ohri.ca/programs/clinical_epidemiology/nosgen.pdf

  23. Assessing Risk of Bias in Included Studies|Cochrane Bias (2018) http://methods.cochrane.org/bias/assessing-risk-bias-included-studies. Accessed 28 May 2018

  24. Brannigan AE, Kerin MJ, McEntee GP (2000) Gilmore’s groin repair in athletes. J Orthop Sports Phys Ther 30:329–332. https://doi.org/10.2519/jospt.2000.30.6.329

    Article  CAS  PubMed  Google Scholar 

  25. Brown RA, Mascia A, Kinnear DG, Lacroix V, Feldman L, Mulder DS (2008) An 18-year review of sports groin injuries in the elite hockey player: clinical presentation, new diagnostic imaging, treatment, and results. Clin J Sport Med Off J Can Acad Sport Med 18:221–226. https://doi.org/10.1097/JSM.0b013e318172831a

    Article  Google Scholar 

  26. Hackney RG (1993) The sports hernia: a cause of chronic groin pain. Br J Sports Med 27:58–62. https://doi.org/10.1136/bjsm.27.1.58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Irshad K, Feldman LS, Lavoie C, Lacroix VJ, Mulder DS, Brown RA (2001) Operative management of “hockey groin syndrome”: 12 years of experience in National Hockey League players. Surgery 130:756–759. https://doi.org/10.1067/msy.2001.118093

    Article  Google Scholar 

  28. Diaco JF, Diaco DS, Lockhart L (2005) Sports hernia. Oper Tech Sports Med 13:68–70. https://doi.org/10.1053/j.otsm.2004.09.004

    Article  Google Scholar 

  29. Jack RA, Evans DC, Echo A, McCulloch PC, Lintner DM, Varner KE et al (2017) Performance and return to sport after sports hernia surgery in NFL players. Orthop J Sport Med 5:2325967117699590. https://doi.org/10.1177/2325967117699590

    Article  Google Scholar 

  30. Jans C, Messaoudi N, Pauli S, Van Riet RP, Declercq G (2012) Results of surgical treatment of athletes with sportsman’s hernia. Acta Orthop Belg 78:35–40

    PubMed  Google Scholar 

  31. Kopelman D, Kaplan U, Hatoum OA, Abaya N, Karni D, Berber A et al (2016) The management of sportsman’s groin hernia in professional and amateur soccer players: a revised concept. Hernia 20:69–75. https://doi.org/10.1007/s10029-014-1322-9

    Article  CAS  PubMed  Google Scholar 

  32. Kumar A, Doran J, Batt ME, Nguyen-Van-Tam JS, Beckingham IJ (2002) Results of inguinal canal repair in athletes with sports hernia. J R Coll Surg Edinb 47:561–565

    CAS  PubMed  Google Scholar 

  33. Lacroix VJ, Kinnear DG, Mulder DS, Brown RA (1998) Lower abdominal pain syndrome in national hockey league players: a report of 11 cases. Clin J Sport Med Off J Can Acad Sport Med 8:5–9

    Article  CAS  Google Scholar 

  34. Mai HT, Alvarez AP, Freshman RD, Chun DS, Minhas SV, Patel AA et al (2016) The NFL orthopaedic surgery outcomes database (NO-SOD): the effect of common orthopaedic procedures on football careers. Am J Sports Med 44:2255–2262. https://doi.org/10.1177/0363546516651426

    Article  PubMed  Google Scholar 

  35. Malycha P, Lovell G (1992) Inguinal surgery in athletes with chronic groin pain: the “sportsman’s” hernia. Aust N Z J Surg 62:123–125. https://doi.org/10.1111/j.1445-2197.1992.tb00009.x

    Article  CAS  PubMed  Google Scholar 

  36. Mann CD, Sutton CD, Garcea G, Lloyd DM (2009) The inguinal release procedure for groin pain: initial experience in 73 sportsmen/women. Br J Sports Med 43:579–583. https://doi.org/10.1136/bjsm.2008.053132

    Article  CAS  PubMed  Google Scholar 

  37. Matikainen M, Hermunen H, Paajanen H (2017) Athletic pubalgia in females: predictive value of MRI in outcomes of endoscopic surgery. Orthop J Sport Med 5:2325967117720171. https://doi.org/10.1177/2325967117720171

    Article  Google Scholar 

  38. Moyen B, Mainetti E, Sansone V, Pedotti E (1993) Surgical treatment of pubic pain refractory to conservative treatment. Ital J Orthop Traumatol 19:43–49

    CAS  PubMed  Google Scholar 

  39. Paajanen H, Syvahuoko I, Airo I (2004) Totally extraperitoneal endoscopic (TEP) treatment of sportsman’s hernia. Surg Laparosc Endosc Percutan Tech 14:215–218. https://doi.org/10.1097/01.sle.0000136662.52454.01

    Article  PubMed  Google Scholar 

  40. Preskitt JT (2011) Sports hernia: the experience of Baylor University Medical Center at Dallas. Proc (Bayl Univ Med Cent) 24:89–91

    Article  Google Scholar 

  41. Roos MM, Bakker WJ, Goedhart EA, Verleisdonk EJMM, Clevers GJ, Voorbrood CEH et al (2018) Athletes with inguinal disruption benefit from endoscopic totally extraperitoneal (TEP) repair. Hernia 22:517–524. https://doi.org/10.1007/s10029-018-1741-0

    Article  CAS  PubMed  Google Scholar 

  42. Sebecic B, Japjec M, Jankovic S, Culjak V, Dojcinovic B, Staresinic M (2014) Is chronic groin pain a Bermuda triangle of sports medicine? Acta Clin Croat 53:471–478

    PubMed  Google Scholar 

  43. Simonet WT, Saylor HL III, Sim L (1995) Abdominal wall muscle tears in hockey players. Int J Sports Med 16:126–128. https://doi.org/10.1055/s-2007-972978

    Article  CAS  PubMed  Google Scholar 

  44. Ziprin P, Williams P, Foster ME (1999) External oblique aponeurosis nerve entrapment as a cause of groin pain in the athlete. Br J Surg 86:566–568. https://doi.org/10.1046/j.1365-2168.1999.01081.x

    Article  CAS  PubMed  Google Scholar 

  45. Ziprin P, Prabhudesai SG, Abrahams S, Chadwick SJ (2008) Transabdominal preperitoneal laparoscopic approach for the treatment of sportsman’s hernia. J Laparoendosc Adv Surg Tech A 18:669–672. https://doi.org/10.1089/lap.2007.0130

    Article  PubMed  Google Scholar 

  46. Ingoldby CJ (1997) Laparoscopic and conventional repair of groin disruption in sportsmen. Br J Surg 84:213–215. https://doi.org/10.1002/bjs.1800840220

    Article  CAS  PubMed  Google Scholar 

  47. Atkinson HDE, Johal P, Falworth MS, Ranawat VS, Dala-Ali B, Martin DK (2010) Adductor tenotomy: its role in the management of sports-related chronic groin pain. Arch Orthop Trauma Surg 130:965–970. https://doi.org/10.1007/s00402-009-1032-4

    Article  PubMed  Google Scholar 

  48. Akermark C, Johansson C (1992) Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 20:640–643. https://doi.org/10.1177/036354659202000604

    Article  CAS  PubMed  Google Scholar 

  49. Biedert RM, Warnke K, Meyer S (2003) Symphysis syndrome in athletes: surgical treatment for chronic lower abdominal, groin, and adductor pain in athletes. Clin J Sport Med Off J Can Acad Sport Med 13:278–284. https://doi.org/10.1097/00042752-200309000-00002

    Article  Google Scholar 

  50. De Queiroz RD, de Carvalho RT, de Queiroz Szeles PR, Janovsky C, Cohen M (2014) Return to sport after surgical treatment for pubalgia among professional soccer players. Rev Bras Ortop 49:233–239. https://doi.org/10.1016/j.rboe.2014.04.001

    Article  PubMed  PubMed Central  Google Scholar 

  51. Maffulli N, Loppini M, Longo UG, Denaro V (2012) Bilateral mini-invasive adductor tenotomy for the management of chronic unilateral adductor longus tendinopathy in athletes. Am J Sports Med 40:1880–1886. https://doi.org/10.1177/0363546512448364

    Article  PubMed  Google Scholar 

  52. Mei-Dan O, Lopez V, Carmont MR, McConkey MO, Steinbacher G, Alvarez PD et al (2013) Adductor tenotomy as a treatment for groin pain in professional soccer players. Orthopedics 36:e1189–e1197. https://doi.org/10.3928/01477447-20130821-23

    Article  PubMed  Google Scholar 

  53. Robertson IJ, Curran C, McCaffrey N, Shields CJ, McEntee GP (2011) Adductor tenotomy in the management of groin pain in athletes. Int J Sports Med 32:45–48. https://doi.org/10.1055/s-0030-1263137

    Article  CAS  PubMed  Google Scholar 

  54. Sansone M, Ahlden M, Jonasson P, Thomee R, Falk A, Sward L et al (2014) Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes. Knee Surg Sports Traumatol Arthrosc 22:786–792. https://doi.org/10.1007/s00167-013-2738-y

    Article  PubMed  Google Scholar 

  55. Schilders E, Dimitrakopoulou A, Cooke M, Bismil Q, Cooke C (2013) Effectiveness of a selective partial adductor release for chronic adductor-related groin pain in professional athletes. Am J Sports Med 41:603–607. https://doi.org/10.1177/0363546513475790

    Article  PubMed  Google Scholar 

  56. Ahumada LA, Ashruf S, Espinosa-de-los-Monteros A, Long JN, de la Torre JI, Garth WP et al (2005) Athletic pubalgia: definition and surgical treatment. Ann Plast Surg 55:393–396. https://doi.org/10.1097/01.sap.0000181344.22386.fa

    Article  CAS  PubMed  Google Scholar 

  57. Dojcinovic B, Sebecic B, Staresinic M, Jankovic S, Japjec M, Culjak V (2012) Surgical treatment of chronic groin pain in athletes. Int Orthop 36:2361–2365. https://doi.org/10.1007/s00264-012-1632-4

    Article  PubMed  PubMed Central  Google Scholar 

  58. Harr JN, Brody F (2017) Sports hernia repair with adductor tenotomy. Hernia 21(1):139–147. https://doi.org/10.1007/s10029-016-1520-8

    Article  CAS  PubMed  Google Scholar 

  59. Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, Spencer L et al (2008) Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain. Surg Laparosc Endosc Percutan Tech 18:363–368. https://doi.org/10.1097/SLE.0b013e3181761fcc

    Article  PubMed  Google Scholar 

  60. Messaoudi N, Jans C, Pauli S, Van Riet R, Declercq G, Van Cleemput M (2012) Surgical management of sportsman’s hernia in professional soccer players. Orthopedics 35:e1371–e1375. https://doi.org/10.3928/01477447-20120822-24

    Article  PubMed  Google Scholar 

  61. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR (2000) Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group). Am J Sports Med 28:2–8. https://doi.org/10.1177/03635465000280011501

    Article  CAS  PubMed  Google Scholar 

  62. Paajanen H, Hermunen H, Karonen J (2008) Pubic magnetic resonance imaging findings in surgically and conservatively treated athletes with osteitis pubis compared to asymptomatic athletes during heavy training. Am J Sports Med 36:117–121. https://doi.org/10.1177/0363546507305454

    Article  PubMed  Google Scholar 

  63. Paajanen H, Brinck T, Hermunen H, Airo I (2011) Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman’s hernia (athletic pubalgia). Surgery 150:99–107. https://doi.org/10.1016/j.surg.2011.02.016

    Article  PubMed  Google Scholar 

  64. Rossidis G, Perry A, Abbas H, Motamarry I, Lux T, Farmer K et al (2015) Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity. Surg Endosc 29:381–386. https://doi.org/10.1007/s00464-014-3679-3

    Article  PubMed  Google Scholar 

  65. Van Der Donckt K, Steenbrugge F, Van Den Abbeele K, Verdonk R, Verhelst M (2003) Bassini’s hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes. Acta Orthop Belg 69:35–41

    Google Scholar 

  66. Bradshaw C, McCrory P, Bell S, Brukner P (1997) Obturator nerve entrapment. A cause of groin pain in athletes. Am J Sports Med 25:402–408. https://doi.org/10.1177/036354659702500322

    Article  CAS  PubMed  Google Scholar 

  67. Comin J, Obaid H, Lammers G, Moore J, Wotherspoon M, Connell D (2013) Radiofrequency denervation of the inguinal ligament for the treatment of “Sportsman’s Hernia”: a pilot study. Br J Sports Med 47:380–386. https://doi.org/10.1136/bjsports-2012-091129

    Article  PubMed  Google Scholar 

  68. Deysine M, Deysine GR, Reed WPJ (2002) Groin pain in the absence of hernia: a new syndrome. Hernia 6:64–67. https://doi.org/10.1007/s10029-002-0057-1

    Article  CAS  PubMed  Google Scholar 

  69. Ekberg O, Blomquist P, Olsson S (1981) Positive contrast herniography in adult patients with obscure groin pain. Surgery 89:532–535

    CAS  PubMed  Google Scholar 

  70. Gore S, Franklyn-Miller A, Richter C, Falvey EC, King E, Moran K (2018) Is stiffness related to athletic groin pain? Scand J Med Sci Sports 28:1681–1690. https://doi.org/10.1111/sms.13069

    Article  CAS  PubMed  Google Scholar 

  71. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM et al (1999) Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 353:439–443. https://doi.org/10.1016/S0140-6736(98)03340-6

    Article  CAS  PubMed  Google Scholar 

  72. Jansen JACG, Mens JMA, Backx FJG, Stam HJ (2009) Changes in abdominal muscle thickness measured by ultrasound are not associated with recovery in athletes with longstanding groin pain associated with resisted hip adduction. J Orthop Sports Phys Ther 39:724–732. https://doi.org/10.2519/jospt.2009.3068

    Article  CAS  PubMed  Google Scholar 

  73. Kesek P, Ekberg O, Westlin N (2002) Herniographic findings in athletes with unclear groin pain. Acta Radiol 43:603–608. https://doi.org/10.1034/j.1600-0455.2002.430612.x

    Article  CAS  PubMed  Google Scholar 

  74. Moreno C, Mattiussi G, Nunez FJ, Messina G, Rejc E (2017) Intratissue percutaneous electrolysis combined with active physical therapy for the treatment of adductor longus enthesopathy-related groin pain: a randomized trial. J Sports Med Phys Fitness 57:1318–1329. https://doi.org/10.23736/S0022-4707.16.06466-5

    Article  PubMed  Google Scholar 

  75. Rodriguez C, Miguel A, Lima H, Heinrichs K (2001) Osteitis pubis syndrome in the professional soccer athlete: a case report. J Athl Train 36:437–440

    PubMed  PubMed Central  Google Scholar 

  76. Schilders E (2007) Adductor-related groin pain in competitive athletes; role of adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. J Bone Jt Surg 89:2173. https://doi.org/10.2106/JBJS.F.00567

    Article  Google Scholar 

  77. Schilders E, Talbot JC, Robinson P, Dimitrakopoulou A, Gibbon WW, Bismil Q (2009) Adductor-related groin pain in recreational athletes: role of the adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. J Bone Jt Surg Am 91:2455–2460. https://doi.org/10.2106/JBJS.H.01675

    Article  Google Scholar 

  78. Schoberl M, Prantl L, Loose O, Zellner J, Angele P, Zeman F et al (2017) Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study. Knee Surg Sports Traumatol Arthrosc 25:1958–1966. https://doi.org/10.1007/s00167-017-4423-z

    Article  CAS  PubMed  Google Scholar 

  79. Topol GA, Reeves KD, Hassanein KM (2005) Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain. Arch Phys Med Rehabil 86:697–702. https://doi.org/10.1016/j.apmr.2004.10.007

    Article  PubMed  Google Scholar 

  80. Topol GA, Reeves KD (2008) Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series. Am J Phys Med Rehabil 87:890–902. https://doi.org/10.1097/PHM.0b013e31818377b6

    Article  PubMed  Google Scholar 

  81. Weir A, Veger SAS, Van de Sande HBA, Bakker EWP, de Jonge S, Tol JL (2009) A manual therapy technique for chronic adductor-related groin pain in athletes: a case series. Scand J Med Sci Sports 19:616–620. https://doi.org/10.1111/j.1600-0838.2008.00841.x

    Article  CAS  PubMed  Google Scholar 

  82. Weir A, Jansen J, van Keulen J, Mens J, Backx F, Stam H (2010) Short and mid-term results of a comprehensive treatment program for longstanding adductor-related groin pain in athletes: a case series. Phys Ther Sport 11:99–103. https://doi.org/10.1016/j.ptsp.2010.06.006

    Article  PubMed  Google Scholar 

  83. Weir A, Jansen JACG, van de Port IGL, Van de Sande HBA, Tol JL, Backx FJG (2011) Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther 16:148–154. https://doi.org/10.1016/j.math.2010.09.001

    Article  CAS  PubMed  Google Scholar 

  84. Nolli L, Baraggiolo S, Pagani M, Origo D, Bergna A (2017) Osteopathic manipulative treatment in soccer players with chronic groin pain: a pilot study. Gazz Med Ital Arch Sci Med 176:322–329. https://doi.org/10.23736/S0393-3660.16.03369-6

    Article  Google Scholar 

  85. Masala S, Fiori R, Raguso M, Ojango C, Morini M, Cuzzolino A et al (2017) Pulse-dose radiofrequency in athletic pubalgia: preliminary results. J Sport Rehabil 26:227–233. https://doi.org/10.1123/jsr.2015-0149

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Center for perioperative optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    S. G. Jørgensen, S. Öberg & J. Rosenberg

Authors
  1. S. G. Jørgensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Öberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Rosenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. G. Jørgensen.

Ethics declarations

Conflict of interest

SGJ declares no conflicts of interest. SÖ declares no conflicts of interest. JR declares personal fees from Bard and Merck outside this work.

Ethical approval

No ethical approval was necessary according to Danish law.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

No informed consent was necessary according to Danish law.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 262 KB)

Supplementary material 2 (PDF 322 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jørgensen, S.G., Öberg, S. & Rosenberg, J. Treatment of longstanding groin pain: a systematic review. Hernia 23, 1035–1044 (2019). https://doi.org/10.1007/s10029-019-01919-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-019-01919-7

Keywords

Search

Navigation