Researchers looking to help explain injuries like thigh bone stress
fractures and groin strains in field-based sports found that older
athletes and those with weaker groin muscles were also at higher
“You can’t prevent age, but you can prevent the second injury by
making sure the first one gets taken care of adequately and
appropriately,” said Dr. W. Ben Kibler.
He is medical director of the Lexington Clinic Orthopedics-Sports
Medicine Center in Kentucky and was not involved in the new
Many professional and recreational athletes, Kibler said, don’t give
a first hip or groin injury enough rest and don’t spend enough time
rehabbing before returning to play.
“You just have to let it heal,” he told Reuters Health.
Hip and groin injuries are especially common in sports that involve
kicking, twisting and sudden changes in direction or speed,
researchers led by Julianne Ryan from the University of Limerick in
They reviewed seven studies on risk factors for such injuries in
The studies included a total of 1,875 soccer, rugby and Australian
rules football players, from the amateur to the elite level.
Athletes who were originally healthy were evaluated and followed for
anywhere from one season to 10 years. All were men.
Because the studies assessed injuries in different ways, the
researchers could not determine how common they were across the
Most of the studies reported that athletes with a previous hip or
groin injury were more likely to sustain another, according to the
results published in the British Journal of Sports Medicine.
Two out of three studies that looked at age as a potential risk
factor found that older athletes had more injuries, and two
identified weak groin muscles as a possible contributor.
Individual studies also suggested that hip range of motion and the
relative strength of different muscle groups both might be linked to
Two studies investigating athlete weight came to opposite
conclusions: one suggested heavier athletes were at a higher risk of
injury and the other found it was slimmer athletes that had the
greatest risk. However, the researchers point out, the second of
those reports was based on only 29 athletes and four chronic groin
injuries. The “more robust argument,” they write, is that heavier
athletes are more likely to sustain a hip or groin injury than their
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Dr. Adam Weir said researchers know very little about what
predisposes people to groin injuries. But a prior injury means it’s
a good bet they have some of those risks factors.
“If you’ve already got one (injury), that means you had all these
things that combined to lead you to get the injury, so you’re much
more likely to have one in the future,” Weir, from the Aspetar
Orthopaedic and Sports Medicine Hospital in Doha, Qatar, told
And, he added, “Once the structure or tissue is injured, it’s
normally not healing to the level it was before the injury. When you
put those together, that’s a recipe for a high risk for getting
another injury in the future.”
Weir was not involved in the new review but he studies groin pain.
Weir said athletes who get injured should try to make the injured
area stronger than it was before the injury, prior to returning to
And avoiding getting injured in the first place, through strength
training and other exercises, is ideal.
Kibler said athletes whose sports involve lots of starting,
stopping, cutting and twisting should make sure to get in a good
warm-up and stretching session before they start playing, and then
should warm down afterward.
Ryan emphasized the importance of working in some lunges, squats and
other strengthening exercises.
"A lot of people overlook their strength and conditioning base at
the start," she told Reuters Health. "It’s important to incorporate
strength training along with your aerobic sessions."
“Prevention is better than cure, and that really holds true with
groin injuries,” Weir said.
British Journal of Sports Medicine, online May 2, 2014.
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