Groin Injuries in Figure Skating

Epidemiology of Groin Injuries1 Groin Injuries in Figure Skating By Gemmie S. Devera, PA-C, MPH Vaca Valley FSC, Children’s Specialists of San Diego ...
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Epidemiology of Groin Injuries1

Groin Injuries in Figure Skating By Gemmie S. Devera, PA-C, MPH Vaca Valley FSC, Children’s Specialists of San Diego

Anatomy of the Groin Region3

 Hip & pelvis: 3rd mc sk8ing injury, but most    

difficult to rehabilitate ↑ing in frequency w/ lower back & core muscle injuries seen in sk8ers who do 3x jumps Injured muscle: usually adductor longus or gracilis2 Risk factors: ?ed abductor ROM & adductor strength3


Types of Adductor Muscle Strains2,5-6 Etiology of an Adductor Muscle

       

Multi-revolution jumps Falling Running Quickly changing directions Splits: forced abduction of hip Kicking Imbalances in strength & flexibility & inadequately strong core muscles

Symptoms / Signs3

Strain1,4 

Acute (immediate pain) Chronic (insidious onset of pain) 

   

normal activity for a while after good warm-up or stretching

1st degree: pain, min. loss of strength / fn. 2nd degree: tissue damage, but not complete loss of strength & fn. 3rd degree: complete disruption of muscle tendon unit & complete loss of fn. DDX: stress / avulsion fx, sports hernia, osteitis pubis, nerve compression

Main symptom: Pain in the groin region (medial thigh) Signs: tenderness to palpation in groin region on adduction against resistance


Diagnostic Studies2   

Usually a clinical diagnosis X-Rays to rule out fracture MRI to confirm m. strain / tears (if unsure) 

Partial & complete tendon tears

US: to diagnose muscle & tendon tears, not strains

Other Considerations2 

Biomechanical abnormalities   

Location of muscle strain / tear  

Foot & lower leg malalignment Leg length discrepancy Gait / sport-specific motion abnormality MT junction  aggressive rehab Acute partial tear at tendinous insertion of adductors to pubic bone  rest

Treatment1-6  

Patience Initial treatment (1-2 weeks):     

Rest Ice: to numb the pain Heat: to relax the muscles Elevation Refrain from activities that exacerbate pain

Chronicity of symptoms


Treatment (cont.) 

Continued treatment: gradual return to activity   

 

Strength Flexibility Endurance

Goal: return to full activity in 8-12 weeks…or within 6 months Consider surgery if unresponsive to conservative tx

Special Facts6  

Groin injuries can take a LONG time to heal !!! Adequate rest period needed  

Allow muscle strain to heal Prevent re-injury

Prevention2,6  

Stretching Conditioning    

Warm up / cool down Core strength Strengthening hip & thigh muscles Flexibility / endurance


Groin Specific Stretches7 

Butterfly stretch

Groin Specific Stretches 

Splits (a.k.a. straddle-sit-n’-reach)

Groin Strengthening Exercises8 



Groin Strengthening Exercises 


Groin Strengthening Exercises 


Skating Specific Stretches7 

Spirals for hip extension Right foot spiral


References: 

      

1. Lipetz J, Kruse RJ. Injuries and Special Concerns of Female Figure Skaters. Clinics in Sports Med. [serial online]. 2000;19: 1-9. Available at das/journal/view/0/N/1124789?ja=172676&PAGE=1.html&source=. Accessed 10/28/2007. 2. Morelli V, Smith V. Groin Injuries in Athletes. American Fam Physician. 2001;64:1405-1014. 3. Morelli V, Weaver V. Groin Injuries and Groin Pain in Athletes: Part 1. Prim Care Clin Office Pract. 2005; 2:163-183. 4. Rupp TJ. Groin Injury. eMedicine. [serial online]. 2005. Available at Accessed 10/21/2007. 5. Lynch SA, Rensrom AF. Groin Injuries in Sport: Treatment Strategies. Sports Med. 1999;2:137-144. Nichoas SJ, Tyler TF. Adductor Muscle Strains in Sport. Sports Med. 2002;32(5):339-344. 7. Poe CM. Conditioning for Figure Skating. San Francisco: Contemporary Books, 2002. 8. Exercises for your legs. Available at Accessed 12/18/2007.

Acknowledgements 

Coach Ann Baharie, Ice Town-La Jolla, Brittany Ward for demo of skating stretches, Dr. Griselda Tiu, MD, Emma and Jerome Peter, Coach Jennifer Borus, Vacaville Ice Sports, Dana Economeau, San Diego Rehab, Vaca Valley FSC, La Jolla FSC, San Diego FSC