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hello every one
I have pateint is football player and when he shooting ball he feel tension at groin and
in adductor side , he regardless an did'nt care and continuos play after day he feel great pain at adductor region and groin he keep in rest and use ice back for 3 days and after that his pain reliefed and becom good
after 3 week he returned to play football but during play he feel pain again
and stop play ,
he came to me ( physiotherapy).
what's plan of treatmen can I set to treat him ?
Hi Muhana,
U din mention the age of the patient.I've dealt with a patient like this before.I used short wave diathermy with 8 layered pading in his skin for about 8mints.He was also a male patient.When his pain subsided we started with adductor and abductor strengthening exs.
well i would suggest hydrotherapy... ask him to walk inside the pool .. that is forward walks ,stride walk... put him on rest and then continue with icing and ift to reduce the pain... test if its ostetis pubis/ infection of the urinary tract...
have a proper diagnosis treat the route cause not the symptoms....
proper diagnosis then reduce the pain later on rehabilitation done to prevent the recurrence
hello umamadhu
the age of patient 28 and the injury was befor 4 weeks and now he just feel pain when he run and walk long distance at groin region.
I now use with hi ICE for 10 min and ultrasound 1mHz freq .7 w/cm and puls:space ratio 2:8 and use TENS 15 Hz
what do you think about my plan and what about use hot packs instead ice packs ?
please replay and thanks for all
Hi Muhana,
Tens is jus good,y cant u try with hot packs,instead of ice.I think the patient should be able to cope up better,being a sports person.Start simple excs with re-education board as a support.
well i think its good with ice... i feel cryotherapy is good.... continue with it ya....
hello umamadhu & arthyyy
OK that's good but what about use ultrasoud is it good ? (ultrasound 1mHz freq .7 w/cm and puls:space ratio 2:8 ) .
yeah i think ultrasound pulsed mode 1:4 ... 0.9 freq is ok... well i wont say that wat u r giving is wrong..... u can give it for 8 mins.... where so give??? i mean the region??
Have you ruled out a sportsmans hernia. This is common in footballers, responds v well to rest but returns when you start activity again.
If it is just an adductor strain, I would use deep transverse frictions on the painful area. You also need to stretch out the muscle and begin a strength programme. The strength programme should consist of isometric contractions while pain is still present moving on to concentric then eccentric after pain has gone. To maintain his fitness, in this case he should stil be able to run in straight lines.
well when there is pain the adductor... reducing pain using cryo, and modalities... followed by METS(MUSCLE ENERGY TECHNIQUE ) is advisable ya... i do agree with deep transverse friction massage (nothing but the trigger release) but then u should be aware that muscle doesn get sore.... in that case MET is best
OK thanks for every one advised me and gave openions to help me
thanks and thanks and thanks
Hey karen.hankey
You mention the possibility of a sportsmen hernia.. Can you tell me how you would go about identifying this diagnosis? Common signs & symptoms? how do you differentiate it from adductor strain etc
Also what would be the difference between a general hernia and a 'sportsmen hernia'..?
I look forward to your response
Also anyone elses input is appriciated
Kind regards
Bobby
Hi Bobby,
The symptoms of a sportsman's hernia are very much the same as an adductor strain in terms of location and aggravating factors. However, the main difference is that it will normally cause more pain and stiffness the day after play and resolve with rest.
The sportsman's hernia is essentially a tear in the adductor muscle close to its insertion on the pelvis. By tear, I don't mean a usual muscles tear, its normally a hole.
The way to test for it is to have your patient lying on their back with their knees bent, feet together and legs dropped to the side (i.e. the position you would stretch the adductors). Get the patient to push their knees together against your resistance (to test the adductors) and monitor the response. Then do the same again but this time ask the patient to contract their transverse abdominus - if there is less or no pain with this it normally indicates a sportsman's hernia.
In terms of treatment, it really depends on how acute/chronic the problem is. I would always try conservative management first. You can keep your patient active, even allow them to run as its the torsional stresses on the pelvis that aggravate the problem. You then need to work on their core strength to again stop those torsional stress on the pelvis. If the hernia is not too bad this should get rid of the problem. If it is not helping then surgery is the answer - but now they can do it arthroscopically so recovery time is reduced as no wound to heal
This post is very helpful,thanks