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Br J Sports Med. 2017 Nov;51(22):1611-1621. doi: 10.1136/bjsports-2016-096619. Epub 2017 Apr 21.

Is lower hip range of motion a risk factor for groin pain in athletes? A systematic review with clinical applications.

Author information

1
Manual Therapy and Sports Rehabilitation, Physiotherapy Utrecht Oost, Utrecht, The Netherlands.
2
Academic Center for Evidence based Sports Medicine (ACES), AMC, Amsterdam, The Netherlands.
3
Engelaar Sports Physiotherapy, Doetinchem, The Netherlands.
4
Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
5
Dutch Center for Allied Health Care, Amersfoort, The Netherlands.
6
Master Physical Therapy in Sports, Avans+ Improving Professionals, Breda, The Netherlands.
7
Department of Orthopedic Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
8
Manual Therapy and Sports Rehabilitation, Physiotherapy Dukenburg Nijmegen, Nijmegen, The Netherlands.
9
School of Sports & Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
10
Codarts University of the arts, Rotterdam, The Netherlands.
11
Department of Sports Medicine, Aspetar hospital, Doha, Qatar.

Abstract

BACKGROUND:

Whether hip range of motion (ROM) is a risk factor for groin pain in athletes is not known.

OBJECTIVES:

To systematically review the relationship between hip ROM and groin pain in athletes in cross-sectional/case-control and prospective studies.

STUDY DESIGN:

Systematic review, prospectively registered (PROSPERO) according to PRISMA guidelines.

METHODS:

Pubmed, Embase, CINAHL and SPORTDiscus were systematically searched up to December 2015. Two authors performed study selection, data extraction/analysis, quality assessment (Critical Appraisal Skills Programme) and strength of evidence synthesis.

RESULTS:

We identified seven prospective and four case-control studies. The total quality score ranged from 29% to 92%. Heterogeneity in groin pain classification, injury definitions and physical assessment precluded data pooling. There was strong evidence that total rotation of both hips below 85° measured at the pre-season screening was a risk factor for groin pain development. Strong evidence suggested that internal rotation, abduction and extension were not associated with the risk or presence of groin pain.

CONCLUSION:

Total hip ROM is the factor most consistently related to groin pain in athletes. Screening for hip ROM is unlikely to correctly identify an athlete at risk of developing groin pain because of the small ROM differences found and poor ROM measurement properties.

KEYWORDS:

Athletes; Flexibility; Groin pain; Hip; Range of motion; Risk factor

PMID:
28432076
PMCID:
PMC5754850
DOI:
10.1136/bjsports-2016-096619
[Indexed for MEDLINE]
Free PMC Article

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