Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial

Background Groin pain is common among athletes. A major cause of long-stand ing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with physi otherapy treatment without active training (PT) in the treatment of adducto r-related groin pain in athletes. Methods 68 athletes with long-standing (median 40 weeks) adductor-related g roin pain-after examination according to a standardised protocol-were rando mly assigned to AT or PT. The treatment period was 8-12 weeks. 4 months aft er the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome mea sure was full return to sports at the same level without groin pain. Analys es were by intention to treat. Findings 23 patients in the AT group and four in the PT group returned to s ports without groin pain (odds ratio, multiple-logistic-regression analysis , 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p = 0.006) linear trend towards a b etter effect in the AT group. A per-protocol analysis did not show apprecia bly different results. Interpretation AT with a programme aimed at improving strength and coordina tion of the muscles acting on the pelvis, in particular the adductor muscle s, is very effective in the treatment of athletes with long-standing adduct or-related groin pain, The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, c linical trials.