Pain provocation tests and clinical entities in male football players with longstanding groin pain are associated with pain intensity and disability

Mathias F Nielsen; Lasse Ishøi; Carsten Juhl; Per Hölmich; Kristian Thorborg

doi:10.1016/j.msksp.2023.102719

Pain provocation tests and clinical entities in male football players with longstanding groin pain are associated with pain intensity and disability

Musculoskelet Sci Pract. 2023 Feb:63:102719. doi: 10.1016/j.msksp.2023.102719. Epub 2023 Jan 10.

Authors

Mathias F Nielsen¹, Lasse Ishøi², Carsten Juhl³, Per Hölmich², Kristian Thorborg²

Affiliations

¹ Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital - Amager-Hvidovre, Hvidovre, Denmark. Electronic address: mathias.fabricius.nielsen@regionh.dk.
² Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital - Amager-Hvidovre, Hvidovre, Denmark.
³ Research Unit Musculoskeletal Function and Physiotherapy, Department of Sport Science and Clinical Biomechanics (IOB), University of Southern, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.

PMID: 36736197
DOI: 10.1016/j.msksp.2023.102719

Abstract

Background: Clinical examination of male football players with longstanding groin pain can be considered difficult. Pain provocation tests are used to examine and classify longstanding groin pain into clinical entities as adductor-, iliopsoas-, inguinal-, and pubic-related. It is unknown if pain provocation tests and clinical entities are associated with pain intensity and disability.

Objectives: To investigate if the number of positive pain provocation tests and clinical entities are associated with pain intensity and disability, measured by the Copenhagen 5-Second Squeeze Test (5SST) and the Copenhagen Hip and Groin Outcome Score (HAGOS), respectively.

Design: Cross-sectional.

Method: Forty male football players (age: mean 24 years [SD: 3.2]; height: mean 182 cm [SD: 5.7]; weight: mean 78 Kg [SD: 6.6]) with longstanding groin pain for a median of 8.5 months (IQR: 4-36) were included. The players underwent a bilateral groin examination with 33 pain provocation tests and were classified with clinical entities (0-7) based on the test findings.

Results: The number of positive pain provocation tests (median 10, range 2-23) correlated with pain intensity (5SST: r_s = 0.70 [95% CI: 0.50, 0.83]) and disability (HAGOS subscales Sport: r_s =-0.62 [95% CI: -0.81, -0.36], Pain: r_{s =} -0.38 [95% CI: -0.69, -0.06], Symptoms: r_s = 0.52 [95% CI: -0.73, -0.24], ADL: r_s = -0.48 [95% CI: -0.71, -0.18]). The number of clinical entities (median 3, range: 1-7) showed similar but weaker correlations to pain intensity and disability.

Conclusions: In male football players with longstanding groin pain, the number of positive pain provocation tests and clinical entities shows weak to strong correlations with pain intensity and disability. Consequently, when pain intensity and disability are severe, a higher number of pain provocation tests may be positive, and more clinical entities may be present.

Keywords: Diagnosis; Groin pain; Pain provocation tests; Soccer.

MeSH terms

Adult
Cross-Sectional Studies
Groin
Humans
Male
Pain Measurement
Pelvic Pain*
Soccer*
Young Adult