Associations between clinical findings and MRI injury extent in male athletes with acute adductor injuries — A cross-sectional study

Hölmich, Per; Tol, Johannes L.; Thorborg, Kristian; Yamashiro, Eduardo; Weir, Adam

doi:10.1016/j.jsams.2020.11.003

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…To evaluate the associations of all explanatory variables with injury and re-injury, two models of logistic regression analyses were performed and odds ratios with 95% confidence intervals (CI) were calculated. Variable selection for logistic regression models was based on backward stepwise empirical approach removing non-significant variables using p < 0.05 as the cut-off level 23 . We started with a basic model containing all the predictors and then by removing the weakest contributor in every single model we finally developed the model containing only the variables significantly relevant for the injury or re-injury occurrence.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with injury and re-injury occurrence in female pole dancers

Szopa

Domagalska-Szopa

Urbanska³

et al. 2022

Sci Rep

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The aim of the study was to recognise what participant-, training- and post-injury-related factors are associated with an injury and re-injury occurrence in female pole dancers (PDs). 320 female PDs fulfilled a custom survey. 1050 injuries were reported by 276 PDs, 59% of injuries were related to lower extremity, 39% to upper extremity and 10% to spine and trunk. 156 PDs reported sustaining a re-injury, and overall, 628 re-injuries were reported. The median weekly pole-specific training session volume was 90 min and 240 min in the low and high qualified group, respectively. The total training volume was 180 min in the low qualified PDs and 240 min in the high qualified group. PDs with higher height and spending more time on pole-specific training in studio and on other forms of training have higher odds of sustaining an injury. PDs with lower level of experience in training, who sustained an injury, and who had a shorter pause between the moment of injury and the return to performance, and thus who did not fully recover, have higher odds of sustaining a re-injury. Sport-specific injury prevention strategies should be developed and implemented in this cohort, since over 85% of pole dancers reported sustaining some kind of injury.

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Section: Methodsmentioning

confidence: 99%

Factors associated with injury and re-injury occurrence in female pole dancers

Szopa

Domagalska-Szopa

Urbanska³

et al. 2022

Sci Rep

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“…Clinical revaluation has been shown to have a good correlation with MRI findings [8], with high negative predictive values shown with passive adductor stretch (100%) and with palpation pain at the adductor longus insertion (98%). Three quarters of adductor injuries are avulsions [9,10] but the subsequent care remains controversial in terms of conservative over surgical re-implantation with some advocating the size of the avulsion as a possible determinant on the choice of management [11]. However, a recent systematic review shows how surgery and conservative or non-operative management for avulsions with a mean size of 3.3cm + 0.6 gives no advantage in return to normal pre-injury activity and they also have a statistically significant longer return to sport (3.9 ± 1.5 months vs. 2.2 ± 1.0 months, P = 0.0001), so surgery has its caveats for adductor avulsion injuries [12].…”

Section: Adductor Tendinopathymentioning

confidence: 99%

Evaluation, Diagnosis and Management of Persisting Pain Post Sportsman’s Groin Repair

2023

Sports Injr Med

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Aim: This article is aimed as a guide to a clinician who sees a patient representing with persistent groin pain after they have undergone a sports hernia repair. Methods & Results: Groin pain related to a repetitive strain injury better known as either inguinal disruption, athletic pubalgia or more commonly the sportsman's groin is discussed. Once a diagnosis of the loss of the inguinal canal integrity or a posterior wall weakness is diagnosed and then surgically treated by any technique, any further recurrence or persistence of groin pain requires evaluation for the other possible causes of groin pain. Diagnoses such as an adductor tendinopathy, rectus abdominis origin tear, femoroacetabular impingement, pubic bone oedema or even the presence of a true hernia must again be re-evaluated. Any specific management will subsequently be aimed at the other cause (s). Discussion: Understanding of the complexity of the groin both anatomically, as well as physiologically, will help diagnose and treat persistent and recurrent groin pain, with a multi-disciplinary approach key to a successful outcome.

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“…The absence of pain during passive adductor stretch and the absence of palpation pain on the proximal adductor longus insertion can be used to confidently rule out an acute complete adductor longus tendon avulsion. 17 MRI is considered the gold standard for use in the diagnosis of avulsion injuries, and detailed MRI variations of avulsion injuries are reported to potentially influence treatment decisions. 14 There is scant data to inform clinical decision making on management and whether to choose a surgical reattachment or a nonsurgical exercise-based treatment approach of these injuries.…”

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confidence: 99%

One-Year Clinical and Imaging Follow-up After Exercise-Based Treatment for Acute Complete Adductor Longus Tendon Avulsions in Athletes: A Prospective Case Series

et al. 2021

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Background: Complete avulsions of the adductor longus tendon are serious injuries, yet we have few data to inform clinical decisions on management. Previous studies are limited by a lack of detailed follow-up. Purpose: To describe detailed clinical and imaging measures 1 year after complete proximal adductor longus avulsion injuries in athletes who received exercise-based treatment. Study Design: Case series; Level of evidence, 4. Methods: A total of 16 adult male competitive athletes were included in this study <7 days after an acute adductor longus tendon avulsion injury. All athletes were advised to complete a supervised standardized criterion-based rehabilitation protocol. Standardized clinical examination, a modified Copenhagen Hip and Groin Outcome Score (HAGOS), the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O), and detailed magnetic resonance imaging (MRI) assessment were performed after inclusion, on the day of completion of the treatment protocol (return to sport), and at 1-year follow-up after injury. Results: One player was lost to follow-up. Median return-to-sport time was 69 days (interquartile range [IQR], 62-84). One player had an early reinjury and performed an additional rehabilitation period. One-year follow-up was completed a median from 405 days (IQR, 372-540) after injury. The median HAGOS score was 100 for all subscales (IQRs from 85-100 to 100-100), and the median OSTRC-O score was 0 (IQR, 0-0). The median range of motion symmetry was 100% (IQR, 97%-130%) for the bent-knee fall-out test and 102% (IQR, 99%-105%) for the side-lying abduction test. Side-lying eccentric adduction strength symmetry was 92% ± 13% (mean ± SD), and median supine eccentric adduction strength symmetry was 93% (IQR, 89%-105%). MRI results at 1-year follow-up showed that from the original complete discontinuity in all cases, 10 athletes (71%) had partial tendon continuity, and 4 (29%) had complete tendon continuity. Conclusion: Nonsurgically treated athletes with a complete acute adductor longus avulsion returned to sport in 2 to 3 months. At the 1-year follow-up after injury, athletes had high self-reported function, no performance limitations, normal adductor strength and range of motion, and signs of partial or full tendon continuity as shown on MRI. This indicates that the primary treatment for athletes with acute adductor longus tendon avulsions should be nonsurgical as the time to return to sport is short, there are good long-term results, and there is no risk of surgical complications.

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Associations between clinical findings and MRI injury extent in male athletes with acute adductor injuries — A cross-sectional study

Cited by 4 publications

References 22 publications

Factors associated with injury and re-injury occurrence in female pole dancers

Factors associated with injury and re-injury occurrence in female pole dancers

Evaluation, Diagnosis and Management of Persisting Pain Post Sportsman’s Groin Repair

One-Year Clinical and Imaging Follow-up After Exercise-Based Treatment for Acute Complete Adductor Longus Tendon Avulsions in Athletes: A Prospective Case Series

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