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37 Pain provocation tests and clinical entities in male footballers with longstanding groin pain are associated with pain intensity and disability
  1. Mathias Fabricius Nielsen1,
  2. Lasse Ishøi1,
  3. Carsten Juhl2,3,
  4. Per Hölmich1,
  5. Kristian Thorborg1
  1. 1Sports Orthopedic Research Center – Copenhagen (sorc-c), Department Of Orthopedic Surgery, Hvidovre Hospital, Kettegård alle 30, Denmark
  2. 2Research Unit Musculoskeletal function and physiotherapy, Department of Sport Science and Clinical Biomechanics (IOB), University of Southern Denmark, Campusvej 55, Denmark
  3. 3Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital – Herlev and Gentofte, Gentofte, Gentofte hospitalsvej 1, Denmark


Introduction 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. We aim to investigate if the numbers of positive pain provocation tests and clinical entities are associated with pain intensity and disability, measured by the five-second squeeze test (5SST) and the Hip And Groin Outcome Score (HAGOS), respectively.

Materials and Methods Forty male footballers (mean 24 [SD: 3.2] years; 182 [5.7] cm; 78 [6.6] kg) with longstanding groin pain (≥ 6 weeks) for a median of 8.5 (IQR: 4–36) months were included. They underwent a bilateral groin examination with 33 pain provocation tests and were classified with clinical entities (0–7) based on test findings.

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

Conclusion In footballers 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 positive pain provocation tests in the region are positive, and more clinical entities are present.

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