Cracking To The Core Of Groin Pain In A Crossfit Athlete - Page #1

Author: Laura Mattson, DO
Co Author #1: Andrea Aagesen, DO
Senior Editor: Joseph Chorley, MD
Editor: Yaowen Hu, MD, MBA

Patient Presentation:
33 year old female athlete with a history of surgically repaired inguinal hernia 10+ years ago presents to the clinic with left groin pain.

She was actively engaged in Crossfit, kickboxing and recreational running at the time of pain onset 7 months prior. The pain had developed insidiously and worsened with time. Pain was described as burning and aching in quality, with occasional radiation into the left upper quadrant. Provocative factors included performing lunges, sit-ups and flutter kicks, as well as running, especially on an incline or when changing her speed or stride length. Pain was not present at rest and she denied any associated sensation of bulging in the abdomen or groin. She had not received any treatment but had modified her activities to avoid those that were particularly aggravating.

Physical Exam:
She had full ROM in the bilateral hips with negative FABER, FADIR and hips scour. There was tenderness to palpation over the left pubic rami and the left adductor origin without a palpable defect in the muscle or tendon. There was pain with resisted active adduction on the left with full strength. She had full strength in hip abduction, hip flexion, knee flexion and knee extension. She had positive modified Thomas test for bilateral hip flexor tightness but negative Ober test. In addition, there was impaired abdominal and gluteal core strength and stability with single leg stance, pelvic lifts, and other dynamic tests causing compensated Trendelenburg stance: contralateral hip elevation and lateral trunk lean with single leg stance. Case Photo #4

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