The Groin Pain in the Gymnasts and its Possible Reasons

Abstract

Objectives: The overuse injury in gymnasts due to overstretching of the joints is quite frequent. One of the most frequent complaints due to overuse injuries is pain on the insertion region of rectus femoris at the iliac apophysis. In the present study the possible reasons of the groin pain in the gymnasts were evaluated. Methods: Twenty-two amateur athletes from the gymnastic club aged between 8-12 years, were included in this study. Twenty were female and two male, Athletes have been training for 2-4 hours in 5-6 days a week, for 3 to 10 years, performing floor exercises (17 rhytmic gymnasts and five artistic gymnasts,). Gymnasts, who have groin pain and the ones have not, were evaluated according to the ligament laxity, the range of internal and external rotation of the hip joint and gymnastic discipline, which has been performed. The results were compared with Fisher’s Exact test and unpaired t-test. Results: Athletes, who have groin pain complaint and have not, were compared according to the age, the distance between thumb-forearm, hyperextension range in the elbow and the sum of internal and external rotation angle of the hips. Furthermore, the athletes, whose external rotation is more than internal rotation, were compared with the ones whose internal rotation is more than external rotation, to evaluate anteversion angle of the hip clinically. The difference was not statistically significant (p>0.05). On the other hand, while 7 of the 17 gymnast, who perform rhythmic gymnastics, had groin pain and none of the 5 athletes, who perform artistry gymnastic, has groin pain. Conclusion: Overuse injuries are more common in the gymnastic sport. Repetitive microtrauma with thwarted repair might cause persistent injury in the tendon-bone junction. The anatomic factors (i.e malalignement) and overtraining predispose the athletes to overuse injuries most frequently. During adolescent growth spurt while the growth of long bones proceeds, the rectus femoris muscle, that cross more than one joint, might not gain flexibility enough and leads to excessive tensile stress on the iliac apophysis. Also, the gymnasts with generalized ligamentous laxity are more prone to the overuse injuries. Because lax ligaments fail to provide ligament stability and under further stress on the tissues neighbourhood of joint might cause overuse injuries. However, we were not able to find any difference between the athletes, who have groin pain and the ones have not, from the age, ligament laxity and hip rotation angles points of view. On the other hand, the high prevalence of groin pain complaint in the athletes, who perform rhythm gymnastic, might be related to the discipline specific exercises. So, the overuse injuries might be prevented by the well-planned training program in each particular discipline including strengthening and balance.