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The effects of rehabilitation on athletic groin pain: neuromuscular and biomechanical factors

Baida, Samuel (2021) The effects of rehabilitation on athletic groin pain: neuromuscular and biomechanical factors. PhD thesis, Dublin City University.

Abstract
Introduction: Athletic groin pain (AGP) is an overuse musculoskeletal presentation accounting for approximately 7% of all football injuries, resulting in an average time-off period of 16 ± 23 days and with a re-injury rate of 11% (Werner et al., 2019). During dynamic sporting actions (e.g. jumping, change-of-direction etc.) repetitive loading on the myotendinous and bony structures which stabilize and transfer force across the anterior pelvis may contribute to pain and injury if tissue tolerance levels are exceeded. The exact pathomechanics underlying AGP are poorly understood. Biomechanical analyses of joint loading, movement technique and muscle strength has previously been utilized to improve understanding of injury mechanisms in other overuse lower limb injuries. However, to date their remains a lack of biomechanical research investigating AGP. Therefore, the primary aim of this thesis was to examine movement patterns using three-dimensional biomechanical analysis to increase understanding of injury mechanisms. Methods: This thesis incorporates the work from four research questions (Chapters 4, 5, 6, 7) and a systematic review on movement variability (Chapter 3). The analysis approach utilized combines both case-control and pre- to post-rehabilitation analyses for robust examination of factors deterministic of injury. Data collection included three- dimensional motion and force plate capture of jumping and hopping tasks, isometric hip strength, passive hip range-of-motion, lower limb reactive strength and patient reported outcome measures. Results: Athletes with AGP demonstrated significant deficits in isometric hip strength and reduced lower limb reactive strength compared to uninjured control athletes. These deficits were no longer significant following successful rehabilitation. Furthermore, AGP athletes demonstrated significantly reduced landing impulse during a single leg countermovement jump and reduced peak force and longer ground contact times during a continuous hopping task in comparison to uninjured controls. Following successful rehabilitation, landing impulse further decreased in the AGP group and remained significantly less to the control group, while peak force and ground contacts improved and were no longer significantly different to the control group. The magnitude of movement variability and ground reaction force variability were not affected by AGP when compared to uninjured control athletes. Conclusion: This thesis adds important insights into potential biomechanical and strength factors that are affected by AGP and importantly which return to normal with successful rehabilitation. Targeting these factors may be used to enhance rehabilitation programs for AGP and may play a role in secondary injury prevention as athletes return- to-play.
Metadata
Item Type:Thesis (PhD)
Date of Award:November 2021
Refereed:No
Supervisor(s):Moran, Kieran
Uncontrolled Keywords:Athletic Groin Pain; Injury
Subjects:Medical Sciences > Biomechanics
Medical Sciences > Exercise
Medical Sciences > Sports sciences
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health > School of Health and Human Performance
Research Institutes and Centres > INSIGHT Centre for Data Analytics
Use License:This item is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 License. View License
Funders:SFI/12/RC/ 2289_P2, Sport Surgery Clinic, Santry, Dublin, Ireland
ID Code:25875
Deposited On:29 Oct 2021 10:11 by Kieran Moran . Last Modified 29 Oct 2021 10:11
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