1/4 Hour Neuro #21: "What Strategies to Adopt to Fight Groin Pain in Footballers"

Hello everyone, and welcome to the Neuro Quarter Hour! Today, we tackle a common issue among footballers: groin pain. How should we approach it? What are the different avenues to explore for effective management?

Groin pain can have various origins, whether joint-related, muscular, or even reflexive. Its complexity requires a holistic approach involving multiple health professionals for accurate diagnosis and tailored treatment. It is crucial not to limit oneself to the apparent symptoms but to seek the root cause of the problem.

The Multidisciplinary Approach and Seeking Underlying Causes

To address groin pain, a comprehensive assessment with a physiotherapist and a physical trainer is essential to determine the type of groin pain. It may be joint-related or have more complex and varied causes.

A notable experience with a rugby player suffering from groin pain for four months, who had seen no success with physiotherapy and physical training, highlighted the importance of osteopathy. After osteopathic treatment targeting a cranial trauma that had locked the dura mater and thus put tension on the pubic symphysis, the player was back on the field a week later. This underscores the need for a multi-practitioner approach to understand the foundations of the problem, seeking the real cause rather than focusing solely on the symptom.

The Role of Reflexes and Body Synergies

It is important to consider synergies and cross proprioceptive patterns. Good mobility and controlled maximum range at the temporomandibular joint (TMJ) or cervical spine can significantly impact the pelvis. Cervical mobilizations (right-left, circles, figure eights) have already shown improvements in groin pain. These observations guide us towards osteopathy to identify and treat the primary cause.

Beyond the cervical area, plantar reflexes play a crucial role. Increased sensitivities in the arch of the foot, testable with tools like the neuro spike or even a pen, can affect the adductors and hips. Foot strengthening and rehabilitation work are often overlooked, yet they are fundamental for bodily balance.

The body operates through complex synergies between agonists and antagonists, flexors and extensors. An excess of muscle tone in a specific area can create imbalances and affect opposing muscle groups. The goal is to rebalance this tone and restore agonist-antagonist synergies, a process that involves the brainstem and includes reflexive and involuntary responses.

Emotional and Psychological Factors

The emotional factor should not be underestimated in the onset and persistence of groin pain. Just like sleep, stress or emotional trauma can significantly influence our physical problems. Some cases of groin pain have emerged after significant emotional traumas. While athletes often prefer to focus on tangible performance, it is essential to consider these aspects for lasting recovery.

The Dangers of Masking Symptoms

Groin pain is often insidious: the pain decreases once the body is warmed up, which can lead to training through the pain or using aids like the "Isostrap short". The latter, by compressing the glutes and adductors, can temporarily mask the problem by distributing tension. However, it does not address the cause of the pain and may even create other pathologies in the long term by inhibiting natural muscle action. Many players rely on these tools for entire seasons, but they risk increased pain once training ends and the body cools down.

Excessive use of tools meant to enhance performance can actually have the opposite effect by maladapting the muscles. While these aids can provide short-term benefits, prolonged use can prevent the muscles from performing their usual work, leading to new injuries.

Finally, considering the condition of the cleats is a practical detail but not to be overlooked. Having appropriate and well-maintained cleats can prevent many musculoskeletal problems related to playing football.