Adductor Assessment

[brian]

High school soccer player had ankle sprain injury last season. This past weekend he tweaked his adductor muscle.

As additional background, the player is "bow-legged".

I know it is virtually impossible to diagnose the reason for the groin strain, but based on the above factors, is there an assessment that a qualified PT can make to help pin-point the source of these injuries?

From your experience, are groin strains more of a function of lack of endurance strength rather than absolute strength in the adductor muscles?

I would like to bring this player to my PT for an evaluation and prehab/rehab exercises.

What would you be looking for in your assessment?

Thanks in advance.

Brian

[Bill Hartman]

I injuries can arise in any number of ways but fall into 3 main categories:

Chaos - the body is always searching for other (better?) ways to do things. Some will improve performance. Some will cause a breakdown. We have no control over it.

Accidental - Usually easy to figure out the cause. You see it happen. Most violent injuries are a result.

Non-accidental - overtraining, overloading, and bad technique issues are typically the cause. Oftentimes what appears to be the cause is simply "the straw that broke the camel's back".

The bad thing in all this is that by nature we want to know why injuries occur. Rarely do we ever know. Most diagnoses of why an injury occurs are guesses.

With that in mind, look at his entire training program...sets, reps, practice volumes, intensities, games. See if there are any clues that may have resulted in a non-accidental injury.

Most of the times as a PT we'll look for asymmetries in gait, strength, dynamic balance, etc. and attempt to correct "the problem". My concern with this is that rehab is never done at sport specific speed or loads therefore you can never tell if an athlete is fully recovered.

This is a possibility with your soccer player. Perhaps the ankle wasn't fully recovered and he was performing some kind of compensation (or developed one as he recovered) that resulted in overload of the adductor (or it was a fluke). If a muscle fires to soon or to late during a normal running cycle, it can quite frequently be strained. This happens a lot with sprinters who pull hammies. There supplementary training can actually screw up the contraction timing and the hammies contract too soon at the end of swing or too late at ground contact.

Your best bet is to get him healthy, progessively condition the tissues noting that connective tissues adapt more slowly, and then observe him in progressively challenging game situations. Then you may be able to find out more. Video tape him if necessary.

Bill