Groin pain

Longstanding adductor-related groin pain

The beneficial short-term effect seen with a specific exercise therapy program aimed at improving strength and coordination of the muscles acting on the pelvis was shown to be highly effective in one study.[22]Hölmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomized trial. Lancet. 1999;353:439-443. http://www.ncbi.nlm.nih.gov/pubmed/9989713?tool=bestpractice.com A follow-up study reported that effects lasted over a 10-year period.[29]Hölmich P, Nyvold P, Larsen K. Continued significant effect of physical training as treatment for overuse injury: 8- to 12-year outcome of a randomized clinical trial. Am J Sports Med. 2011;39:2447-2451. http://www.ncbi.nlm.nih.gov/pubmed/21813441?tool=bestpractice.com

Certain conditions, such as tension-sided femoral neck stress fractures, require prompt recognition and timely surgical management to avoid complications and added morbidity.

Femoral-neck stress fractures

Medial (compression)-sided femoral neck stress fractures are inherently stable and have an excellent prognosis for healing with conservative measures.

Their lateral (tension)-sided counterparts are potentially unstable fractures at increased risk for displacement leading to significant morbidity. However, prompt surgical treatment with internal fixation drastically decreases the risk of displacement, with minimal added treatment-related morbidity.

The long-term prognosis following early identification and appropriate treatment of these injuries is highly favorable. The risk of recurrence of a femoral neck stress fracture is low provided the patient is compliant with his or her restrictions and treatment plan.