Groin Pain

Groin Pain is a common problem among many poorly conditioned ice hockey players. These players are suffering from Femoral Anterior Glide Syndrome.  During hip flexion the head of the femur is supposed to glide posteriorly in the hip joint.  If it does not move posteriorly when flexion occurs the anterior joint structures become impinged.  This can be mis labelled as tendonitis of the iliopsoas muscle.  However, strengthening of the iliopsoas will not correct the problem because the same faulty pattern is still present.

One thing that is some what unique to ice hockey players is that Femoral Anterior Glide Syndrome is often accompanied with excessive lateral rotation of the hip.  This is because abduction and lateral rotation happen repeated while skating.  In Shirley Sahrmann's great book 'Diagnosis and Treatment of Movement Impairment Syndromes' she states, "Activities such as ice skating and ice hockey in which abduction and lateral rotation are the repeated motions can predispose participants to this syndrome with lateral rotation".

With Femoral Anterior Glide Syndrome with lateral rotation we can also see the anterior hip joint pain when the hip is extended.  Hip extension and lateral rotation with insufficient posterior glide over stretches the anterior joint tructures. Often times a mis-diagnosis of tendinopathy or bursitis occurs.  However, treatment of these issues will do little to resolve pain because the faulty movement pattern is still present. 

With Femoral Anterior Glide Syndrome with lateral rotation the hip lateral rotators overpower the medial rotators and the hamstring muscles are dominant over the glutes.  Also, the piriformis and glute max muscles are short and the glute medius and iliopsoas muscles are weak.

In conclusion, strengthening of the groin muscles will do little to relieve chronic groin pain in our players.  What is needed is restoration of proper posterior glide of the femoral head.  Soft tissue work with foam rollers and a lacrosse ball around the hip are a must.  Also, we must institute stretching of the glute max and piriformis to restore proper tissue length.  Strengthening and activation of the glute medius is crucial.  Lastly strengthening of the pectinius, gracillis, and adductor magnus muscles which medially rotate the hip is vitally important.