Let’s Talk About the Groin Area: No More Taboos

Link Between Core and Other Injuries

Meyers who has been performing core muscle surgeries since the late 80s, continues to push for more research on these types of injuries and how they can contribute to problems in other parts of the body.

Because of the complexity of the core anatomy, patients with groin pain often find themselves being passed from one specialist to another before the right diagnosis is made.

The research body on core muscle injuries is growing though. “Mini-Open Incision Sports Hernia Repair: A Surgical Technique for Core Muscle Injury” published in August 2017 in Arthroscopy Techniques has offered up a new surgical technique for core muscle injury where not only is the rectus abdominis repaired to the pubis, but the adductor longus is also elongated.

Another study, “Prevalence of Surgical Repair for Athletic Pubalgia and Impact on Performance in Football Athletes Participating in the National Football League Combine” published in May 2017 in the Arthroscopy Journal offered positive news on athletes’ recovery after core muscle surgery. The researchers found that when treated correctly, these injuries don’t have any long-term impact on an athlete’s performance. The authors wrote, “Athletes with a history of successful athletic pubalgia surgery invited to the NFL Combine and those with persistent pathology on the MRI are not at increased risk for diminished performance in the NFL.”

Studies have also shown that while core muscle injuries/athletic pubalgia and femoroacetabular impingement have always been considered separate conditions, they can actually both play a role in why an athlete experiences groin pain.

One of the most recent studies conducted so far has even explored the connection between core muscle injuries and extremity injuries. “Impaired Core Stability as a Risk Factor for the Development of Lower Extremity Overuse Injuries: A Prospective Cohort Study,” which was published in the June 2019 issue of The American Journal of Sports Medicine suggests that core stability issues are a risk factor for lower extremity overuse injuries.

During the study, participants went through baseline testing for dynamic postural control, isometric core and hip muscle strength, core muscle endurance, core neuromuscular control and proprioception, and functional movement. Then they were followed for 1.5 years.

According to the results, 34 of the 139 participants experienced a lower extremity overuse injury during the follow-up period. An increased side-by-side difference in dynamic postural control (p = .038), decreased isometric hip extension:flexion strength ratio (p = .046), and decreased abdominal core muscle endurance (p = .032) were also found to be significant risk factors for lower extremity overuse injuries.

Meyers who was not involved in the study said that this concept that core instability leads to lower extremity injuries is a real finding.

“My definition of the core (mid-thigh to mid-chest) is different though and therefore some of the injuries they identified are actually part of the core because they defined the core from pubic bone up. Therefore, my interpretation of their findings is that weakness in one part of the core leads to weakness in other parts of the core and the lower extremities.”

Despite these differences, he still feels though that “this is the sort of data we should be looking for. “I deal with this every day. The longer the core injury, the higher the likelihood of upper or lower extremity injury.”