title: Do Australian Football players have sensitive groins? Players with current groin pain exhibit mechanical hyperalgesia of the adductor tendon.
abstract: OBJECTIVE
  This is the first study to evaluate the mechanical sensitivity, clinical classifications and prevalence of groin pain in Australian football players.
  
  
  METHODS
  Case-control.
  
  
  METHODS
  Professional (n=66) and semi-professional (n=9) Australian football players with and without current or previous groin injuries were recruited. Diagnoses were mapped to the Doha Agreement taxonomy. Point and career prevalence of groin pain was calculated. Pressure pain thresholds (PPTs) were assessed at regional and distant sites using handheld pressure algometry across four sites bilaterally (adductor longus tendon, pubic bone, rectus femoris, tibialis anterior muscle). To assess the relationship between current groin pain and fixed effects of hyperalgesia of each site and a history of groin pain, a mixed-effect logistic regression model was utilised. Receiver Operator Characteristic (ROC) curve were determined for the model.
  
  
  RESULTS
  Point prevalence of groin pain in the preseason was 21.9% with a career prevalence of 44.8%. Adductor-related groin pain was the most prevalent classification in the pre-season period. Hyperalgesia was observed in the adductor longus tendon site in athletes with current groin pain (OR=16.27, 95% CI 1.86 to 142.02). The ROC area under the curve of the regression model was fair (AUC=0.76, 95% CI 0.54 to 0.83).
  
  
  CONCLUSIONS
  Prevalence data indicates that groin pain is a larger issue than published incidence rates imply. Adductor-related groin pain is the most common diagnosis in pre-season in this population. This study has shown that hyperalgesia exists in Australian football players experiencing groin pain indicating the value of assessing mechanical pain sensitivity as a component of the clinical assessment.
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia; Department of Physical Therapies, Australian Institute of Sport, Australia. Electronic address: michael.drew@ausport.gov.au.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Drew
authors.affiliation: Department of Sports Medicine, Australian Institute of Sport, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Lovell
authors.affiliation: Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Thorvaldur S
authors.initials: TS
authors.lastname: Palsson
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia.
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Chiarelli
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Osmotherly
mesh_terms: D000328:Adult; D001315:Australia; D016022:Case-Control Studies; D005538:Football / Q000293:injuries*; D006119:Groin / Q000293:injuries* / Q000503:physiopathology; D025981:Hip Injuries / Q000503:physiopathology*; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D017288:Pain Threshold / Q000145:classification*; D015995:Prevalence; D013708:Tendon Injuries / Q000503:physiopathology*; D055815:Young Adult
keywords: Athlete; Australian football; Groin; Hyperalgesia; Mechanical sensitivity; Pressure pain threshold