Ludwig O, Kelm J
Sportwissenschaftliches Institut, Universität des Saarlandes, Saarbrücken, Deutschland.
Chirurgisch-orthopädisches Zentrum Illingen, Illingen, Deutschland.
Sportverletz Sportschaden. 2016 Aug;30(3):163-7. doi: 10.1055/s-0042-110249. Epub 2016 Aug 4.
Soccer and football players are exposed to a high risk of groin pain. In some cases, the pubic symphysis is the origin of the problems.This article presents a case report of a young elite soccer player who, over a period of two years, suffered from pain in the groin and symphysis area. The right leg was the kicking leg. Imaging techniques did not reveal pathological findings. Sports hernia, osteomyelitis, enthesopathy, adductor tendonitis, and muscle sprains, as well as rheumatic or urogenital disorders were excluded.A 3 D posture analysis was performed to examine the statics of the body and pelvis. The maximum isometric strength of the left and right leg adductors and abductors, as well as the knee flexors and extensors were measured.We found a muscular imbalance resulting from the type of sport the athlete engaged in with an unfavourable ratio between the right knee extensor and flexor muscles. Comparing sides, an imbalance was also identified between the right and left knee extensor. This imbalance resulted in a one-sided forward tilt of the right hemi-pelvis. This pelvic torsion may lead to an increase in shear forces in the pubic symphysis, which we suspected to be the reason for the recurring problems.After three months of specific training exercises, the pelvic position was harmonised and the muscular imbalances were significantly reduced. Even 6 months after completion of the specific training exercises, the player remained without complaints despite his unvaried soccer training intensity.Causal treatment of functional pain in the groin or symphysis area should take into account the ipsilateral and contralateral strength ratios of the knee extensors and flexors as well as the three-dimensional position of the pelvis.
足球运动员面临着腹股沟疼痛的高风险。在某些情况下，耻骨联合是问题的根源。本文介绍了一名年轻的精英足球运动员的病例报告，该运动员在两年时间里一直遭受腹股沟和耻骨联合区域的疼痛。右腿是踢球腿。影像学检查未发现病理结果。排除了运动疝、骨髓炎、附着点病、内收肌腱炎、肌肉拉伤以及风湿性或泌尿生殖系统疾病。进行了三维姿势分析以检查身体和骨盆的静态情况。测量了左右腿内收肌和外展肌以及膝关节屈伸肌的最大等长力量。我们发现，由于运动员从事的运动类型，导致右膝伸肌和屈肌之间比例不利，从而出现肌肉失衡。比较两侧时，还发现左右膝伸肌之间存在失衡。这种失衡导致右半骨盆单侧前倾。这种骨盆扭转可能会导致耻骨联合处剪切力增加，我们怀疑这是反复出现问题的原因。经过三个月的特定训练练习，骨盆位置得到协调，肌肉失衡明显减少。即使在完成特定训练练习6个月后，尽管足球训练强度不变，该运动员仍无不适症状。对腹股沟或耻骨联合区域的功能性疼痛进行病因治疗时，应考虑膝关节伸肌和屈肌的同侧和对侧力量比例以及骨盆的三维位置。
