Groin pain or as it is commonly referred to in many current sporting circles as Osteitis pubis or OP, is in fact a combination of possible pathologies and careful examination is required to identify the biomechanical difficulties and then target treatment appropriately.

Many current treatments rely on a variety of surgical approaches with varied success. These stem from hernia repairs, nerve ablations or muscle tendon dissections. The rise of these surgical techniques comes from the pressure of athletes to return to sport quickly. The aetiology of these conditions has been researched by our team at the University of Melbourne and the condition is a combination of stressors resulting in the presentation of pain and bone overload. The diagnosis of this is complex for the inexperienced and the temptation to rush in an suggest a 'curative option' of surgery is great.

The Diagnosis

Dr Andy Franklyn-Miller developed with colleague's Dr Eanna Falvey and Prof Paul McCrory the Groin, Gluteal and Greater trochanter triangles.

To aid diagnosis:

• Franklyn-Miller A, Falvey E, McCrory P, Briggs, C
  Landmarks for the 3G approach. European Journal of Anatomy: 2008 12(2): 81-87
• Franklyn-Miller, A., E. Falvey, McCrory P.
  The Gluteal Triangle: A clinical patho-anatomical approach to the diagnosis of gluteal pain in athletes. BJSM 2009 43(6):460-6
• Falvey E, Franklyn-Miller, A McCrory P.
  The groin Triangle: A Clinical patho-anatomic approach to the diagnosis of chronic groin pain. BJSM 2009 43(3):213-20
• Falvey E, Franklyn-Miller, A McCrory P.
  The greater trochanter Triangle: A Clinical patho-anatomic approach to the diagnosis of hip pain BJSM 2009 43(2):146-52

This innovative approach to the condition allows a compartmentalised approach to triggers and in conjunction with appropriate assessment gives the best combined approach

Current Assessment

The approach utilised by Andy at SPARC is unique in the UK with a full biomechanical assessment as part of the initial consultation process. This 3D reconstruction gives a true picture of the muscle action and stability of not only the pelvis but knee and ankle. The assessment is sport specific so a soccer player would be assessed differently to a rugby player or a judo player to a sprinter.

This visual and definitive feedback can be used to track recovery and expediate return to play. In some cases referral for surgical intervention is appropriate if a clear indication is present but a rehabilitation process with soft tissue techniques is often overlooked in the pressures of today’s sport. We can offer this rehabilitation in house with Physiotherapy colleagues and Strength and Conditioning trainers or a programme can be delivered for back at home or at your club."