Doha agreement meeting on terminology and definitions in groin pain in athletes

Adam Weir¹, Peter Brukner², Eamonn Delahunt³, Jan Ekstrand⁴, Damian Griffin⁵, Karim M Khan⁶, Greg Lovell⁷, William C Meyers⁸, Ulrike Muschaweck⁹, John Orchard¹⁰, Hannu Paajanen¹¹, Marc Philippon¹², Gilles Reboul¹³, Philip Robinson¹⁴, Anthony G Schache¹⁵, Ernest Schilders¹⁶, Andreas Serner¹⁷, Holly Silvers¹⁸, Kristian Thorborg¹⁷, Timothy Tyler¹⁹, Geoffrey Verrall²⁰, Robert-Jan de Vos²¹, Zarko Vuckovic¹, Per Hölmich²²

Affiliations

¹ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
² Latrobe University, Melbourne, Victoria, Australia.
³ School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland Institute for Sport and Health, University College Dublin, Dublin, Ireland.
⁴ Football Research Group, Department of Medicine and Health, University of Linköping, Linkoping, Sweden.
⁵ Warwick Medical School, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK.
⁶ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
⁸ Vincera Institute, Philadelphia, Pennsylvania, USA.
⁹ Hernia centre Dr. Muschaweck, Munich, Germany.
¹⁰ School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
¹¹ Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
¹² The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado, USA McMaster University, Hamilton, Ontario, Canada University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
¹³ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Hernia Center, Clinique du Sport, Merignac, France.
¹⁴ Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, University of Leeds, Leeds, UK.
¹⁵ Department of Mechanical Engineering, The University of Melbourne, Melbourne, Victoria, Australia.
¹⁶ Fortius Clinic, Leeds Beckett University, The Wellington Hospital, London, UK.
¹⁷ Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen, Denmark.
¹⁸ Santa Monica Sports Medicine Foundation & Institute for Sports Science, University of Delaware, Delaware, USA.
¹⁹ The Nicholas Institute of Sports Medicine & Athletic Trauma @ Lenox Hill Hospital, New York, New York, USA.
²⁰ SPORTSMED.SA Sports Medicine Clinic, Adelaide, South Australia, Australia.
²¹ Department of orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
²² Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen, Denmark.

PMID: 26031643
PMCID: PMC4484366
DOI: 10.1136/bjsports-2015-094869

Doha agreement meeting on terminology and definitions in groin pain in athletes

Adam Weir et al. Br J Sports Med. 2015 Jun.

. 2015 Jun;49(12):768-74.

doi: 10.1136/bjsports-2015-094869.

Authors

Affiliations

¹ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
² Latrobe University, Melbourne, Victoria, Australia.
³ School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland Institute for Sport and Health, University College Dublin, Dublin, Ireland.
⁴ Football Research Group, Department of Medicine and Health, University of Linköping, Linkoping, Sweden.
⁵ Warwick Medical School, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK.
⁶ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
⁸ Vincera Institute, Philadelphia, Pennsylvania, USA.
⁹ Hernia centre Dr. Muschaweck, Munich, Germany.
¹⁰ School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
¹¹ Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
¹² The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado, USA McMaster University, Hamilton, Ontario, Canada University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
¹³ Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Hernia Center, Clinique du Sport, Merignac, France.
¹⁴ Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, University of Leeds, Leeds, UK.
¹⁵ Department of Mechanical Engineering, The University of Melbourne, Melbourne, Victoria, Australia.
¹⁶ Fortius Clinic, Leeds Beckett University, The Wellington Hospital, London, UK.
¹⁷ Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen, Denmark.
¹⁸ Santa Monica Sports Medicine Foundation & Institute for Sports Science, University of Delaware, Delaware, USA.
¹⁹ The Nicholas Institute of Sports Medicine & Athletic Trauma @ Lenox Hill Hospital, New York, New York, USA.
²⁰ SPORTSMED.SA Sports Medicine Clinic, Adelaide, South Australia, Australia.
²¹ Department of orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
²² Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen, Denmark.

PMID: 26031643
PMCID: PMC4484366
DOI: 10.1136/bjsports-2015-094869

Abstract

Background: Heterogeneous taxonomy of groin injuries in athletes adds confusion to this complicated area.

Aim: The 'Doha agreement meeting on terminology and definitions in groin pain in athletes' was convened to attempt to resolve this problem. Our aim was to agree on a standard terminology, along with accompanying definitions.

Methods: A one-day agreement meeting was held on 4 November 2014. Twenty-four international experts from 14 different countries participated. Systematic reviews were performed to give an up-to-date synthesis of the current evidence on major topics concerning groin pain in athletes. All members participated in a Delphi questionnaire prior to the meeting.

Results: Unanimous agreement was reached on the following terminology. The classification system has three major subheadings of groin pain in athletes: 1. Defined clinical entities for groin pain: Adductor-related, iliopsoas-related, inguinal-related and pubic-related groin pain. 2. Hip-related groin pain. 3. Other causes of groin pain in athletes. The definitions are included in this paper.

Conclusions: The Doha agreement meeting on terminology and definitions in groin pain in athletes reached a consensus on a clinically based taxonomy using three major categories. These definitions and terminology are based on history and physical examination to categorise athletes, making it simple and suitable for both clinical practice and research.

Keywords: Consensus statement; Evidence-based; Groin; Hip; Injury.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PubMed Disclaimer

Figures

**Figure 1**
**Defined clinical entities for groin pain.** *Adductor-related groin pain*: Adductor tenderness AND pain on resisted adduction testing. *Iliopsoas-related groin pain*: Iliopsoas tenderness+more likely if pain on resisted hip flexion AND/OR pain on hip flexor stretching. *Inguinal-related groin pain*: Pain in inguinal canal region AND tenderness of the inguinal canal. No palpable inguinal hernia is present. More likely if aggravated with abdominal resistance OR Valsalva/cough/sneeze. *Pubic-related groin pain*: Local tenderness of the pubic symphysis and the immediately adjacent bone. No particular resistance tests to test specifically for pubic-related groin pain.

See this image and copyright information in PMC

References

1. Serner A, van Eijck CH, Beumer BR, et al. . Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015;49:813. - PMC - PubMed
1. Branci S, Thorborg K, Nielsen MB, et al. . Radiological findings in symphyseal and adductor-related groin pain in athletes: a critical review of the literature. Br J Sports Med 2013;47:611–19. - PubMed
1. Holmich P, Renstrom PA. Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 207 patients. Br J Sports Med 2007;41:247–52. 10.1136/bjsm.2006.033373 - DOI - PMC - PubMed
1. Waldén M, Hägglund M, Ekstrand J. The epidemiology of groin injury in senior football: a systematic review of prospective studies. Br J Sports Med 2015;49:792–7. 10.1136/bjsports-2015-094705 - DOI - PubMed
1. Orchard JW. Men at higher risk of groin injuries in elite team sports: a systematic review. Br J Sports Med 2015;49:798–802. 10.1136/bjsports-2015-094705 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Doha agreement meeting on terminology and definitions in groin pain in athletes

Affiliations

Doha agreement meeting on terminology and definitions in groin pain in athletes

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical