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Case Reports
. 2015 Dec;59(4):390-7.

Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report

Eric St-Onge  1 , Ian G MacIntyre  2 , Anthony M Galea  2
Affiliations
Case Reports

Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report

Eric St-Onge et al. J Can Chiropr Assoc. 2015 Dec.

Abstract
in English, French

Objective: To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management.

Clinical features: A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey.

Intervention: The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks.

Discussion: This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain.

Summary: Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy.

Objectif: Présenter la prise en charge clinique d’une perturbation inguinale chez un joueur de hockey et mettre en évidence l’importance que revêt une approche multidisciplinaire pour le diagnostic et la prise en charge.

Caractéristiques cliniques: Un joueur de hockey professionnel souffrant d’une douleur récurrente au niveau de l’aine s’est présenté à la clinique à la suite d’une exacerbation aiguë de la douleur survenue au cours de la pratique de son sport.

Intervention: Le patient a reçu un diagnostic clinique d’une perturbation inguinale. L’imagerie médicale a révélé la présence d’une déchirure au niveau du grand droit de l’abdomen. La prise en charge comprenait deux injections de plasma riche en plaquettes (PRP) dans le tissu lésé, ainsi qu’une thérapeutique manuelle et des exercices ultérieurs. Le patient a retrouvé son niveau de performance antérieur en 3,5 semaines.

Discussion: Ce cas prouve l’importance de recourir à une équipe pluridisciplinaire et la nécessité d’utiliser des technologies d’imagerie de pointe chez les athlètes souffrant de douleurs récurrentes au niveau de l’aine.

Résumé: La qualité des recherches relatives à la prise en charge non-chirurgicale des perturbations inguinales demeure faible. Ce cas est une preuve supplémentaire que le PRP, associé à une thérapeutique manuelle et à des exercices, peut constituer une stratégie de prise en charge non-chirurgicale relativement rapide et efficace.

Keywords: PRP; athletic pubalgia; chiropractic; inguinal disruption; platelet-rich plasma; sports hernia.

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Figures

Figure 1.
Figure 1.
First ultrasound-guided PRP injection of left rectus abdominis (week 1). A) 12.6mm × 4.4mm tear of the left rectus abdominis. B) Insertion of needle into the tear (pre-injection). C) Distended left rectus abdominis (post-injection).
Figure 2.
Figure 2.
Second ultrasound-guided PRP injection of left rectus abdominis (week 2). A) 4.6mm × 2.6mm tear of the left rectus abdominis. B) Insertion of needle into the tear (pre-injection). C) Distended left rectus abdominis (post-injection).
Figure 3.
Figure 3.
Transversus abdominis setting
Figure 4.
Figure 4.
Monster walks with blue theraband
Figure 5.
Figure 5.
Walking lunge with overhead reach
Figure 6.
Figure 6.
Hip airplane
Figure 7.
Figure 7.
Bowler squat
Figure 8.
Figure 8.
High hurdle steps
Figure 9.
Figure 9.
One leg squat with opposite leg towel slide
See this image and copyright information in PMC

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