Download complaint is of pain in the groin which in some instances can be

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Brit J. Sports Med. - Vol. 16, No. 2, June 1982, p. 101
101
WRONG DIAGNOSIS IN ATHLETES
A. J. BANKS, MSc, FRCS* and P. D. MALIMSON, FRCSt
*Boton Royal Infirmary
tPark Hospital, Davyhulme, Manchester
INTRODUCTION
High performance athletes are prone to a wide variety
of acute and chronic soft-tissue problems. A common
complaint is of pain in the groin which in some instances
can be severe enough to curtail further sporting
activities. Most cases are due to soft-tissue injuries such
as adductor, psoas and rectus femoris strains (Renstrom
and Peterson, 1980).
Some cases of groin strain can be due to other causes
such as hip joint lesions, nerve entrapment syndromes
and herniae. Three cases of painful herniae are reported
in athletes who sought medical advice following failure
of prolonged physiotherapy. In all cases physiotherapy
was instituted on a self-referral basis and in no instance
did the symptoms resolve.
CASE 1
A twenty year old female high jumper presented with a
nine month history of pain in the left groin. She had
received private physiotherapy treatment for nine
months which included ultrasonics, massage and a
variety of exercises. She proved to have a small indirect
inguinal hernia. Following surgical repair she was able to
return to her sport three months post operatively.
CASE 2
A 26 year old male badminton player presented with a
four month history of pain in the left groin. He had
received three months treatment through private physiotherapy. Following repair of the hernia he was able to
return to his game three months post operatively.
CASE 3
A 25 year old male squash player presented after having
had private physiotherapy for four months for what he
termed a "groin strain". This proved to be an indirect
inguinal hernia. Following treatment he was able to
return to his sport three months post operatively.
COMMENT
Over the last few years there has been an upsurge in
the interest in the treatment of sporting injuries resulting
in a proliferation of so called sports medicine or sports
injuries clinics. In addition the private sector physiotherapists have become involved. Lack of sympathy by
many general practitioners (understandably in many
cases) together with long waiting lists in orthopaedic
departments drives the frustrated sportsman into the
private fringe medicine sector. This can be an expensive
procedure both financially and in terms of time lost
from sporting interest. For example the sum spent by
Case 1 would have covered the cost of a private medical
consultant together with the operating fee.
While not wishing to under-estimate the value and
skill of many chartered physiotherapists, we feel it important that sportsmen should seek medical advice at
some stage during the course of treatment, especially
after a prolonged period, when symptoms have remained
unchanged.
Since completion of this report four more similar
cases have been encountered.
REFERENCE
Renstrom, P. and Peterson, L., 1980 "Groin injuries in athletes". Brit.J.Sports Med. 14: 30.
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Wrong diagnosis in athletes.
A. J. Banks and P. D. Malimson
Br J Sports Med 1982 16: 101
doi: 10.1136/bjsm.16.2.101
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