Successful study on hip and groin injuries among elite Gaelic footballers
Posted on February 4, 2015
The increasing problem of hip and groin injuries among elite Gaelic footballers was the issue for an extensive study by ARTI members recently.
Overall, the research highlighted the extent of the problem and reached findings that will be of benefit to therapists while also providing a platform for further research on the topic.
The research was conducted at DCU by a group that included Dr Noel McCaffrey, Miriam Downey, Enda Whyte, Tiarnán Ó Doinn and Davide Susta. Fourth year students who collected the data included, Sean Callinan, Ciara Jennings, Doireann Church, Ian Hickey, Conall Hoey, Mark O’Connor, Regina Halpin and Paul Dean.
One of the main successes was in commencing a study into this particular type of injury as Tiarnán explains it is something that hasn’t really been looked at in depth.
“The impetus for the research is that hip and groin pain is becoming recognised as a common and debilitating problem for elite GAA players and so far research has been limited despite the fact that it represents the fourth most common injury.
“The view was backed up by our findings which revealed that 80 per cent of the players we tested had current or previous (or both) hip and groin pain. That validates the problem of hip and groin pain in this type of cohort”, he explained.
“In many cases these can be long-standing injuries with a high re-injury rate, but in general there is very little information out there in terms of Gaelic football, and that was one of the main reasons for conducting the research”, added Tiarnán.
The study was made possible by access to a group of some of the country’s top GAA players ranging in age from 16 to their early thirties, and conducted under the following six headings:
Range of Motion Testing
In terms of Imaging, MRIs were carried out over a four month period and broken down into four categories:
1) Those that never had an episode of pain at any stage of their career. 2) Those who had a history but were asymptomatic at the time. 3. Those who were symptomatic. 4) Those who developed pain between the MRI and follow-up call- roughly three months later.
The results showed that there were no significant differences in the probability of having an overall abnormal hip/groin finding on MRI across the four groups, which led to the conclusion that it is important for MRIs to be interpreted with a thorough history.
The Functional Testing research produced significant findings as the group developed the ‘Lateral Rebound Hop Test’ where a player jumped sideways from one foot to the other as far as they could, then back immediately. It proved to be a very reliable test and was able to identify significantly differences between dominant and non-dominant sides.
It was established that this hop test could be reliably applied to clinical practice. This could help determine when a player is ready to return to play due its ability to distinguish between side-to-side asymmetries. Also, the normative data collected could be applied to a similar cohort as a benchmarking tool in the return to play process.
The Strength Test also showed the benefit of the ‘Lateral Rebound Hop Test’ as this could be used in a practice as a more economic substitute for a dynamometer. This was because a moderate correlation was found between the return phase of the lateral rebound hop test and adductor to abductor ratios. However, the strength testing was unable to demonstrate a link between those previously injured and those free from injury.
Hip rotation is an established risk factor for hip and groin injury among other football codes. In this study a novel method of testing using a smartphone inclinometer app was used. This method proved to have excellent reliability and improved the speed and accuracy of measurement. Once again the results showed no difference between those previously with or without pain. However, this novel method has numerous other applications.
The Questionnaire revealed that 46 per cent of players had a history of hip and groin pain during their careers, while 80 per cent said they had current or previous pain, or both.
Reflecting on the comprehensive study, Tiarnán Ó Doinn, felt that overall it was very successful.
“The fact that we could establish that 80 per cent of the players experienced current or previous pain (or both) validates the problem of hip and groin pain among this type of cohort and it shows the need for research in this area. It suggests that this is a big problem and that we need to do something about it.
“We can also say that one of the successes is the fact that MRIs must be interpreted with caution as they won’t necessarily help with diagnosis”, Tiarnán added.
“One of the positives is that we have a very solid screening system as every test developed had excellent reliability”, he explained and pointed out that the benefit to ARTI members is that this screening can be implemented within their practice.
According to Tiarnán, some of the benefits mean that players from this cohort could be tracked over the course of their careers to see the implications of imbalances and how they can be addressed. It also allowed for the possibility of tailoring training programmes to reduce the risk of injury.