3D Biomechanics Clusters and Rehab Outcomes in Athletic Groin Pain

Using 3D motion capture of single-leg squats, drop landings, hurdle hops and planned and unplanned cuts, Andy's group found three kinetic clusters, driven mainly by the ankle, knee or hip. The clusters did not match the anatomical pain sites, but poor thorax control, low ankle plantar flexion work and long ground contact times stood out. The rehab program ran three parallel levels: intersegmental control and strength, linear running load, and change of direction with sprinting, with progression criteria such as a pain-free squeeze and crossover test and tolerance of running. All patients got the same program whatever the presumed structure. Afterward the thorax and pelvis were more stable, ground contact time fell, and ankle work rose from 29% to 34% while knee and hip work fell. Squeeze tests and HAGOS scores improved, 73% returned to play pain free, and mean rehab time was 9.9 weeks, against 16 weeks for the Doha program. Discriminating features used to target rehab include hip flexion angle, ankle rotation, ankle moments, thorax lateral sway and hip abduction.