Friday, May 21, 2010
Groin Strains in Track & Field
Coach Martin asked me for some comments on this topic. First of all we need to define it, since it's sort of non-specific. I take it to mean the area including, but not exclusive to the adductors, sartorius, pectineus, iliopsoas, origin of the rectus, and the lower abs.
Before we even get started, keep a close eye if the pain is right up on the pubic ramus (bottom/front pelvic bone), or in the AIIS (anterior inferior iliac spine). They are frequent sights of stress fractures, especially in females and all athletes in the 14yr. old range. Way more common then you think.
Not too much GOOD research on the groin area. The best functional study of the adductors I have seen is from way back in Partridge Family era 1970! Get out your platform shoes and polyester shirts cause we're goin' retro (Am.J. Phys. Med. 49(4): 223-240, 1970). Researchers Greene & Morris found subjects with enough guts to walk around with fine wire electrodes in their legs. Here's what they found about how the adductors functioned in walking/running:
The left adductor magnus and the right adductor longus exhibited equal activity at left heel strike. The reverse occurred at right heel strike. This would be consistent with the magnus functioning as a hip extensor and the longus functioning as a hip flexor. As subjects walked with their trunks intentionally held in a forward flexed position, the activity of the adductor magnus increased dramatically, while the adductor longus activity appeared to change very little. Walking with an extended trunk increased longus activity and decreased magnus activity. Apparently, the adductor magnus plays a major role in decelerating hip flexion and accelerating hip extension. The opposite would be true for the longus.
The authors then had the subjects walk with a very wide and a very narrow base. Although this appears to be a change in the frontal plane, the authors intended to change the amount of transverse plane motion of the pelvis. Their measurements of pelvic rotation showed that the wide base decreased pelvic rotation and the narrow base accentuated it. With both “tweaks” the pattern of activity (opposite magnus and longus contracting together) remained the same. With the wide base of support there was still significant activation of both muscles. Of great interest is the substantial increase in the “amplitude and duration” of both muscles produced by the increased pelvic rotation caused by the narrow gait. (Thanks for D. Tiberio of GIFT for the commentary).
-What's to be learned from this?
1. The adductors obviously don't adduct the legs in walking or running; gravity gives that to us for free.
2. The adductors don't dig (using 70's terminology) the pelvis wiggling around during running (Jack- here is where the cramping could come in). Strength training is important here.
3. If #2 is true, then it is conceivable that the adductors, rather than being week, may be taking on the butts role is decelerating leg adduction and internal rotation. Again, dormant butt= strength training (functional that is).
4. Getting back to numero dos- remember the pelvis is an interdependent ring. What goes on one side has a direct influence on the other. Remember runners who run in straight lines are subject to what Vlad Janda called "pattern overload". Their bodies may have become adapted to running and movement patterns rigidly grooved.
Now- what the hell to do about it.
-in the short term, reduction in activity and E-stim/sound combo treatments, ice, massage stick, light IASTM if it's available, and MET (muscle energy technique) about the pelvis is valuable to reduce spasm and make the athlete more comfortable.
-The long term muscle spasm can create adaptations in the pelvis like rotations and upslips in the innominate bones of the pelvis. That's fancy wording meaning you can wind up with more groin strains. The MET's work great on this stuff.
-for long term- I believe 3D running should be an integral part of the recovery/restoration process. Backpedaling and backward running, slide steps, carioca; with a variety of arm swings should be included in the cool down process, or included on what Bowerman would call "the easy days".
-for long term- Plenty of 3D lunges, squats, and step ups. Combine them with an overhead reach if you want to do some "integrated isolation" on the groin.
Phew! Talked too much! Good luck this weekend Coach Martin and all coaches! Would love to be there but I've got baseball/softball at Williams Field.