Hypothesis: A multi-modal treatment program (MMT) is more effective than exercise therapy (ET) for the treatment of long-standing adductor-related groin pain. Study design: Single blinded, prospective, randomised controlled trial.
Methods: Patients: Athletes with pain at the proximal insertion of the adductor muscles on palpation and resisted adduction for at least two months. Interventions: ET: a home-based ET and a structured return to running program with instruction on three occasions from a sports physical therapist. MMT: Heat, Van den Akker manual therapy followed by stretching and a return to running program. Primary outcome: time to return to full sports participation. Secondary outcome measures: objective outcome score and the visual analogue pain score during sports activities. Outcome was assessed at 0, 6, 16 and 24 weeks.
Results: Athletes who received MMT returned to sports quicker (12.8 weeks, SD 6.0) than athletes in the ET group (17.3 weeks, SD 4.4. p ¼ 0.043). Only 50e55% of athletes in both groups made a full return to sports. There was no difference between the groups in objective outcome (p ¼ 0.72) or VAS during sports (p ¼ 0.12).
Conclusions: The multi-modal program resulted in a significantly quicker return to sports than ET plus return to running but neither treatment was very effective