High prevalence of groin pain identified in elite basketball U20s athletes and its impact on function and quality of life

Introduction: Previous research on groin pain in basketball athletes shows the injury rate of adductor strains is 3.4% (males) and 1.8% (females), though these studies are limited by varied injury definitions. Current reporting standards in groin pain include the use of patient-reported outcome questionnaires and isometric strength testing to define groin injuries. This study aims to show the prevalence of groin pain in male and female elite youth basketball athletes.

Methods: Male (n = 39) and female (n = 10) elite youth basketball athletes were recruited during the 2018 U20s Australian Basketball Championships and completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire. Within the two days prior to competition, a subset of male (n = 27) and female (n = 9) athletes had their isometric adductor strength measured using a handheld dynamometer as well as their numerical pain rating score during testing. Twenty male athletes also had their isometric abduction and adduction strength tested using a GroinBar (Vald Performance, Australia) to calculate their hip adduction/abduction ratio. Participants were divided into cases (historical or current self-reported hip and/or groin pain/discomfort) or controls (no history of hip and/or groin pain). To assess whether a difference between cases and controls was observed, a mixed-effect logistic regression was built with case as the dependent variable.

Results: Of the 49 players, 32.7% of athletes reported historical or current hip/groin pain and/or discomfort. An athlete was found to be significantly more likely to be classified in the case group if they had a decreased HAGOS subscale values for Symptoms (OR = 0.95, 95%CI 0.91–0.99; p = 0.02), Pain (OR = 0.93, 95%CI 0.87–1.00; p = 0.04), Function in daily living (OR = 0.88, 95%CI 0.79–0.99; p = 0.03), Function in sport and recreation (OR = 0.92, 95%CI 0.86–0.99; p = 0.02) and hip and/or groin-related Quality of Life (OR = 0.91, 95%CI 0.85–0.98; p = 0.007). Most athletes who had their strength measured reported no pain during testing (case:85%; control, 91%).

Discussion: Although limited by a small sample, the findings from this study indicate that with the utilisation of an athlete self-reported definition the prevalence of groin pain is much higher than previously assumed. This study found that groin pain has a negative effect on basketballer's quality of life, activities of daily living and sports and recreation which suggests a potential impact on an athlete's basketball performance. With few athletes in this study reporting pain with isometric adduction, a clinical indicator of adductor-related groin pain, it is probable that the athletes in this study experience groin pain from other anatomical structures.