Quantifying movement strategies of male athletes with self-reported hip-related and/or groin pain

Research output: ThesisDoctoral Thesis


Hip/groin pain, including recurrence, has been reported in multi-directional team-based sports. The currently recommended method to identify athletes with hip/groin pain is self-report, combined with standardised patient-reported outcome measures, but these have not been previously utilised in basketball athletes. Athletes with hip/groin pain are reported to use altered movement strategies, quantified via muscle activation patterns and three-dimensional (3D) motion analysis. Muscle activation patterns have not been measured during running, while previous 3D motion analysis has been conducted at the group-level potentially overlooks movement strategies specific to individual athletes. The assessment of muscle activation patterns during running and individual joint kinematics and kinetics may uncover new knowledge that can lead to targeted interventions for athletes with hip/groin pain.
The aims of this thesis were to: (1) investigate the prevalence of hip/groin pain in male basketball athletes, through self-reported definitions, and players’ perceptions on the impact of hip/groin pain; (2) determine how muscle functional magnetic resonance imaging (mfMRI) has previously been utilised to explore leg muscle activation patterns following exercise; (3) investigate the impact of both male athletes’ anthropometrics and MRI magnet field strength on the calculation of thigh muscle activation patterns; (4) investigate hip adductor spatial muscle activation patterns of athletes with and without a history of self-reported hip/groin pain following multi-directional running; and (5) investigate the 3D movement strategies of individuals with and without a history of self-reported hip/groin pain during change-of-direction (COD).
Study One: A survey of state/national representative level male basketball players investigated self-reported current/historical hip/groin ‘discomfort/pain’ and ‘problems’ and its impact on sport participation and quality of life using the Copenhagen Hip and Groin Outcome Score (HAGOS).
Study Two: A systematic review identified studies that used mfMRI to quantify spatial muscle activation patterns in healthy physically active adults.
Study Three: An in vivo methodology study determined the impact of anthropometrics (body mass index; thigh and buttock girth; thigh length) and magnet field strength (1.5T vs. 3T) on the calculation of thigh mfMRI activation patterns.
Study Four: A mfMRI pilot study examined spatial muscle activation patterns of individual hip adductor muscles in male athletes with and without a self-reported history of hip/groin pain following multi-directional running.
Study Five: A 3D motion analysis study determined lower limb and trunk kinematics and kinetics in athletes with and without a self-reported history of hip/groin pain during a reactive COD.
Study One: The prevalence of self-reported hip/groin ‘discomfort/pain’ was 41% (n=21), while hip/groin ‘problems’ was 24% (n=12). Players did not report hip/groin ‘problems’ unless they missed time on court. However, all players reporting hip/groin ‘discomfort/pain’ reported it negatively impacted them on- and off-court (HAGOS).
Study Two: Seven included studies (hamstring, n=5; quadriceps, n=1; extrinsic foot, n=1) with differing research questions used different MRI methodologies related to scan acquisition time, repetition time, and number of echo times.
Study Three: Images from 3T magnet field strength had reduced signal intensity in the anteromedial and posteromedial thigh in males with larger anthropometrics, which did not occur on 1.5T images, and resulted in altered spatial muscle activation calculations.
Study Four: Between limb differences in hip adductor spatial muscle activation patterns were Study Five: As a group, athletes with historical hip/groin pain had increased lumbopelvic lateral flexion and rotation away from the COD exit compared to those without, whereas individual graphical analysis identified 19 kinematic and five kinetic variables previously associated with hip/groin pain, leg injuries and poor load absorption, with only two variables observed in all athletes with historical hip/groin pain.
Overall, this thesis found athletes do not readily self-report experiencing hip/groin pain, which limited the sample sizes included in subsequent studies exploring movement strategies. It is suggested 1.5T magnet field strengths are used to investigate hip adductor spatial muscle activation patterns, especially in individuals with larger anthropometrics, to avoid inaccurate conclusions. Neither dominance nor hip/groin pain history appeared to alter hip adductor spatial activation patterns following running. Using 3D motion analysis to examine kinematics and kinetics in individuals may be beneficial and provide valuable insights to movement strategies that possibly contribute to hip/groin pain.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Newcastle
  • Snodgrass, Suzanne J, Principal Supervisor, External person
  • Edwards, Suzi, Co-Supervisor
  • Drew, Michael K, Co-Supervisor, External person
  • Schultz, Adrian, Co-Supervisor, External person
Award date15 Feb 2022
Place of PublicationAustralia
Publication statusPublished - 2022


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