Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series

Am J Phys Med Rehabil. 2008 Nov;87(11):890-902. doi: 10.1097/PHM.0b013e31818377b6.


Objective: To obtain multisport and long-term outcome data from the use of regenerative injection therapy on career-threatened athletes.

Design: Consecutive enrollment of elite performance-limited athletes with chronic groin/abdominal pain who failed a conservative treatment trial. The treatment consisted of monthly injections of 12.5% dextrose in 0.5% lidocaine in abdominal and adductor attachments on the pubis. Injection of the nociceptive source was confirmed by repetition of resistive testing 5 mins after injection.

Results: Seventy-five athletes were enrolled. Seventy-two athletes (39 rugby, 29 soccer, and 4 other) completed the minimum two-treatment protocol. Their data revealed a mean groin pain history of 11 (3-60) mos. Average number of treatments received was 3 (1-6). Individual paired t tests for Visual Analog Scale (VAS) of pain with sport (VAS Pain) and Nirschl pain phase scale measured at 0 and an average of 26 (6-73) mos indicated VAS Pain improvement of 82% (P < 10) and Nirschl pain phase scale improvement of 78% (P < 10). Six athletes did not improve following regenerative injection therapy treatment, and the remaining 66 returned to unrestricted sport. Return to unrestricted sport occurred in an average of 3 (1-5) mos.

Conclusions: Athletes returned to full elite-level performance in a timely and sustainable manner after regenerative injection therapy using dextrose.

Publication types

  • Clinical Trial

MeSH terms

  • Athletic Injuries / drug therapy*
  • Athletic Injuries / rehabilitation
  • Cartilage / drug effects
  • Cartilage / injuries
  • Cohort Studies
  • Glucose / administration & dosage*
  • Groin / injuries*
  • Humans
  • Injections
  • Ligaments / drug effects
  • Ligaments / injuries
  • Ligaments / physiology
  • Male
  • Pubic Symphysis / drug effects
  • Pubic Symphysis / injuries
  • Recovery of Function
  • Regeneration*
  • Tendinopathy / drug therapy*


  • Glucose