Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial

Man Ther. 2011 Apr;16(2):148-54. doi: 10.1016/j.math.2010.09.001. Epub 2010 Oct 16.


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.

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 = 0.043). Only 50-55% of athletes in both groups made a full return to sports. There was no difference between the groups in objective outcome (p = 0.72) or VAS during sports (p = 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / rehabilitation*
  • Chronic Disease
  • Combined Modality Therapy
  • Exercise Therapy*
  • Female
  • Groin*
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations*
  • Osteitis / rehabilitation
  • Pain / rehabilitation*
  • Prospective Studies
  • Single-Blind Method
  • Tendinopathy / rehabilitation