Evaluating the Prevalence of Signs and Symptoms Associated With Hip-Related Groin Pain in Youth Ice Hockey and Ringette, Part 1: A Reliability and Cross-Sectional Study.

OBJECTIVES

This study aimed to investigate the prevalence of hip-related groin pain (HRGP), and femoroacetabular impingement (FAI) syndrome-related signs and symptoms, in ice hockey and ringette athletes, considering important covariables (eg, age, sex).

DESIGN

Intra and interrater reliability and cross-sectional.

SETTING

University, Sport Medicine Centre.

PARTICIPANTS

Male and female ice hockey/ringette athletes at 14 to 24 without a history of traumatic hip/pelvic injuries/surgeries.

INTERVENTIONS: Novel screening for the assessment of HRGP and signs and symptoms associated with FAI syndrome.

MAIN OUTCOME MEASURES: HGRP-focused hip history questionnaire, International Hip Outcome tool, clinical hip screen (hip passive range of motion (ROM), p-ROM; hip muscle strength testing; hip impingement special tests).

RESULTS

HRGP was reported by 61% of participants [105/166 (63%) male, 60/104 (57%) female]. Men with HRGP had reduced ROM in flexion (with = 124 degrees, 95% CI, 122-125 degrees; without = 126 degrees, 95% CI, 124-127 degrees, t = 1.81, P = 0.04), adduction (with = 26 degrees, 95% CI, 25-27 degrees; without = 28 degrees, 95% CI, 27-29 degrees; t = 0.21, P = 0.01), and internal rotation (with = 31 degrees, 95% CI, 30-33 degrees; without = 34 degrees, 95% CI, 33-35 degrees; t = 2.86, P = 0.002) compared with male without HRGP. Both male and female with HRGP reported up to 5-fold increased odds of positive findings on impingement tests compared with those without HRGP [flexion-adduction-internal rotation (FADIR): male, odds ratio (OR = 2.84, 95% CI, 1.73-4.69; female OR = 5.37, 95% CI, 2.21-14.87)]. When modelled and fit with other covariates, FADIR (OR = 0.76, 95% CI, 0.51-1.12) and maximal squat distance (OR = 1.69, 95% CI, 1.30-3.60) increased odds of having HRGP. International Hip Outcome scores (OR = 0.96, 95% CI, 0.95-0.98) displayed an inverse relationship with HRGP.

CONCLUSION

Findings from this study provide evidence to support the use of hip screening in athletes at risk of FAI syndrome. Challenges to the assessment of the hip joint continue to limit the reliability of screening tools.