Groin pain in athletes and non-interventional rehabilitative treatment: a systematic review.

Groin pain is a frequent problem in athletes, but there has been no strong agreement on which non-surgical rehabilitation approach works best. This systematic review searched several major databases for studies, mostly randomized clinical trials, comparing different non-interventional treatments for athletic groin pain, from passive therapies to active exercise programmes and multi-modal strategies. The included trials consistently suggested that active treatment outperformed passive treatment for improving clinical signs, and that combining active and passive elements into a multi-modal programme led to a faster return to sport than active treatment alone. An integrated approach, pairing active and passive treatment with pain monitoring, a structured return-to-running plan, and sport-specific exercise, appeared most consistently effective across the literature.

However, the authors are explicit that the evidence remains limited, and they were unable to translate these patterns into firm clinical guidelines, calling for further research to define an optimal treatment algorithm.

If you've dealt with groin pain as an athlete, you know how frustrating and hard to pin down it can be. Researchers wanted to know which non-surgical rehab approaches actually help, so they pulled together findings from existing studies, mostly clinical trials, comparing passive treatments like rest or manual therapy to more active approaches like targeted exercise, and to combined programmes using both.

The pattern across these studies was that doing active exercises tended to help more than passive treatment alone, and combining active exercise with passive treatment, along with tracking pain and gradually building back up through running and sport-specific drills, seemed to get people back to sport faster than active exercise by itself. That said, the researchers are upfront that the overall quality and amount of evidence is still limited, so they couldn't lay out firm treatment guidelines. This is a summary of patterns across studies rather than a tested, proven protocol.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This review speaks to a common clinical uncertainty: which non-interventional strategy best supports athletes with groin pain, given the absence of strong evidence favouring either conservative or surgical management. Drawing on database searches from 1997 to 2017, the authors synthesised findings largely from randomized clinical trials comparing passive, active, and multi-modal rehabilitation approaches. The synthesis indicates that active treatment produced better improvement in clinical signs than passive treatment, and that multi-modal programmes combining active and passive components enabled faster return to sport than active treatment alone, though the abstract does not report the statistical strength of these comparisons.

An integrated strategy incorporating active and passive work, pain monitoring, a return-to-running progression, and sport-specific exercise emerged as a recurring theme across the included literature, but this reflects a pattern across studies rather than a tested combined protocol with its own evaluated effect. Critically, the authors themselves describe the evidence as poor and state they could not derive practice guidelines. The abstract does not specify the number or risk of bias of included studies, so this should be read as hypothesis-generating rather than a basis for a defined treatment algorithm.