Dr. Miller: Your coach tells you you have a groin pull. Is that really what it is? We're going to talk about that next on Scope Radio.
I'm Dr. Tom Miller and I'm here with Dr. Travis Maak他是犹他大学的一名整形外科医生 Department of Orthopedics. Travis specializes in sports medicine. 特拉维斯，谈谈腹股沟疼痛的问题. 是腹股沟肌肉拉伤还是别的什么?
Groin Pulls & FAI
Dr. Maak: 这可能是，很多运动员都很习惯这种类型的伤害，他们的训练师或教练告诉他们，如果你是一名跑步运动员，你弯腰或跑步时就会爆炸. And all of a sudden, 你的腹股沟疼痛，你被告知你拉伤了腹股沟，你需要休息一段时间, stretch it, out walk it off, take some anti-inflammatories like Aleve, ibuprofen, Advil and when the pain goes away, you get back doing what you were doing.
是的，有些肌肉，在你看来，你可以在腹股沟里拉扯. Those are called the adductor muscles. They are on the inside of your hip. Frankly, multiple groin pulls are not common.
Dr. Miller: They're not common?
Dr. Maak: They're not common.
Dr. Miller: Contrary to what everybody hears.
Dr. Maak: That is true.
Dr. Miller: We always talk about a groin pull. For the audience, 我认为腹股沟拉伤是指你大腿内侧靠近骨盆的部位疼痛, right?
Dr. Maak: That is correct.
Dr. Miller: If it's not a pulled muscle, then what is it?
Dr. Maak: Well, 一个人有腹股沟拉伤的倾向，从小就有运动史，被告知他们拉伤了腹股沟, they pulled their groin, they pulled their groin and it never seems to get . . . 它会暂时消失，但很快又会回来. 另一种可能导致这种情况的诊断，叫做 femoral acetabular impingement or FAI.
Femoral Acetabular Impingement
Dr. Miller: That's a big word. What does it mean? What does that look like?
Dr. Maak: So the femur, that's the thigh bone
Dr. Miller: That's the big bone in the thigh?
Dr. Maak: That's the big hole in the thigh. 髋臼，是关节的窝或球和窝. 球是股骨，窝是髋臼. Just the two bones of the hip joint. 撞击是指两块骨头撞在一起.
Dr. Miller: They rub?
Dr. Maak: They rub.
Dr. Miller: When they rub, they cause pain.
Dr. Maak: That's exactly right.
Dr. Miller: Are certain people predisposed to this problem?
Dr. Maak: They are. 这似乎是北欧人的伤至少从骨头的形状来看是这样. 尽管它可能发生在任何种族或人群中. 有趣的是，大发娱乐也有一些证据表明，特定的运动让人们有患上这种疾病的风险.
Which Sports Can Lead to FAI?
Dr. Miller: Do tell, which ones?
Dr. Maak: 长曲棍球是一项发病率很高的运动，足球，曲棍球.
Dr. Miller: 现在，为什么是长曲棍球而不是篮球或足球?
Dr. Maak: Interesting question. 大发娱乐认为这与操纵杆的旋转有关. Part of this, 目前有一种理论认为这与髋关节的生长板有关随着时间的推移，小的生长板损伤会使你的髋关节形状有所不同.
Diagnosing a Pulled Groin or FAI
Dr. Miller: 如果发生这种情况，你就会感到疼痛和不适. 如何可靠地将其与拉伤的肌肉或肌腱区分开来你知道这是髋关节的问题.
Dr. Maak: Sure. So the history is actually fairly classic here. 所以虽然腹股沟拉伤最初的剧烈刺痛会很快发生, 特别是当你从街区爆炸或者你扭扭的时候，你会被擒住, 几天后疼痛就会消失，基本上就会恢复正常. With FAI, there's typically a subtle, continued discomfort, particularly when you sit for long periods of time. 如果你去健身房的时候，你的教练说, get down, 深蹲这个重量，每次你发现自己做不到的时候 . . .
Dr. Miller: Get discomfort.
Dr. Maak: Right.
Treatments for FAI
Dr. Miller: What do you do then? What are the treatments?
Dr. Maak: Well, the first treatment is physical therapy so athletic trainers are very good at this. Many physical therapists are as well. As long as you have the diagnosis, 去学习如何用不同的方式举起重物, 避免深蹲运动，加强臀部周围的肌肉以及一点消炎, like Aleve, ibuprofen, Advil can help you. 当这些都失败时，有时其他干预措施可以大发娱乐你.
Dr. Miller: 这对年轻运动员来说是一次改变游戏规则的机会吗?
Dr. Maak: 所以我可以告诉你，如果最终被诊断出来，运动员发现自己限制了他们的运动参与，因为他们的腹股沟在治疗时受伤了, the beautiful thing, while no one wants to get surgery, if it ends up getting surgery . . . 手术基本上是让髋部的球再次变圆，这是通过摄像机完成的. 它是微创的，有三个小洞. 然后你进去重塑这个球，让它再次变圆. It's curative, it does not return and effectively, 他们在没有疼痛的情况下以更高的水平恢复运动.
Dr. Miller: 一开始你要考虑的是这个问题被误诊的可能性. 那么对于腹股沟疼痛的运动员，你的建议是什么?
Dr. Maak: 第一件事可能是一开始不要担心. 如果这是你第一次被教练告知腹股沟拉伤, odds are you probably did. That being said, 如果它继续发生，你有一个，两个，三个，甚至四个腹股沟拉伤继续发生, 我的建议是给你的臀部拍个x光片. 没有什么比简单的髋关节x光片更花哨的了，你可以诊断出这个问题.
Dr. Miller: 他们完全可以通过他们的初级保健医生来做到这一点?
Dr. Maak: Absolutely.
Dr. Miller: So, in summary, this groin pain may not actually be a groin pain, 这可能是髋关节本身的撞击如果你有重复的腹股沟疼痛就应该检查一下.
Dr. Maak: That's exactly right.
updated: March 9, 2022
originally published: August 9, 2016
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