HC Behandeling van liesblessures bij sporters Flashcards
Q: What are the main categories in the classification system for groin pain?
A:
- Adductor-related groin pain
- Iliopsoas-related groin pain
- Inguinal-related groin pain
- Pubic-related groin pain
- Hip-related groin pain
- Other causes
Q: What is characteristic of adductor-related groin pain in athletes?
- Tenderness in the adductor region
- Pain on resisted adduction
Q: How is inguinal-related groin pain identified?
- Tenderness in the inguinal canal
- No palpable inguinal hernia
- Pain with Valsalva, coughing, or sneezing
- Pain with resisted abdominal contraction
Q: What are the key signs of iliopsoas-related groin pain?
- Tenderness in the iliopsoas region
- Pain on resisted hip flexion
- Pain with hip flexor stretching
Q: Describe pubic-related groin pain.
- Tenderness at the pubic symphysis or adjacent bone
- No specific resistance tests
Q: What imaging is commonly used for groin pain and what are its advantages?
Ultrasound: Low-cost, dynamic, can correlate directly with symptoms, allows for immediate intervention
MRI: Useful for soft tissue and bone abnormalities
Q: What is the relationship between imaging findings and pain in athletes with adductor and pubic-related groin pain?
Many athletes show changes in the adductor and pubic bone regions, but these changes do not always correlate 1:1 with pain
Q: What is the recommended approach to treatment for adductor-related groin pain?
- Rehabilitation exercises
- Manual therapy and compression shorts as adjuncts
Q: What is the best treatment approach for inguinal-related groin pain when rehabilitation fails?
Surgical intervention (e.g., TEP, which has shown effectiveness in RCTs over rehabilitation)
Q: What factors are considered in the treatment approach for groin injuries?
- Load management
- Physical capacity
- Extrinsic factors (e.g., technique, environment)
Q: What are the phases of groin injury rehabilitation?
- Active flexibility
- Early activation
- Intensity progression
- Advanced sports-specific training
Q: How is hip-related groin pain identified?
- No specific test
- Hip joint range of motion
- Flexion, rotations, ab and adduction
- FABER test
- FADIR test
- Good for ruling out
Voordelen van echografie (CHO):
- Laagdrempelig en makkelijk toegankelijk
- Dynamisch onderzoek mogelijk (bijv. - Valsalva-manoeuvre, snapping hip)
- Directe correlatie met klachten mogelijk
- Mogelijkheid tot directe interventie tijdens het onderzoek
- Lagere kosten in vergelijking met andere beeldvormingstechnieken
Nadelen van echografie (CHO):
- Lagere resolutie bij diepere structuren in de lies (afhankelijk van de lichaamsbouw)
- Minder overzichtelijk bij moeilijk te lokaliseren klachten
- Niet geschikt voor het goed beoordelen van kraakbeen, botafwijkingen of andere intra-articulaire structuren
De behandeling voor adductor gerelateerde liesproblemen zijn?
- Load management
- Oefentherapie:
o Opbouwende intensiteit à beginnen met isometrisch, concentrisch, excentrisch - Extra mogelijkheden:
o massage -> doet veel pijn, om spierspanning te verlagen. Dit helpt de oefentherapie een handje
o liescompressiebroek -> zelfde prestaties, maar minder pijn bij trainin
