Groin Assessment

External Rotation Stinchfield Test | Core Muscle Injury Assessment

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External Rotation Stinchfield Test

External Rotation Stinchfield Test | Core Muscle Injury Assessment

In another post, we discuss the Doha agreement on groin pain in athletes, which classified groin pain into 4 entities: adductor-related, iliopsoas-related, inguinal-related, and pubic-related groin pain. Core muscle injuries or CMIs aka. Athletic pubalgia which is traditionally known as a “sports hernia” would fall within the fourth entity – the pubic-related groin pain. They are characterized by abdominal wall weakening or tearing with no abdominal hernia and concomitant injury to the insertion of the adductor longus and rectus abdominis muscle on the pubis.

Kurowicki et al. (2020) proposed 3 tests to assess for CMIs in their diagnostic cohort study. As a stand-alone test, the external rotation Stinchfield test had a low sensitivity of 15% and specificity of 60% and thus has a weak clinical value in the diagnosis of CMIs due to the poor likelihood ratios and should be used in a cluster.

To conduct the test, the patient is in supine lying position. The patient’s leg on the affected side is in full extension and placed in external rotation. Then the patient is asked to lift the leg off the table against the examiner’s resistance.

Pubic or groin pain indicates a positive test.

Groin pain requires accurate differential diagnosis as other possible root causes such as femoroacetabular impingement syndrome, referred pain from the lumbar spine, or SI joint share similar symptoms. You can find out more about valid assessments for these regions on our channel as well. Again, special testing has limited value and should be integrated into a consistent history as well as positive diagnostic ultrasound findings.

Other common orthopedic tests that aim to provoke abdominal area are:

 

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References

Kurowicki, J., Kraeutler, M. J., Dávila Castrodad, I. M., Hahn, A. K., Simone, E. S., Kelly, M. A., … & Scillia, A. J. (2020). Diagnostic accuracy of physical examination tests in core muscle injury. The American Journal of Sports Medicine, 48(8), 1983-1988.

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