Straight Leg Sit-Up Test | Core Muscle Injury / Inguinal Hernia
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 straight-leg sit-up test had a sensitivity of 74% and low specificity of 20% 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 along with other tests (see below).
To conduct the test, the patient is in supine lying position. The patient is then instructed to lift both the extended legs and shoulders 20-25cm or 8 to 10 inches off the examination table.
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 in 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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