An Exercise-based Rehabilitation Program for a Recreational Long-distance Runner With Long-standing Groin Pain
A Pain-guided Rehabilitation Program in a Recreational Long-distance Runner With Long-standing Groin Pain: A Single-case Experimental Study
1 other identifier
interventional
1
1 country
1
Brief Summary
Groin injuries are among the most common injuries in sports that require changes of directions, shooting, passing etc, and are presented both as acute and long-standing. Although there are many exercise-based rehabilitation programs for long-standing groin pain in athletes, there is still the need for a more flexible pain-guided program based on specific progression and return to sport criteria. In addition, there is no much focus on less demanding sports such as track and field. The current study introduces a pain-guided rehabilitation program for a long-distance runner with long-standing groin pain.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for not_applicable
Started Jul 2026
Shorter than P25 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
July 21, 2026
CompletedStudy Start
First participant enrolled
July 22, 2026
CompletedFirst Posted
Study publicly available on registry
August 6, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 30, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
October 10, 2026
ExpectedSeptember 15, 2026
September 1, 2026
2 months
July 21, 2026
September 12, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (3)
Return to sport time
The time to return to sport is defined as the total number of weeks recorded from the date of the first rehabilitation session to the day the athlete fulfils the return to sport criteria.
Return to sport time is determined as the time (number of days) from the first rehabilitation session to the day the athlete fulfils the return to sport criteria. The estimated time of the rehabilitation completion is up to 12 weeks.
Adductor muscle strength
Maximum eccentric and isometric adductor muscle strength will be assessed with a mid-range unilateral supine isometric adduction test and an outer-range unilateral supine eccentric adduction test, following standardized procedures which have demonstrated good intra-tester reliability \[EHAD ICC 0.91 (0.70-0.98), SEM: 6.3%, IHAD ICC 0.78 (0.30-0.95), SEM: 7.3%\]. Strength values will be normalized to the athlete's body weight and recorded as Nm/kg.
Eccentric and isometric adductor muscle strength will be tested on weekly basis from baseline to the completion of the treatment. The estimated number of testing sessions throughout the intervention is 12.
Tissue tolerance
Tissue tolerance is defined as the maximum adductor strength generated when the athlete reaches a pain level of 2/10 of the NPRS, and will be assessed with the use of a bilateral squeeze test at 0° of hip and knee flexion. Strength values will be normalized to the athlete's body weight and recorded as Nm/kg.
Tissue tolerance will be evaluated on weekly basis from baseline to the completion of the treatment. The estimated number of testing sessions throughout the intervention is 12.
Secondary Outcomes (2)
Hip-related quality of life
Hip-related quality of life will be evaluated baseline and at the end of the rehabilitation. The estimated time for the intervention completion is 12 weeks.
Athlete's recovery perception
Subjective overall recovery perception will be evaluated on a weekly basis. Although the overall duration of the intervention cannot be defined due to the criteria-based nature of the progression, the estimated time for completion is 12 weeks.
Study Arms (1)
A single treatment
EXPERIMENTALInterventions
A pain-guided unsupervised rehabilitation program
Eligibility Criteria
You may qualify if:
- Male or female long-distance runner
- Long-standing groin pain (≥ 6 weeks)
- ≥ 18 years
You may not qualify if:
- \- Neurological or musculoskeletal condition which do not allow the athlete to perform the strength testing and the program intervention.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
University of West Attica
Athens, Athens, 12243, Greece
Related Publications (20)
Kontakiotis, N., Gioftsos, G. Translation into Greek, cross-cultural adaptation and test-retest reliability of the Global Perceived Effect Scale for use with patients with sciatica. Archives of Hellenic Medicine. 2022;39(3):381-7.
BACKGROUNDGriffin DR, Parsons N, Mohtadi NG, Safran MR; Multicenter Arthroscopy of the Hip Outcomes Research Network. A short version of the International Hip Outcome Tool (iHOT-12) for use in routine clinical practice. Arthroscopy. 2012 May;28(5):611-6; quiz 616-8. doi: 10.1016/j.arthro.2012.02.027.
PMID: 22542434BACKGROUNDStasi S, Stamou M, Papathanasiou G, Frantzeskaki P, Kanavas E, Evaggelou-Sossidis G, Gouskos A, Palantzas A, Poursanidis K, Macheras GA. International Hip Outcome Tool (12-items) as health-related quality-of-life measure in osteoarthritis: validation of Greek version. J Patient Rep Outcomes. 2020 May 27;4(1):41. doi: 10.1186/s41687-020-00207-8.
PMID: 32462334BACKGROUNDLight N, Thorborg K. The precision and torque production of common hip adductor squeeze tests used in elite football. J Sci Med Sport. 2016 Nov;19(11):888-892. doi: 10.1016/j.jsams.2015.12.009. Epub 2015 Dec 12.
PMID: 26750142BACKGROUNDThorborg K, Petersen J, Magnusson SP, Holmich P. Clinical assessment of hip strength using a hand-held dynamometer is reliable. Scand J Med Sci Sports. 2010 Jun;20(3):493-501. doi: 10.1111/j.1600-0838.2009.00958.x. Epub 2009 Jun 23.
PMID: 19558384BACKGROUNDBorg E, Borg G, Larsson K, Letzter M, Sundblad BM. An index for breathlessness and leg fatigue. Scand J Med Sci Sports. 2010 Aug;20(4):644-50. doi: 10.1111/j.1600-0838.2009.00985.x. Epub 2009 Jul 2.
PMID: 19602182BACKGROUNDSerner A, Weir A, Tol JL, Thorborg K, Lanzinger S, Otten R, Holmich P. Return to Sport After Criteria-Based Rehabilitation of Acute Adductor Injuries in Male Athletes: A Prospective Cohort Study. Orthop J Sports Med. 2020 Jan 29;8(1):2325967119897247. doi: 10.1177/2325967119897247. eCollection 2020 Jan.
PMID: 32064292BACKGROUNDHolmich P, Holmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med. 2004 Aug;38(4):446-51. doi: 10.1136/bjsm.2003.004754.
PMID: 15273182BACKGROUNDSerner A, Reboul G, Lichau O, Weir A, Heijboer W, Vuckovic Z, Boudreau SA. Digital body mapping of pain quality and distribution in athletes with longstanding groin pain. Sci Rep. 2022 Jun 13;12(1):9789. doi: 10.1038/s41598-022-13847-1.
PMID: 35697738BACKGROUNDWeir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, Lovell G, Meyers WC, Muschaweck U, Orchard J, Paajanen H, Philippon M, Reboul G, Robinson P, Schache AG, Schilders E, Serner A, Silvers H, Thorborg K, Tyler T, Verrall G, de Vos RJ, Vuckovic Z, Holmich P. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015 Jun;49(12):768-74. doi: 10.1136/bjsports-2015-094869.
PMID: 26031643BACKGROUNDYousefzadeh A, Shadmehr A, Olyaei GR, Naseri N, Khazaeipour Z. The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Holmich Protocol. Rehabil Res Pract. 2018 Mar 12;2018:8146819. doi: 10.1155/2018/8146819. eCollection 2018.
PMID: 29721339BACKGROUNDPaajanen H, Brinck T, Hermunen H, Airo I. Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman's hernia (athletic pubalgia). Surgery. 2011 Jul;150(1):99-107. doi: 10.1016/j.surg.2011.02.016. Epub 2011 May 5.
PMID: 21549403BACKGROUNDWeir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther. 2011 Apr;16(2):148-54. doi: 10.1016/j.math.2010.09.001. Epub 2010 Oct 16.
PMID: 20952244BACKGROUNDKachingwe AF, Grech S. Proposed algorithm for the management of athletes with athletic pubalgia (sports hernia): a case series. J Orthop Sports Phys Ther. 2008 Dec;38(12):768-81. doi: 10.2519/jospt.2008.2846.
PMID: 19047766BACKGROUNDHolmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, Krogsgaard K. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999 Feb 6;353(9151):439-43. doi: 10.1016/S0140-6736(98)03340-6.
PMID: 9989713BACKGROUNDMoran MW, Rogowski KR. HIP AND PELVIC STABILITY AND GAIT RETRAINING IN THE MANAGEMENT OF ATHLETIC PUBALGIA AND HIP LABRAL PATHOLOGY IN A FEMALE RUNNER: A CASE REPORT. Int J Sports Phys Ther. 2020 Dec;15(6):1174-1183. doi: 10.26603/ijspt20201174.
PMID: 33344033BACKGROUNDPippas C, Gioftsos G, Weir A, Karanasios S, Papandreou M, Serner A. Rehabilitation of Long-Standing Groin Pain in Athletes: A Scoping Review of Exercise Content and Reporting. J Orthop Sports Phys Ther. 2026 Jul;56(7):427-447. doi: 10.2519/jospt.2026.13708.
PMID: 42381618BACKGROUNDEdouard P, Branco P, Alonso JM. Muscle injury is the principal injury type and hamstring muscle injury is the first injury diagnosis during top-level international athletics championships between 2007 and 2015. Br J Sports Med. 2016 May;50(10):619-30. doi: 10.1136/bjsports-2015-095559. Epub 2016 Feb 17.
PMID: 26887415BACKGROUNDEdouard P, Feddermann-Demont N, Alonso JM, Branco P, Junge A. Sex differences in injury during top-level international athletics championships: surveillance data from 14 championships between 2007 and 2014. Br J Sports Med. 2015 Apr;49(7):472-7. doi: 10.1136/bjsports-2014-094316. Epub 2015 Jan 24.
PMID: 25618889BACKGROUNDSerner A, Tol JL, Jomaah N, Weir A, Whiteley R, Thorborg K, Robinson M, Holmich P. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med. 2015 Aug;43(8):1857-64. doi: 10.1177/0363546515585123. Epub 2015 May 14.
PMID: 25977522BACKGROUND
Study Officials
- STUDY CHAIR
George Gioftsos, Physiotherapy
University of West Attica
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NA
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- PhDc, MSc, OMPT
Study Record Dates
First Submitted
July 21, 2026
First Posted
August 6, 2026
Study Start
July 22, 2026
Primary Completion
September 30, 2026
Study Completion (Estimated)
October 10, 2026
Last Updated
September 15, 2026
Record last verified: 2026-09
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP
- Time Frame
- Beginning after study publication
- Access Criteria
- IPD and supporting information (raw data) will be available after request from the lead author
Strength raw data