Experimental pain in the groin may refer into the lower abdomen

Implications to clinical assessments

M. K. Drew, T. S. Palsson, R. P. Hirata, M. Izumi, G. Lovell, M. Welvaert, P. Chiarelli, P. G. Osmotherly, T. Graven-Nielsen

    Research output: Contribution to journalArticle

    Abstract

    Objectives To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Design Repeated-measures design. Methods In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the adductor longus (AL) tendon to produce experimental groin pain or into the rectus femoris (RF) tendon as a painful control. Pain intensity was recorded on a visual analogue scale (VAS) with pain distribution indicated on body maps. Pressure pain thresholds (PPT) were assessed bilaterally in the groin area. Electromyography (EMG) of relevant muscles was recorded during six provocation tests. PPT and EMG assessment were measured before, during and after experimental pain. Results Hypertonic saline induced higher VAS scores than isotonic saline (p < 0.001), and a local pain distribution in 80% of participants. A proximal pain referral to the lower abdominal region in 33% (AL) and 7% (RF) of participants. Experimental pain (AL and RF) did not significantly alter PPT values or the EMG amplitude in groin or trunk muscles during provocation tests when forces were matched with baseline. Conclusions This study demonstrates that AL tendon pain was distributed locally in the majority of participants but may refer to the lower abdomen. Experimental adductor pain did not significantly alter the mechanical sensitivity or muscle activity patterns.
    Original languageEnglish
    Pages (from-to)904-909
    Number of pages6
    JournalJournal of Science and Medicine in Sport
    Volume20
    Issue number10
    DOIs
    Publication statusPublished - Oct 2017

    Cite this

    Drew, M. K., Palsson, T. S., Hirata, R. P., Izumi, M., Lovell, G., Welvaert, M., ... Graven-Nielsen, T. (2017). Experimental pain in the groin may refer into the lower abdomen: Implications to clinical assessments. Journal of Science and Medicine in Sport, 20(10), 904-909. https://doi.org/10.1016/j.jsams.2017.04.007
    Drew, M. K. ; Palsson, T. S. ; Hirata, R. P. ; Izumi, M. ; Lovell, G. ; Welvaert, M. ; Chiarelli, P. ; Osmotherly, P. G. ; Graven-Nielsen, T. / Experimental pain in the groin may refer into the lower abdomen : Implications to clinical assessments. In: Journal of Science and Medicine in Sport. 2017 ; Vol. 20, No. 10. pp. 904-909.
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    abstract = "Objectives To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Design Repeated-measures design. Methods In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the adductor longus (AL) tendon to produce experimental groin pain or into the rectus femoris (RF) tendon as a painful control. Pain intensity was recorded on a visual analogue scale (VAS) with pain distribution indicated on body maps. Pressure pain thresholds (PPT) were assessed bilaterally in the groin area. Electromyography (EMG) of relevant muscles was recorded during six provocation tests. PPT and EMG assessment were measured before, during and after experimental pain. Results Hypertonic saline induced higher VAS scores than isotonic saline (p < 0.001), and a local pain distribution in 80{\%} of participants. A proximal pain referral to the lower abdominal region in 33{\%} (AL) and 7{\%} (RF) of participants. Experimental pain (AL and RF) did not significantly alter PPT values or the EMG amplitude in groin or trunk muscles during provocation tests when forces were matched with baseline. Conclusions This study demonstrates that AL tendon pain was distributed locally in the majority of participants but may refer to the lower abdomen. Experimental adductor pain did not significantly alter the mechanical sensitivity or muscle activity patterns.",
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    author = "Drew, {M. K.} and Palsson, {T. S.} and Hirata, {R. P.} and M. Izumi and G. Lovell and M. Welvaert and P. Chiarelli and Osmotherly, {P. G.} and T. Graven-Nielsen",
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    Drew, MK, Palsson, TS, Hirata, RP, Izumi, M, Lovell, G, Welvaert, M, Chiarelli, P, Osmotherly, PG & Graven-Nielsen, T 2017, 'Experimental pain in the groin may refer into the lower abdomen: Implications to clinical assessments', Journal of Science and Medicine in Sport, vol. 20, no. 10, pp. 904-909. https://doi.org/10.1016/j.jsams.2017.04.007

    Experimental pain in the groin may refer into the lower abdomen : Implications to clinical assessments. / Drew, M. K.; Palsson, T. S.; Hirata, R. P.; Izumi, M.; Lovell, G.; Welvaert, M.; Chiarelli, P.; Osmotherly, P. G.; Graven-Nielsen, T.

    In: Journal of Science and Medicine in Sport, Vol. 20, No. 10, 10.2017, p. 904-909.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Experimental pain in the groin may refer into the lower abdomen

    T2 - Implications to clinical assessments

    AU - Drew, M. K.

    AU - Palsson, T. S.

    AU - Hirata, R. P.

    AU - Izumi, M.

    AU - Lovell, G.

    AU - Welvaert, M.

    AU - Chiarelli, P.

    AU - Osmotherly, P. G.

    AU - Graven-Nielsen, T.

    PY - 2017/10

    Y1 - 2017/10

    N2 - Objectives To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Design Repeated-measures design. Methods In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the adductor longus (AL) tendon to produce experimental groin pain or into the rectus femoris (RF) tendon as a painful control. Pain intensity was recorded on a visual analogue scale (VAS) with pain distribution indicated on body maps. Pressure pain thresholds (PPT) were assessed bilaterally in the groin area. Electromyography (EMG) of relevant muscles was recorded during six provocation tests. PPT and EMG assessment were measured before, during and after experimental pain. Results Hypertonic saline induced higher VAS scores than isotonic saline (p < 0.001), and a local pain distribution in 80% of participants. A proximal pain referral to the lower abdominal region in 33% (AL) and 7% (RF) of participants. Experimental pain (AL and RF) did not significantly alter PPT values or the EMG amplitude in groin or trunk muscles during provocation tests when forces were matched with baseline. Conclusions This study demonstrates that AL tendon pain was distributed locally in the majority of participants but may refer to the lower abdomen. Experimental adductor pain did not significantly alter the mechanical sensitivity or muscle activity patterns.

    AB - Objectives To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Design Repeated-measures design. Methods In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the adductor longus (AL) tendon to produce experimental groin pain or into the rectus femoris (RF) tendon as a painful control. Pain intensity was recorded on a visual analogue scale (VAS) with pain distribution indicated on body maps. Pressure pain thresholds (PPT) were assessed bilaterally in the groin area. Electromyography (EMG) of relevant muscles was recorded during six provocation tests. PPT and EMG assessment were measured before, during and after experimental pain. Results Hypertonic saline induced higher VAS scores than isotonic saline (p < 0.001), and a local pain distribution in 80% of participants. A proximal pain referral to the lower abdominal region in 33% (AL) and 7% (RF) of participants. Experimental pain (AL and RF) did not significantly alter PPT values or the EMG amplitude in groin or trunk muscles during provocation tests when forces were matched with baseline. Conclusions This study demonstrates that AL tendon pain was distributed locally in the majority of participants but may refer to the lower abdomen. Experimental adductor pain did not significantly alter the mechanical sensitivity or muscle activity patterns.

    KW - Adductor longus tendon

    KW - Athlete

    KW - EMG

    KW - Pressure pain sensitivity

    KW - Rectus femoris tendon

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    UR - http://dx.doi.org/10.1016/j.jsams.2017.04.007

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    JO - Australian Journal of Science and Medicine in Sport

    JF - Australian Journal of Science and Medicine in Sport

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