Patients are often coming to us with pain in the groin or genital area, even without any gynecological, urological or surgical findings. And often times we don’t even find any structural damages or disorders. That is illustrated in the following case studies, where the patients were successfully healed thanks to the radial shock wave therapy.
CASE NO. 1
Pain in the right groin, lower belly and genital area
Patient (female), age 68, came to our clinic complaining about pain in her right groin, lower belly and genital area. Functional clinical examination revealed a wrong position of the pelvis. Right hip joint of the patient was fully mobile, but the inner rotation and adduction and extension of the leg was causing pain in the groin. We located the trigger points in the muscles located in the area of the hip (m. piriformis, m. obturatorius internus and m. obturatorius externus). For dealing with these trigger points we applied radial shockwave therapy. And physiotherapeutic techniques on imbalance causing the incorrect position of the pelvis.
Application of radial shock wave therapy to affect the m. piriformis located in the hip area is now widely spread, but we recommend to completely treat the same way also the inner rotators of the hip joint. Obturator muscles should be treated the same way.
Client is lying on his back during the therapy, legs should be relaxed, treated leg has to be bending in the knees and resting on the soles of the feet. Therapist is standing towards the client and palpates the attachments of the adductor muscles on the hip and pubic bone. The same way we treat the adductor muscle with radial shockwave.
We had four therapy sessions with patient no. 1. The patient was by fifth therapy already without any pain, and the positive effect of the therapy remained and now she is already living one year without any problem.
CASE NO. 2
Pain in the groin resulting from overload and rectocele
Fifty-two year old female visited us - football player with surgically treated groin hernia on the right side of the body. She described to us that the post-operational pain retreated in her right groin, but worsened condition in the left groin. She was at this moment diagnosed with rectocele which often occurs by athletes. Functional examination also proved that presence of trigger points in the muscles located in the hip area (m. piriformis, m gluteus medius, m. obturatorius internus and externus).
Thanks to radial shock wave we treated the trigger points and then we continued to work manually with the tension in the pelvic area.
Condition of the patient significantly improved and she is able to do sport again. She still continues to work on the remaining symptoms (most likely caused by rectocele) with physiotherapist.
In conclusion we can say that in case of patients who feel pain in the groin area without any obvious cause, thorough examination of the inner rotators of the hip joint is needed. In case of trigger point diagnosis, radial shock wave therapy in combination with application of kinesio tape proved to be very effective.
Here are few short and simple examples of exercise methods for relieving the pelvic area and stretching the groins and muscles in the hip area, which you can exercise at home.
Author: Mgr. Iva Bílková, FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience in private practice and physiotherapeutic field, FYZIOklinika