These injuries are very common in athletes , about 60% of football players will suffer this type of injury at some point in career.
Athletes can begin to lose range of motion in their hips, and is an early sign for this type of injury.
Because there are several factors at play , you should be able to trace a Kinetic Chain of events in the case history.
1. they place more force on their hips
2. if they are growing rapidly eg 12 to 16 years old, they may suffer a mild slipped capital epiphysis or similar 'growth injury'. These can gradually grow into a hip 'deformity', further restricting range of motion and potentially Aggravating the labrum.
3. All the above could be the factor that causes the labral tear
4 . They will develop a weaker abdominal wall, and secondary adductor pain. Further aggravating problem.
5. Look for restricted joints that should be more mobile especially hip, ankle , shoulders.
So you may have a client come in who demonstrates all these points or just some of them. like the venn diagram shows, groin / hip / adductor pain involves several structures like a true kinetic chain injury. It is thought the injury complex stems from our evolution as quadrupeds who became bipeds dependent on the hip and the gluteus to keep us erect.
History and Diagnosis: Can be challenging because it's easy to focus on only one body part.
After taking a detailed history, speak to trainers (essential)and others who may have worked with the athlete to get their perspectives. Then begin a careful physical examination.
Ask the patient to do some crunches and see if there is pain. Then have the patient do a crunch with the leg in slight flexion. That puts a little load in certain areas of the abdomen. Next, have the patient crunch with a leg in flexion and adduction against resistance, this combines hip/thigh musculature and abdominal function together. These problems are almost always multifactorial.
Get patient to do action that makes it really hurt
Do fundamental movement exam
Record: movements that are the most painful and tender
From this point a picture should be forming of the main aggravating factors and the activities the athlete is unavble to do. This will help you narrow down why they developed the problem in the first place and how you will go about treating / rehabilitating it.