Gilmore's Groin

[Nick]

Tomorrow I have an appointment with an injury rehabilitation centre. I have been given a diagnosis of Gilmore's Groin after a number of mis-diagnosis from other people.

They are confident it can be treated successfully without surgery which is a huge bonus for me. I was wondering if anybody here has (or knows somebody who has) recovered fully from this without surgery?

First discussions with the centre were very promising. The initial appointment is for a 1hr musculo-skeletal screening after which they will tailor a rehabilitation plan for me which I presume will involve a lot of core strengthening. I will then attend on a regular basis for 1-on-1 physical training. My problem appears to have been increased by a rolling of the pelvis due to weak hamstrings, unbalanced with stronger quads.

I've spent the last 3 months feeling quite sorry for myself and presuming I'll never play football again but all of a sudden, after that phone call, I'm feeling a lot more confident. Especially as they assured me that I would come back stronger and quicker than before!

If anybody is interested, I will post updates on my recovery and the techniques used. If any other UK-based sufferers want to know the details of the centre, feel free to message me.

Nick
England, UK

[Heidi]

Hi Nick,

I don't know anyone who has had this problem to be able to comment. However, it would be very interesting to hear what treatment you recieve and what progress you make.

[Nick]

Well, I've just got back from the first session/assessment. I was very impressed with the level of detail gone into and how they were not soley focused on my injury, more how problems in other areas may have caused/contributed to it.

After the assessment my diagnosis wasn't too promising. I appear to have severe problems with pelvic alignment. From what I understood it is caused by the pairing of muscles and how one of the pair is strong whilst the other is weak, causing the weaker one to effectively switch off (?). My quads are strong but my glutes and hamstrings are very weak. My lower back is strong but my stomach muscles are weak. To add to the problem, my right quads are stronger than the left.

The effect of this is that my pelvis is tilting forward, pulled down by the quads, but it is also rotating at the same time due to one side being stronger than the other.

When playing football, the twisting and turning is putting big loads on the pelvis.

I have been sent home with 3 exercises to perform as often as possible, which aim to isolate and activate the glutes and stomach. These are basic exercises mainly involving clenching which will hopefully 'wake the muscles up'. I'm due to return next week to see how things are going and possibly increase the level of movement.

I've been advised to stop all activities which involve twisting and turning but it is ok to keep running and cycling to maintain a level of fitness. I'm pretty down about having to stop playing football but am focussing on repairing myself to ensure I return next season in a much better condition.

I noticed that you're in Norwich Heidi. I am near Cambridge, not that far away. The treatment centre is called Core-Cambridge.com if you're interested in looking it up.

Right, I'm off to clench!

[Heidi]

Thanks Nick,

Thats really interesting. I think I may have heard of them before, looks and sounds good.

Everthing you have said about your assessment makes sense so I am confident you are heading in the right direction.

Keep us posted on your progress!

[Nick]

Heidi,

One thing that I don't understand is why I'm getting such a pain running from inside my left groin all the way to the back of my left knee. I understand the mechanics of pelvic alignment and how this can be improved, but will this alone stop the groin pain? I presume it's referred pain?

I've been examining my posture, in particular whilst walking and have noticed that I use my thighs for power whilst walking and the glutes don't seem to be activated at all. I can really notice the difference when I correct my walking posture. All of a sudden the glutes kick in and I'm much more upright in my stance. In this position, I'm not getting any pain except if I happen to turn direction which must be the extra load being applied to my pelvis, without the core strength to stabilise it.

[Heidi]

Hi, yes possibly referred pain from the pelvis area, or it may be from the groin muscles is they are under strain and being overworked due to the pelvis misalignment.

All the work you are doing with your exercises should improve this but it may take several weeks as it tends to be quite a slow progress. I think this is shown by the improvement when you actively contract your glutes and hamstrings.

[Nick]

Heidi, thank you for your input so far, your help/advice given in this forum is of enormous benefit.

I've just returned from my second session at the rehab clinic and have not come home with great news. They are particularly concerned with my syptoms and want me to get an MRI scan done. Suspicion of Ostitis Pubis was the main concern.

Unfortunately I don't have any private medical care and so I will either have to wait (an average 8 months) for a scan via the NHS or pay for it myself, which they estimated could be as much as £1,000.

I was also told that recovery from Ostitis Pubis is not guaranteed even if surgey is used and so I am potentially looking at hanging up my boots for good.

They've added a couple more exercises to my plan (the clam and hip pop-ups) with the aim of strengthening my glutes and core muscles, which will all be useful in a pre-op stage and hopefully put me in the right place for a good recovery post-op.

Is it possible to book/pay for an MRI scan privately as a one-off and if so how much is this likely to cost me? I will do some research into it and also quiz my union at work to see if there are any options to get this done quicker & cheaper.

[Nick]

A quick look on the internet and a couple of phone calls later... I can book an MRI privately for £350. Much less than the £1,000 suggested! They just need a letter from my GP. The clinic in Cambridge I'm attending is going to write to my GP to try to get me a scan on the NHS so I shall just ask my GP to forward that request to the hospital with his own referral. They operate on a "same week" basis so I shouldn't have to wait long at all.

Things seem a little better than 2hrs ago!

[Heidi]

Oh no, it all sounded so positive! Why the sudden change of heart and fear of osteitis pubis? Has there been a change in symptoms or something else picked up on in your second session?

Just try this: Perform a crunch (laying on your back raise your head, neck and shoulders off the ground). Is this at all painful or uncomfortable? The reason I ask is that in cases of osteitis pubis this can be painful as the abdominal muscles attach to the pubic symphesis (the area of pain and inflammation in osteitis pubis).

I would go with the NHS for now and see how long it takes and how any treatment in the mean time goes. If there is no improvement then go for the private scan.

[Nick]

I'm not really sure why the change to be honest. In the initial consultation they did say they were slightly concerned by a pain I was getting in the symphsis region but would re-assess after a week or so.

Going for a scan was almost the first thing he said when I went back for my second visit so I'm presuming he did some research or sought a second opinion. The purpose of the scan would hopefully be to eliminate rather than confirm any further fears.

I've just returned from my third appointment and having had a pretty good week pain wise, it was re-assuring to be told I was certainly make some progress, even if it is slow.

Performing any abdominal work is painful in the lower abdominal area, but not half as bad as it was 3 weeks ago. Although pain is easing and my range of motion is getting better (I can perform abduction exercises against resistance with only moderate discomfort) I am concerned that this is only due to the rest and any return to activity would take me back to square on. The pain I was getting in my pubis symphsis region was slightly off-centre, on my right side, but that has completely gone now. Up until today, I had been advised against any abdominal work, but they are happy for me to start a very light programme to hopefully stabilise my core.

I'm going to try to get referred for a scan privately as it would get done far sooner and hopefully put me back on the road to recovery quicker as treatment can be aimed directly at the results of the scan. The NHS wait here is quit long unfortunately and a generous parent has offered to pay, so I'd be silly not to take it up I guess.

Bumping into Phil Vickery (Engalnd rugby international) during my appointment certainly reassures me that they know what they are talking about and are highly regarded in their field!

[ambax62]

I suffered very similar symptoms to yourself back in 1995. Couldn't kick a football more than 15 metres. Problems with my gait.... I spent several months seeing specialist within NHS and had 2 MRI scans. Several course of physio and sports massage later...over a number of months and have to say any benefit was short lived. Ultimately I paid for surgery by Oliver Gilmore.... I have to say it was money well spent. Took me about 3 months to get back to total fitness but played football for at least another 6 seasons before old age finally caught up. Have also been playing squash and cricket since. Regretablly I think I have just suffered similar injury on my right side. Was hoping that someone in the NHS would now accept this injury and diagnosis. Would welcome comments from anyone who has found anyone on the NHS willing to carry out surgery. I wish you well with your treatment please let me know if it is successful. Andy

[Nick]

Hi Andy,

I'll be honest, reading your post was a little depressing! But only because I am convincing myself that I can overcome this with the correct phsyio. My symptoms have certainly eased off considerably in the past 3 weeks but I'm beginning to think this is more to do with rest than the exercises I am performing and that the problem will resurface as soon as I play football again.

On the other hand, the people I am seeing have successfully rehabilitated another chap with the same problem (but more severe) after only 7 months physio... no surgery at all. So there is hope.

I am finding that if I do antagonise the problem and get pain, that the pain will subside pretty quickly (normally overnight) rather than hanging about for 48hrs like it used to.

At the moment, I can only trust what they tell me and put faith in their experience. I continue to perform the exercises as often as possible. I have written off the rest of this season, with the aim of getting fit for next season at the earliest. That gives me a good 5 months of rest/rehab.

I'll keep this updated with any news as my treatment continues.

[Nick]

I'm going for an MRI scan on Monday, after getting it booked privately. I'm hoping the scan shows something so that treatment can be directed at it.

I've done an awful lot of research on the web into OP and it's amazing how many people are suffering from it and the various suggested treatments. I even saw one place recommending a heavy weight lifting regime, centred on the quads/adductors. It said to continue to exercise through the pain as that's what will heal it. With advice like that, it's no wonder people aren't getting better.

The general consensus appears to be that it is a problem which will heal itself over time, with total rest. However a programme of strengthening the muscles used to stabilise the pelvis and correcting any postural abnormalities could help it to heal quicker and would help to prevent a recurrence.

I am currently performing the following programme on a daily basis (twice a day if I get time):

-Warmup/Stretching of Hamstrings, Rectus Femoris & Hip Flexors
-Horse Stance Vertical 3x15
-Bridging 3x15
-Clam 3x15
-Lying Leg Lift 3x15
-Face Down Glute Raise 3x15

On less painful days I will also add in some adductor strengthening and gentle abdominal exercises.

The important factor is not to perform the exercise, but to perform it correctly. I think there are too many people on the net looking for a quick fix and just copying other people's programmes without having the movements explained correctly to them.

Unfortunately, this is an injury/condition which will take months rather than weeks to repair. I have written off playing football until at least September and will only go back when I am completely fit. In the meantime I've taken up coaching a local youth side which I hope will keep my interest in the game and give me an incentive and focus to keep doing the exercises and get back fit as soon as my body will allow.

The result from the scan should be available by the end of next week so I will report back then.