#024 – The Role of the Ankle in Groin Pain

I used to have a very myopic view of groin pain.

Earlier in my career, I used to struggle with helping people with groin pain. I did all the things we were taught in school – hip mobility, groin strength, core strength. They did all the hip CARs, Copenhagens and side planks. Still, some of these clients didn’t get better. It really left me scratching my head, wondering where I was going wrong.

Then I heard a quote by Ed Gagnon of the Buffalo Sabres that completely changed how I viewed the hip & groin. 

“The ankle is the force transducer for the hip”.

 

Ever since then, I’ve included the foot/ankle as a part of all hip & groin assessments.

I didn’t appreciate the importance of the kinetic chain until I started assessing the ankle. If you have athletes dealing with groin pain, a small group of them will not get better if you don’t check the ankle.

Once you begin checking the ankle, you will gain the trust of so many more of your athletes. They will have seen multiple practitioners who gave them groin stretches and Copenhagens. But none will have checked their ankles until you. You’ll be the one to help get them out of groin pain, and they will come back to you for every other problem they have.  

Now, here’s what you need to look for in the ankle that is likely contributing to chronic or recurring groin pain.

#1. Ankle Dorsiflexion.

Limited ankle dorsiflexion has been correlated with:

    • Increased anterior pelvic tilt

    • Increased pelvic drop

    • Increased hip flexion

Greater hip flexion and adduction during high-speed cutting tasks will change joint forces across the hip and pelvis. 

There is evidence suggesting these changes can increase the strain on the hip, which might be the cause of groin pain in a lot of athletes. 

#2. Ankle elastic ability.

Athletes with groin pain tend to have longer ground contact times during plyometric tasks.

This might be due to:

    • Reduced elastic ability

    • Compensation to reduce hip joint forces

Longer contact times can lead to greater muscle work by the groin muscles through a higher range of hip motion.

Lower body elastic ability plays a role in contact times during plyometrics. This includes the ankle. 

Increase ankle elastic ability = lower groin muscle load

Now, I hope after reading this you can appreciate the value of looking at the ankle in athletes with groin pain. I know it’s been a game changer for me, and I know it will be for you. 

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