Knowledge of main malformative, degenerative, traumatic, tumor diseases of the musculoskeletal system, through the anamnesis, the semeiology and the instrumental diagnostics. Knowledge of main conservative and chirpical therapies. Knowledge of musculoskeletal anatomy and peripheral nervous and vascular systems, Physics, Physiology, General Pathology. Anatomical knowledge in particular of osteology, myology and the peripheral nervous system - Evaluation in kinesitherapy joint examination, muscle.. Knowledge of psychomotor development in the developmental age - Knowledge of orthopedic diseases in the developmental age. Congenital anomalies a.
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The secret is hidden in the term itself. That is the crucial point: to correctly identify the cause in order to correctly treat the pathology. This is far from obvious, and Jarvinen et al, 97 , have identified up to 72 different clinical entities, most of which concern muscular-tendon and osteo-articular disorders, but also infectious, vascular,or tumoral pathologies, bursitis, nerve entrapments, and others. All of this only confirms the fundamental importance of a correct diagnosis as an essential condition to plan a rational and effective treatment of the injury.
The pelvis Fig. It is delimited by four bones: two hip bones joined centrally by the pubic symphysis and separated dorsally by the sacrum, with which they are articulated, and the coccyx.
The pelvis includes four joints: two sacroiliac joints, the pubic symphysis and the sacrococcygeal joint. According to the literature, injuries of musculoskeletal or bone-ligament origin revealed by groin pain represent 5. Football includes many technical movements that can favour the symptoms: jumps, dribbling, changes of direction, slide tackle, are all factors that cause considerable strain in the pubic symphysis zone.
In his interesting study Busquet underlines that many years before pubalgia arises in football players, certain compensations can be perceived, mainly during kicking. It is important to emphasize the enormous work done in these compensations by the abdominals they contribute to the lifting of the pubic branches in the swing of the kick, to the dropping of the shoulders and a lumbar kyphosis as well , the iliopsoas which performs the rapid flexion of the hip in synergy with the rectus femoris and the adductors.
The excessive work of these muscles causes:. A long series of intrinsic and extrinsic factors that favour the onset of the symptoms has to be added to the above remarks. According to Bisciotti, possible intrinsic factors are:. In the meantime, in many cases pain will be relieved with ice pack applications at least twice a day for minutes maximum or non-steroidal anti-inflammatory drugs on medical advice or prescription only.
Complete rest is absolutely necessary at least until medical or physiotherapy evaluation, or until complete resolution of the symptoms.
The first approach is a conservative management that consists of an initial period of rest or limited activity, drug therapy and physiotherapy.
Physiotherapy may include physical treatments electrotherapy, laser treatment , manual techniques for the treatment of soft tissue and joint structures such as manipulations or mobilization Weir , Weir , exercise therapy to increase strength and improve coordination of the muscles that stabilise the hip and pelvis Weir , Verrall , Holmich Recent literature reviews indicate that manual therapy permits a quicker return to activity than exercise therapy; anyway, patients performing exercise for reinforcing abdominal and adductor muscles, stretching and functional exercises for the stabilization and coordination of the pelvis obtain better results than those receiving manual therapy Almeida , Marcon Here are a few key reasons why Coaches play a major role in shaping the lives of young people.
As the leaders of the soccer teams we work with, we Shooting is the most rapid and creative phase of football, where decision-making capacity has an essential I always start my lesson on stress by asking a question to my students: In your opinion, is stress a Groin pain in sportsman Groin pain in sportsman. What is groin pain and why is it often difficult to identify and treat? Some useful hints from our physiotherapist.
The recent Balotelli case drew renewed attention to a pathology that had not been mentioned since long in the panorama of professional football, i. Several muscular groups are present in the pelvis Fig. The abdominal muscles inserted at the pubic level are responsible for flexing the trunk, stabilization and fixing the pelvis during the movements of the lower limb; the gluteous muscles that assist in the extension of the hips and the upright position; the trochanter muscles so called because they originate on the pelvis bones and extend to the femur, and activate the movements of the thigh.
The muscles of the thigh are grouped as follows: hip flexors particularly the iliopsoas , extensors quadriceps in primis , flexors of the leg on the thigh ischio-tibials : The muscles of the medial region of the thigh have an adductor function, i. Pelvis muscles. Front view. Rear view. Anyway, if the elasticity of the posterior muscles is weak the player will try to defend them by increasing flexion of the knee , or limiting the flexion angle of the hip. Moreover, even if the width of the hip flexion decreases progressively, the player should keep wide to preserve shot strength.
All this is compensated with an adduction and internal rotation at the end of the shot. As pointed out by Busquet , any player could make use of one of these compensations during the game, but it is the regular repetition of these movements that should raise suspicion for the coach or the therapist of the team. According to Bisciotti, possible intrinsic factors are: A clear asymmetry of the legs; An excessive lumbar lordosis; A functional imbalance of abdominal and adductor muscles, i.
A pathology of the hip or of the sacroiliac articulation. In this sense, a training activity that considers the human body as a whole and is based on the knowledge and respect of physiological rules is the best preventive treatment Busquet Therefore, a functional overload should be avoided by means of the collaboration between the coach, trainer and physiotherapist in order to ensure peak physical conditions of the players and avoid that apparently trivial problems lead to a subversion of muscular equilibrium and pubic pain contractures, aching joints, etc.
According to Busquet , it is important to identify at-risk morphotypes, i. Health and Wellness. Injury recovery. Facebook Twitter LinkedIn. Related content.
Le catene muscolari. Arti inferiori
Busquet L. Kapandji A. Anderson and Behm. Sports Medicine 35 1 , Can J Appl Physiol ; 30 1 Akuthota V, Nadler SF.
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