Our first guest blog!
This is the first in a series of posts highlighting a more holistic approach to Abdominal Core Health and some trusted partners whom our patients have given us great feedback about.
By Conor Nordengren, PT, DPT, CSCS
“At Boston Hernia, we hold a firm conviction that surgeons must pivot their attention from passively acknowledging chronic pain to actively striving to eliminate it as an accepted outcome.”
The above quotation is from one of Boston Hernia’s most recent blog posts. While it was written in the context of surgical approaches to inguinal hernia repairs, I think it applies to the medical profession as a whole. As a physical therapist, I regularly come across diagnoses where I feel chronic pain has become an accepted outcome. One such diagnosis is groin pain.
The team at Boston Hernia continues to be a leader in challenging traditional approaches to patient care. In my experience treating patients with groin pain, this is the approach that’s required as well. Many patients I see with this issue are concerned they won’t get better and that they won’t be able to resume the activities that bring them joy and fulfillment. However, if you’re suffering from groin pain and can’t seem to find relief, there is still hope; we just have to look at this condition differently.
The following are three of the steps I take when treating patients with groin pain. These three steps are foundational to my approach, and I’ve found them to be an effective and efficient way for patients to feel better and return to the activities they love.
Step 1: Knowledge
First, we must collect information to establish a starting point. As humans, we’re all put together a little differently, so there are variations in our individual structure. For example, the shape of our ribcage, curvature of our spine, orientation of our pelvis, and position of our hips aren’t the same from one person to another. These variations can be inherent but are also influenced by things like gravity and how we move through our environment.
As such, we develop habitual postures and patterns of movement. While good for efficiency in everyday life, they may not always be good for you physically and can contribute to pain.
To treat groin pain, the position and interaction between the ribcage, spine, pelvis, and hips must be considered. Certain presentations are more common, but each person should be evaluated individually and treated accordingly.
Step 2: Reposition
Once we have knowledge regarding ribcage shape, spinal position, pelvic orientation, and hip range of motion, we can begin to make changes. As I mentioned in Step 1, we all develop biases in our structure and in our movement. This is completely normal but can lead to issues if we get “stuck” in these patterns and postures.
We must expose the body to something different to change movement. The best way to do this is by selecting exercises that get the body in specific positions and then activating certain muscles while quieting others.
These exercises must be relatively easy at first to ensure they’re properly learned and executed. Once mastered, their level of difficulty is increased.
Step 3: Retrain
By now, we’ve made favorable changes throughout the ribcage, spine, pelvis, and hips that have decreased pain and created new opportunities for movement. To return to physical activity, we must ensure the body is adequately prepared for those demands.
At this stage in the rehab process, working on qualities like strength, power, and endurance becomes necessary. Importantly, they must be trained in the positions established in Step 2 so that the changes made are maintained and new movement patterns are reinforced.
The better these qualities are trained, the more the body will be able to tolerate the physical demands placed on it and the less likely pain and injury will recur.
Conclusion
A diagnosis of groin pain should not be accepted as something that will inevitably turn chronic. If you’re currently dealing with chronic groin pain, it also doesn’t mean that you can’t get better; it just means that you need a different approach. Being guided through the three steps above may be all that’s between you and an enhanced quality of life with less pain.
About the Author
Conor Nordengren, PT, DPT, CSCS is a physical therapist at PT PROGRESSION in South Natick, MA. He received his Bachelor of Arts in Health Science (2010) from Stonehill College and Doctor of Physical Therapy (2017) degree from the University of Massachusetts Lowell. Conor is also a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA).
Conor believes in an individualized approach to help his clients reach their goals in the safest, most efficient way possible. His unique skill set allows him to help his clients decrease pain, increase performance, and improve their quality of life. By blending aspects of rehabilitation, performance therapy, and training, Conor achieves the best possible outcomes for his clients.
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