Continued significant effect of physical training as treatment for overuse injury: 8- to 12-year outcome of a randomized clinical trial

BACKGROUND: The treatment of exercise-related injuries is often a problem, and recurrent injuries are common. Two recent systematic reviews found only one high-quality paper on the treatment of long-standing groin pain. In this randomized clinical trial, a training program including strength training resulted in a return of 79% of the athletes to the previous level of sport without any groin pain. The long-term effect of this exercise program was evaluated.

HYPOTHESIS: The effect of the exercise program for adductor-related groin pain is long lasting.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.

METHODS: Forty-seven (80%) of the 59 original participants of the study agreed to participate in this 8- to 12-year follow-up. They were all interviewed and examined using a standardized and reproducible protocol, identical to the one used in the original trial. The investigating physician (P.N.) was not involved in the original study and was unaware of the original treatment allocation.

RESULTS: A significant effect of the active training treatment still existed for the whole group (P = .047) and even more for the subgroup of 39 (83%) soccer players (P = .012). No significant differences were found regarding age, present sports activity, reasons for activity reduction, or time to follow-up.

CONCLUSION: The beneficial short-term effect of the exercise program used in the primary randomized clinical trial for treating long-standing adductor-related groin pain in athletes was found to be lasting, both for the whole group and even more for the large subgroup of soccer players. This is the first time an exercise treatment for overuse injuries to the musculoskeletal system has been shown to have a long-lasting effect (8-12 years).