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Obturator Nerve Entrapment

A Cause of Groin Pain in Athletes

Olympic Park Sports Medicine Centre, Melbourne, Australia

Paul McCrory, FRACP FACSP FACSM

Olympic Park Sports Medicine Centre, Melbourne, Australia

Simon Bell, FRACS

Olympic Park Sports Medicine Centre, Melbourne, Australia

Peter Brukner, FACSP FACSM

Olympic Park Sports Medicine Centre, Melbourne, Australia

Chronic groin pain in athletes is often difficult to diag nose and treat. There are many anatomic structures in the inguinal and groin region that have the potential to cause pain. We report 32 cases of a previously unde scribed condition in athletes of "obturator neuropathy," a fascial entrapment of the obturator nerve where it enters the thigh. This condition represents a type of groin pain in athletes that is treatable by surgical means. There is a characteristic clinical pattern of ex ercise-induced medial thigh pain commencing in the region of the adductor muscle origin and radiating dis tally along the medial thigh. Needle electromyography demonstrates denervation of the adductor muscles. Surgical neurolysis treatment provides the definitive cure of this problem, with athletes returning to compe tition within several weeks of treatment. The surgical findings are entrapment of the obturator nerve by a thick fascia overlying the short adductor muscle. The role of conservative treatment in the management of this condition is unknown at present.

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