Groin injuries – introduction
| April 2, 2014 | Posted by Melinda under Uncategorized |
Yesterday during my run I got a very real life lesson on technical trail and groin muscle demands.
I hit the trails with Tess between downpours, anticipating a rather slow and mincing run over some rather sloppy footing.
The single track looked solid, but it was hard packed clay, and it was uneven. It was slick. Ridiculously slick. I didn’t actually fall down, but I spent a lot of time trying really hard NOT to brake (even if it meant momentum took me off the side of the trail onto vegetation), and keep my cadence high and my stride length short. Little quick steps that kept my center of gravity close. I wasn’t out of breath, I didn’t feel like I was working my muscles particularly hard. Overall my pace was slow and there were no spectacular flailings.
About 2 miles into the 3 mile run, the technical-ness of the trail wasn’t fun any more and I popped on the gravel road to finish off the run. Three miles in 40 minutes. I told you it was slow! And punctuated by lots of pauses to take pretty pictures of Tess.
So, overall a rather low key run in uneven footing in some slickness that required some fancy footwork. No big deal right?
Thirty min after the run my groin muscles (inner thigh, towards the front) were SORE. As I sat in the car I could barely bring my legs together. A rather simple, slow run produced some rather surprising (at least to me) effects. If I may brag a bit – I’m in pretty good shape right now. And I’ve been doing a lot of trails and a lot of technical trails. But all it took was a little bit of slick and not being able to run on the flattest part of the trail and having to hug the sides where vegetation grew for some additional traction on a rather short easy run for my poor weak groin muscles to speak up and complain.
Which is a perfect segway to the AERC convention seminar on groin and pectoral muscle injuries in our endurance horses.
Turns out that the “triangle” of injury that we classically learn about – more injuries lower, less frequent as you move up the leg – is based on race track data. And the text books written reflect this data.
In Dr. Marcella’s experience with sport horses, this triangle is upside down. Groin and pectoral injuries and other injuries “higher” up in the leg may not occur with less frequency, they just may be diagnosed less frequently – an important distinction. The pectoral muscles and the groin muscles are specifically worked in endurance – but may be overlooked because they are difficult to exam.
They are also difficult to exam in humans. During his presentation Dr. Marcella referenced human sports medicine data and exercise physiology to try and explain some of what is occurring in our horses. There isn’t horse data and we since have to start somewhere and in his words “human(s) are light years ahead of the horse” in exercise, it’s reasonable to try and (carefully) fill in the holes of our equine knowledge with what we know in humans.
Anyways. Diagnosing these sorts of muscle pulls is difficult. Turns out palpation, xray, nerve blocks, nuclear scans, and flexion tests are on the long list of “no help”. MRI is how it’s done in humans – but MRI’s are no good in horses in these areas. Ultrasound may be some help….but not in the the lower grade injuries.
So, what do we do with something that is difficult to diagnose and difficult to evaluate?
We ignore it.
Because we know that always works out so well in our endurance horses.
*eye roll*
As I sat listening to this presentation, I was reminded of 2 things that we all must keep in mind when evaluating information or dogma (such as lameness in horses)
1. We put a lot of emphasis on what we can measure (difficult to measure – we tend to ignore it).
2. Where the data comes from is important. I had no idea that much of what we know about lameness comes from the race track even though it makes sense – that’s where the volume of animals and the money is. But just like how I run down the trail doesn’t have a huge similarity to the 200 meter dash; sprinting around a track for a couple miles and a 50 mile endurance ride over technical terrain differ in important ways too.
The current equine dogma is that “groin pulls do not occur in horses”. Same thing for pectoral muscle injuries. Is this the truth?
He showed us pictures of horses doing amazing feats that were going well – jumping, sprinting, barrel racing, cutting, going up cougar rock. Muscle’s bulging, athletic prowness etc.
And then…he showed pics of things NOT going well. Horses falling, riders falling. Endurance horses slipping and going ass over teakettle while desperately maintaining their balance. He showed naughty horses in turn out doing all sorts of antics – including antics gone wrong.
And he asked the question – does trauma to these muscles really not occur?
Obviously he has the data to prove that they do occur, but Dr. Marcella spent sometime making sure we were convinced too.
Groin injuries, while hard to diagnose in humans, are not uncommon. In soccer 31% of injuries are muscular injuries. Muscular injuries often turn into small nagging injuries that take time to heal. 23% of soccer injuries are groin injuries – I can’t remember if it’s 23% of total injuries or 23% of the 31%, but the point was that groin injuries aren’t infrequent.
Even though applying human ultrarunning concept to endurance horses in terms of training and conditioning can be helpful, it turns out there are other human sports that are more similar/helpful for INJURIES that we see in endurance horses – such as ice hockey. Ice hockey players especially move their legs like the hind legs horse – from the inside out – which means they build muscles in a way that puts them at the same risk for the same sort of injuries. 27% of ice hockey injuries are groin injuries.
Other human sports most likely to injure the groin are – ice skating, ice hockey, soccer, swimming. The SAME areas are being stressed. (in addition to “horse sports gone wrong” he showed pics of these human sports gone wrong and boy oh boy….the stresses that go on during both normal and abnormal situations is amazing).
Time to go to bed. We will continue on this subject tomorrow.
I literally squee’d when I saw the title of this post. I’ve been eagerly awaiting your synopsis on that lecture! It was hands down my favorite of all the lectures available at the convention.
Mine too!!! He was GREAT. So jealous that you guys get to have him at your east coast events. 🙂
Great post, and thanks again for showing us the upper hind end checks, though it may take a refresher at Derby 😉
I may ask you to video me doing a check since it’s the one REALLY cool thing in this presentation that I’m not sure i’m going to be able to explain in pictures and words.
Very happy for this topic! 🙂 Working with groin pulls as an MT is really challenging, and I have the benefit of a Dr or PT diagnosing it for me and clients that talk in words. The slippy trails can suck – that’s what had me DNF at Sonoma50 “Ooh grassy downhill. Oh F*ck it’s wet and there goes my trail”. Bam, hip sublaxation 🙁
Horses and hockey? Oh, bliss!