Manual Therapy for the Treatment of Athletic Pubalgia

Effects on Pain Anda Range of Motion of High Force Lateral Distraction Mobilization of the Hip in Athletes With Hip-related Groin Pain. A Randomized Controlled Trial.

Athletic osteitis pubis is a high prevalent pathology among athletes, especially in those who make quick change of direction of the movement, like runners or footballers. Despite the fact that there is evidence about conservative treatments, there is a lack of evidence about manual therapy (MT) techniques applied in isolation and its consequences in pain and range of movement. The investigators decided to conduct a randomized controlled trial to compare the effects of a MT technique with placebo technique.

Study Overview

• Status: Completed
• Conditions: Osteitis Pubis
• Intervention / Treatment: Other: High force hip Lateral distraction; Other: Placebo force hip lateral distraction

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Soria, Spain
    • Silvia Lahuerta Martín

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Athletes diagnosed with osteitis pubis stage 1 with at least 3 months of evolution.
• Internal rotation ROM limited.
• Positive provocation pain tests.

Exclusion Criteria:

• Pain due to intraarticular hip pathology.
• Hip pain due to inflamatory diseases.
• Previous surgical interventions in hip, pelvis or lumbar spine.
• MRI results or provocation pain tests inconcluyent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lateral distraction group; High force lateral distraction of affected hip.	Other: High force hip Lateral distraction; Hip lateral distraction in adjusted position of maximun flexion and internal rotation, with neutral position of abduction/adduction applying high force of distraction.
Sham Comparator: Placebo distraction group; Placebo lateral traction of affected hip.	Other: Placebo force hip lateral distraction; Hip lateral distraction in adjusted position of maximun flexion and internal rotation, with neutral position of abduction/adduction applying placebo force of distraction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Actual PAIN	actual pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse.	Baseline
Actual PAIN	actual pain reported by the patient using visual analog scale (VAS)from 0 to 10, in which higher scores are worse.	after to two weeks of treatment
Last week PAIN	past week pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse.	Baseline
Last week PAIN	past week pain reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse.	after to two weeks of treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional capacity	Evaluated with a patient reported outcome questionnaire called Copenhagen Hip and Groin Outcome score (HAGOS) which assesses pain, symptoms, physical function in daily living, physical function in sport and recreation, participation in physical activities and hip and groin -related quality of life. For each item answer range from "never" to "always".	Baseline
Range of Movement (ROM)	Hip ROM as described by Pua et al. (2008)	Baseline
Range of Movement (ROM)	Hip ROM as described by Pua et al. (2008)	after to two weeks of treatment
Global Rating of Change	Subjective impression as described in GROC scale by Jaeschke, Singer & Guyat (1989)	after to two weeks of treatment
Group of treatment assignment	Question about which group of treatment was the patient assigned in.	after to two weeks of treatment
Pain in sport activities	Appearance time of pain during activities	Baseline
Pain in sport activities	Appearance time of pain during activities	After two weeks of treatment
Pain intensity in pain provocation tests: Single adductor, squeeze and bilateral adductor tests	Appearance of pain during or after the execution of Single adductor, squeeze and bilateral adductor tests. If pain appears it will be reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse.	Baseline
Pain intensity in pain provocation tests: Single adductor, squeeze and bilateral adductor tests	Appearance of pain during or after the execution of Single adductor, squeeze and bilateral adductor tests. If pain appears it will be reported by the patient using visual analog scale (VAS) from 0 to 10, in which higher scores are worse.	After two weeks of treatment
Muscle function	Velocity (m/s), force (N) and power (W) evaluated for internal and external hip rotators with a rotary axis flywheel-encoder system.	Baseline
Muscle function	Velocity (m/s), force (N) and power (W) evaluated for internal and external hip rotators with a rotary axis flywheel-encoder system.	After two weeks of treatment
Functional capacity	Evaluated with a patient reported outcome questionnaire called Copenhagen Hip and Groin Outcome score (HAGOS) which assesses pain, symptoms, physical function in daily living, physical function in sport and recreation, participation in physical activities and hip and groin -related quality of life. For each item answer range from "never" to "always".	After two weeks of treatment
Treatment credibility and expectancy	Evaluated with Credibility and expectancy Questionaire (CEQ) in which the patient answer question related to the expectations of the intervention. Higher values mean better expectations on the therapy.	Day 1, before treatment

Collaborators and Investigators

• Sponsor: University of Valladolid
• Investigators: Principal Investigator: Silvia Lahuerta Martín, University of Valladolid

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2023
• Primary Completion (Actual): October 30, 2025
• Study Completion (Actual): October 30, 2025

Study Registration Dates

• First Submitted: January 16, 2023
• First Submitted That Met QC Criteria: January 25, 2023
• First Posted (Actual): February 3, 2023

Study Record Updates

• Last Update Posted (Actual): March 25, 2026
• Last Update Submitted That Met QC Criteria: March 20, 2026
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Bone Diseases; Osteitis
• Other Study ID Numbers: CASVE-NM-22-623

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No