Research

Dr Garvey has a Groin Pain database of over 2500 patients dating back to August 1990. He is currently undertaking clinical research on the following subjects:

  • Sports Hernia and Footballers Groin injury
  • Peripheral nerve entrapment
  • Injured workers recovery and return to work rate
  • Post-hernia Groin Pain Syndrome
  • Non-operative management of groin injuries

Research Projects

  • Consultant investigator: Predictors of groin strain injury across four football codes.
    Research project conducted with Dr Lesley Nicholson Dept of Physiotherapy Sydney University and Ms Amanda Turner
  • Genetic susceptibility to Sports Hernia.
    Collaboration with Dr Vincent Higgins, School of Biotechnology and Biomolecular Sciences (BABS), The University of New South Wales, Sydney

Preliminary results have been presented at the following International Meetings:

  • 2nd International Hernia Congress London 2003
  • American Hernia Society Hernia update Scottsdale (AZ) 2008
  • 4th International Congress of the Asia-Pacific Hernia Society Beijing 2008
  • 4th International Hernia Congress Berlin 2009

Garvey JF, Hazard H. Sports hernia or groin disruption injury? Chronic athletic groin pain: a retrospective study of 100 patients with long-term follow-up. Hernia. 2014;18(6):815-23.

INTRODUCTION AND OBJECTIVES:
Chronic groin pain (athletic pubalgia) is a common problem in sports such as football, hockey, cricket, baseball and athletics. Multiple co-existing pathologies are often present which commonly include posterior inguinal canal wall deficiency, conjoint tendinopathy, adductor tendinopathy, osteitis pubis and peripheral nerve entrapment. The mechanism of injury remains unclear but sports that involve either pivoting on a single leg (e.g. kicking) or a sudden change in direction at speed are most often associated with athletic pubalgia. These manoeuvres place large forces across the bony pelvis and its soft tissue supports, accounting for the usual clinical presentation of multiple symptomatic abnormalities forming one pattern of injury.

RESULTS:
The diagnoses encountered in this series of 100 patients included rectus abdominis muscle atrophy/asymmetry (22), conjoint tendinopathy (16), sports (occult, incipient) hernia (16), groin disruption injury (16), classical hernia (11) traumatic osteitis pubis (5), and avulsion fracture of the pubic bone (4). Surgical management was generally undertaken only after failed conservative therapy of 3-6 months, but some professionals who have physiotherapy during the football season went directly to surgery at the end of the football season. A variety of operations were performed including groin reconstruction (15), open hernia repair with or without mesh (11), sports hernia repair (Gilmore) (7) laparoscopic repair (3), conjoint tendon repair (3) and adductor tenotomy (3). Sixty-six patients were available for follow at an average of 13 years after initial consultation and the combined success rate for both conservative treatment and surgery was 94%.

CONCLUSION:
The authors believe that athletic pubalgia or sports hernia should be considered as a 'groin disruption injury', the result of functional instability of the pelvis. The surgical approach is aimed at strengthening the anterior pelvic soft tissues that support and stabilise the symphysis pubis.

Dr John Garvey

Suite 301, 3rd Floor
BMA House
135 Macquarie Street
SYDNEY NSW 2000
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