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Operative Hip Arthroscopy - part 4

Tầm quan trọng của phần còn lại và không qua đào tạo có thể được chú trọng tương xứng. Các triệu chứng kéo dài từ vài tuần đến MỘT SỐ months.2, 17,23,31 và cộng sự báo cáo Fricker al.9 đầy đủ phục hồi bình quân 9,5 tháng 7,0 tháng ở nam giới và phụ nữ Sau khi điều trị bảo thủ. Một nghiên cứu của Holt và cộng sự tìm thấy al. | CHAPTER 5 EXTRAARTICULAR SOURCES OF HIP PAIN 75 ultimately challenging the physician patient trainers and coaching staff. The importance of rest and cross-training cannot be overemphasized. The symptoms last from several weeks to months.2 17 23 31 Fricker et al.9 reported full recovery averaged 9.5 months in men and 7.0 months in women after conservative treatment. A study by Holt et al.17 found that patients returned to full activities within 16 weeks after conservative treatment. The mainstay of treatment for athletic osteitis pubis remains nonop-erative.2 4 8 17 The full spectrum of conservative measures has been documented and includes rest physical therapy ultrasonography nonsteroidal antiinflammatory medication oral glucocorticoids bracing radiation therapy anticoagulation and corticosteroid injections into the pubic symphysis.1 2 4 17 26 The effectiveness of the majority of these treatments has not been validated scientifically. In the athlete the first line of treatment should be reducing the activity level. Choosing nonpainful and nonimpact exercises is central in the treatment. Shock-absorbing footwear may also diminish the shear forces across the symphysis pubis. Stretching exercises of the trunk and lower extremity should be done paying particular attention to hip range of motion and adductor stretching and strengthening.31 A study by Harris and Mur-ray4 of 37 athletic patients found that spontaneous remission was the most likely outcome and that rest from physical exertion was the most effective treatment. The ideal physical therapy program has not been clearly determined for osteitis pubis. For patients with chronic adductor-related groin pain active physiotherapy training with a training program aimed at improving strength and coordination of the muscles acting on the pelvis in particular the abdominal musculature and the adductor muscles has been proven the most effective40 Figure 5.2 . Studies evaluating the effectiveness of intraarticular pubic .