The Groin Injury
Starring Montee Ball and Arian Foster
“I didn’t know Montee Ball was a 1st round pick! I should’ve kept him!” exclaimed my buddy through a text just before our fantasy football draft for a 12-team, standard keeper league. I smiled to myself, thinking the fruits are ripe for my picking. I plucked Ball of the draft board at the 10th pick of the 1st round, excited to build my team around a budding Bronco in a Peyton Manning offense. But maybe I should have let him slide because fantasy karma wasn’t too keen on gloating and struck Ball with subpar production and a groin injury. Just to tease, Ball came back after being sidelined for five games and went on to limp back to the sidelines after reinjuring his groin on the first play back.
The groin is the region between the lower abdominals and thigh on either side of the body. These sets of muscles that make up the groin allow you to shuffle from side-to-side and change direction while stabilizing your hip. During a jog, the hip joint bears up to eight times its body weight which may result in acute and chronic injuries (Anderson et al., 2001). The ball-and-socket model of the hip joint doesn’t have as wide range of motion the shoulder joint has, but is nonetheless very similar in structure. It is stabilized by the acetabular labrum, a ring of fibrocartilage, dense connective tissue attached to the bony rim of the acetabulum (socket). In a hip joint replacement procedure, the acetabulum is restructured and a new socket is essentially made for the femoral head to attach to.
Groin injuries have many different sources, but the most common cause may be due to a labral tear, which could decrease the stability of the hip joint. Articular cartilage damage will significantly increase the stress on the hip, causing pain, clicking, locking, catching or a “giving away” sensation when patients attempt to plant off a foot to change direction. Such injuries may be treated by physical therapy or arthroscopic surgery with the latter being more immediate but a longer recovery price. Sports hernias are often classified as groin injuries in NFL injury reports, but, as I wrote in a past article, are more specific in that they are caused by damage in the inguinal region. Understanding the groin anatomy also reveals that low back pain may also contribute to weaknesses in hip abduction and extension strength. Nadler et al. (2000) observed that female athletes had differing responses to proximal hip musculature to lower extremity injury or lower back pain compared to their male counterparts. The following year, Nadler et al. (2001) confirmed that hip muscle imbalances may be associated with lower back pain. The hip abductor functions to stabilize the pelvis in an upright position during an athletic stance. When hip abductor strength is compromised, lateral trunk stabilizers such as the quadratus lumborum try to over compensate to stabilize the pelvis. Thus, increasing abductor strength is an important strength and conditioning strategy to prevent lower back pain.
Relevant Players:
Montee Ball, RB, Denver Broncos: Montee Ball was one of those fantasy sleepers who never woke up. He had a solid Week 1 in which he scored 13 fantasy points, but was mostly mediocre before injuring his groin in Week 5. This led to the emergence of Ronnie Hillman, leaving fantasy owners to wonder why Ball wasn’t able to produce as Hillman had. A highly touted prospect in the stable behind Knowshon Moreno last year, Ball was stashed in many desperate owners’ rosters through his injury. His return to play in week 11 only ended with even more disappointment as he left the game aggravating the same groin. In the same game, Hillman also went down, and CJ Anderson snatched the starting job unapologetically. Ball should be returning to play this week, but by the way Anderson is playing, I don’t really see Ball as a fantasy factor anymore. This past week, the Broncos beat the Bills 24 to 17 behind Anderson’s play. However, what makes me raise my eyebrows at this seemingly mundane Bronco win is the fact that Peyton Manning’s consecutive 51-game-passing-TD streak came to an end, 4 TDs shy from the record. I think that when records are on the line, coaches will do what they can to put their players in situations to make history. Therefore, it says a lot when Coach Fox largely depended on Anderson’s shoulders, instead of Manning’s arm, to the victory. When Ball returns, I’d imagine he would have a similar role he had last year as a back up to Knowshon Moreno, safe to drop in all standard leagues.
Arian Foster, RB, Houston Texans: Foster pulled his groin in Week 9 which left fantasy owners sighing with disappointment as the annual “Arian Foster Soft Tissue Injury” arrived. Not only does Foster have a history of soft tissue injuries (mostly groin and hamstring problems), but he is also very slow to recover from such ailments. Foster knows it as well, slamming his helmet down in frustration after sustaining the injury. Alfred Blue took the reins and was not shy to display his running ability, totaling 533 yards from scrimmage and 2 total TDs in limited play. But unlike Montee Ball, a healthy Foster remains a top 5 RB and was very effective in his Week 13 return. The biggest take away from these turn of events should be that Alfred Blue is a necessary hand-cuff to all Arian Foster owners. Blue is very capable of producing Foster-like numbers, and with the margin of error cut to a minimum in the fantasy playoff season, the last thing you want is to face a team that uses Blue against you.
Sammy Watkins, WR, Buffalo Bills: After obtaining the AFC Offensive Rookie of the Month award, Watkins has been on a steep decline in production that is largely attributed to a nagging groin injury. Watkins was unable to finish practice on 11/5 because of the injury and only managed 13 receptions, 105 yards, 0 TDs in the whole month of November. However, Watkins is bouncing back into his old self in December, catching 7 passes, for 127 yards against the Broncos this past week. Going forward, Watkins should be a solid WR3/Flex play in the fantasy playoffs, facing the Packers, Raiders, and Patriots to put the finishing touches on his Rookie of the Year campaign.
On Deck: Julio Jone's Hip
In the Hole: Aaron Rodger's Calf
References:
Anderson K, Strickland SM, Warren R. Hip and groin injuries in athletes. Am J Sports Med 2001; 29:521.
Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med 2000; 10:89.
Nadler SF, Malanga GA, Feinberg JH, Prybicien M, Stitik TP, DePrince M. Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study. Am J Phys Med Rehabil 2001; 80:572.
