Lower limb biomechanics during low- and high-impact functional tasks differ between men and women with hip-related groin pain

Background: The effect of pain on lower limb biomechanics during walking has been found to be sex specific for certain joint diseases. However, it is not known if sex is an effect-modifier in people with hip pain. Therefore, the aim of the study was to determine the differences in lower limb biomechanics between men and women with hip-related groin pain during functional tasks. Methods: 65 male and 23 female football players with hip-related groin pain were recruited. Biomechanical data were recorded during walking and the single-leg drop jump. Hip, knee and ankle joint kinematics and kinetics were calculated. Differences between men and women were assessed using statistical parametric mapping. Findings: Walking: Men with hip-related groin pain walked with lower hip flexion and internal rotation angles during stance compared to women. During different sections of stance, men also displayed a lower hip adduction angle and 'external' adduction moment, a lower knee flexion angle and 'external' flexion moment, as well as greater 'external' dorsi-flexion moment and impulse. Single-leg drop jump: Men with hip-related groin pain displayed a lower hip flexion angle during early stance, and greater 'external' knee flexion and ankle dorsi-flexion moments. The impulse of the 'external' dorsi-flexion moment was also greater for men compared to women. Interpretation: Men and women with hip-related groin pain display differing lower limb biomechanics in both low and high impact tasks. Sex may therefore be a potential effect modifier in people with hip-related groin pain. Future research in this area should incorporate sex-specific analyses.