A 26-year old female professional football player presents following an acute injury sustained during a training session with her national team. She reported feeling a sudden pain in her right groin after a controlled slide movement. Physical examination demonstrated a normal, but painful, range of motion in all directions. There was no pain on muscular testing except resisted external rotation. Modest tenderness was noted on the ischial tuberosity.
An x-ray was conducted to assess for a bony injury (and was normal). An MRI conducted the day following the injury showed increased signal within the obturator externus muscle with a complete rupture of the muscle. A diagnosis of a grade III distal obturator externus musculotendinous injury was made.
This player improved quickly with supportive treatment (rehabilitation). They were able to return to play (without pain) within 2 weeks.
Obturator externus muscle injuries are rarely reported. Despite the impressive MRI findings it has been our experience (with professional players) that these players typically have a rapid return to football. This generally occurs within 10 to 20 days. Chronical pain is very rare and may be due to secondary ossification.
The true incidence of this type of injury is unknown. Given that most players appear to have a rapid return to play MRI scan are generally not ordered (as healing occurs so quickly).
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