From Dr. Adam Weir


Blog Post Dr. Adam Weir

What a wonderful world

Imagine a world where all those involved in looking after injured athletes spoke the same language. The end of confusion when athletes visit various doctors or physios and are told different diagnosis while their injury has not changed between visits. Wouldn’t it be great if we stopped using terminology that could be harmful to athletes? Imagine being told your groin is disrupted or you have a pubic aponeurosis defect.

What if we agreed with each other on what to call groin injuries, and how we could assess outcomes of various treatments in a uniform way. We have the tools to start doing this tomorrow.

Back in 2014 we sent 2 clinical cases to 23 different experts in groin pain from all over the world. Sports physicians, physiotherapists, general surgeons, orthopaedic surgeons and a radiologist all took part. The study showed what a mess things have become. In 1 case the 23 experts used 18 different terms to describe the diagnosis – and the second was even worse…. 23 experts and 22 different terms to describe the diagnosis of a football player with pain in his inguinal canal.

We also reviewed all the literature on treatments for groin pain in athletes. In the 72 articles we found we discovered more than 30 different terms in use. Many terms were describing the same clinical picture or even worse, not even defined.

At the end of 2014 we organized a large consensus meeting with all 23 experts where the “Doha agreement” on terminology and definitions in groin pain in athletes was achieved. The article has been downloaded 40,000 times and cited 97 times in the past two years. Hopefully this may help reduce confusion and work as a common language.

What if we all used this common language…

What if this were combined with all new studies using the Hip and Groin Outcome Score (HAGOS)– the only validated patient related outcome score for athletes with groin pain. The HAGOS is now available free online in 13 languages. (

Wouldn’t that be wonderful?

  1. Serner A, van Eijck CH, Beumer BR, Holmich P, Weir A, de Vos RJ. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015;49:813.
  2. Weir A, Hölmich P, Schache AG, Delahunt E, de Vos RJ. Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method. Br J Sports Med. 2015 Apr 23.
  3. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan KM, Lovell G, Meyers WC, Muschaweck U, Orchard J, Paajanen H, Philippon M, Reboul G, Robinson P, Schache AG, Schilders E, Serner A, Silvers H, Thorborg K, Tyler T, Verrall G, de Vos RJ, Vuckovic Z, Hölmich P. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015 Jun;49(12):768-74.
  4. Thorborg K, Hölmich P, Christensen R, Petersen J, Roos EM. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med. 2011 May;45(6):478-91.

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