Persisting pain of the hip, pelvis, and groin among athletes represents a diagnostic and therapeutic challenge. Because of the complex and diffuse clinical findings, the primary cause of injury is hard to detect and to differentiate from secondary symptoms of overuse. Long standing symptoms of pain always lead to more or less impaired function. Therefore, rehabilitation with the ultimate goal of restoring function and normalizing the working flexibility and strength conditions of the hip and pelvis should always be included in the treatment program regardless of diagnosis or other simultaneous medical or surgical treatment. In the initial phase, hip, pelvis, and groin injuries seldom lead to a total disability that prevents participating in physical activity, making it difficult for the athlete to understand the importance of lowering the level of physical activity. Therefore, informing the athlete of simple hip anatomy, biomechanics, etiology, and triggering mechanisms is important in obtaining good compliance. Specific rehabilitation should include the elimination of the pain-triggering factor(s): the increase of the limited flexibility of the hip joint, the stimulation of general and local increase of blood flow and metabolism by low impact activities, or by physical modalities, the strengthening of the abdominal muscles; and the coactivating strengthening of the adductor muscles. It is important that rehabilitation be pain-free and that the work load be increased gradually. Few randomized studies have been done to present a scientifically based rehabilitation and preventive program. Therefore, most suggestions are based on clinical experience.
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