Nerve-related groin pain, whether localised to the inguinal, adductor, or pubic regions, remains underdiagnosed and often mismanaged. This is partly due to the limited sensitivity of conventional imaging and nerve conduction studies in detecting neuropathic causes. The complex and variable anatomy of the abdominal wall nerves further complicates diagnosis and treatment.
This presentation will explore the role of imaging and imaging-guided interventions in the evaluation and management of nerve-related groin pain. Particular emphasis will be placed on the importance of selective nerve blocks in symptom mapping and diagnostic clarification.
The choice of imaging modality is critical, as MRI may reveal incidental findings that are unrelated to the athlete’s performance-limiting pain, highlighting the principle of “treat the player, not the picture.”
Additionally, the presentation will discuss the therapeutic role of neurolysis of abdominal wall nerves, which can provide both interim symptom relief, maintaining player availability and, in selected cases such as obturator neuropathy, long-term benefit.
Understanding and addressing neuropathic causes of groin pain are essential to optimising outcomes in both athletic and surgical populations.
Professor Rowena Johnson is a Consultant Musculoskeletal Radiologist specialising in professional sports, working with international athletes and clubs across Formula 1, the Premier League, Championship football, the Lawn Tennis Association, Olympic disciplines, international rugby and cricket, and the Royal Ballet. She currently works at the Mayo Clinic, London. She has a wide breadth of experience including roles at the University of Toronto Hospitals, Oxford University Hospitals, and as a full-time editor at the British Medical Journal.
Rowena is the Chair of Sports Medicine Imaging at the Carnegie School of Sport, Leeds Beckett University, which is the largest provider of sport in UK higher education. She is also a Visiting Professor at the Dartmouth- Hitchcock Medical Centre, University of Dartmouth, USA. She has held multiple leadership positions at the Royal College of Radiologists, including as Chair and Clinical Lead of Education, Faculty Board, Professional Support and Standards Board, and as Editor of the RCR Newsletter. Professor Johnson is a member of the NIHR Imaging Working Group, with a particular interest in Artificial Intelligence. Further roles include Vice-Chair of the International Society for Clinical Densitometry, UK/Ireland Panel and a member of the International Scientific Advisory Council.
