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Groin pain syndrome: Experiences in the prevention and treatment with Sport Leggings by Maurizio Ronchi *, 2015 with the collaboration of Dr. Marco Gibin ft *, MFT Federico Polimene * * members of the medical staff of Seregno Rugby The electrostatic induction and the elastic-compressive effect exerted by sport leggings can be used as prevention and treatment of the one of most discomforting and limiting sport activities, the groin pain syndrome. This work is based on my thirty years of experience in the field of sport bodyworks, supported by the search for experiential evidence in the last ten years working with medical staff of Seregno Rugby and the technical staff of CobraGym-FitnessClub, for the prevention injury in sports, and rehabilitation. INTRODUCTION The purpose of this article is to focus attention on this syndrome for both athletes and medical-technical staff, which for anatomy researchers and medic sports rehab with the hope that further investigations and depth studies can be

carried out to continue improve more and more specific protocols. The criterion adopted for this study is not of clinical procedure or research, but simply experiential, and report based on our considerations, evaluations and suggestions.

(Figure 1) I will explain briefly the type of protocol used by us, PEC - Proprioceptivity Equilibrium Coordination (Ronchi et al.) - to develop certain aspects/concepts of preventive actions to fight the pain of the pubic-groin syndrome during physical activity. Thw most common physical and athletic issues that can lead to pain/stress on the tissues related the pelvis girdle: muscles, tendons, ligaments, fascia and connective tissues. It will be considered only problems from a biomechanical and musculoskeletal pain related to the pelvis from athletic activities, and not those related to internal medicine diseases. Then we focus those aspect highlighted by the case studies sports that create dysfunction, as a lack of physical preparation, failure to strength training,

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athletic overload/overuse, postural imbalances and traumatic events. In our experience it is not as risky hypothesis that the use of synthetic sport leggings during sports, because of the electrostatic induction and the elasto-compressive action exerted on the body tissues, can be beneficial in the prevention of the groin pain syndrome. We'll try to motivate our thoughts and experiences through the opinions of some eminent scientists, and the latest discovery research on the effects of these electrical charges and currents have on the soft tissues and their basic components as collagen and extra cellular matrix and fibroblast. As evidenced by the vast literature into Sport-Fit&Med- Rehab, groin syndrome is not easy to diagnose. Experts are agree in tracing one of the initial reports in 1932, when Spinelli focused for the first time, that some osteoarticular problems to the foot of a fencer, could give rise to that nagging pain in pubis-groin area. Studies done in the 1980s/90s (Busquet, De Paulis, Jarvinen) began to estimate tens causes for this syndrome. The most advanced research in the first decade of the new millennium (Bisciotti, Meyers, Passigli, Rabe, Shortt), confirmed the difficulty of diagnosis on the factors triggering the groin pain, because of the different and various correlations of traumatic nature, overload, or postural pathological, which can either singly or as a contributory cause provoke the onset of disease. In fact just to visualize the anatomy of the pelvis to understand the amount of myofascial and connective tissues that originate and fit on it. Being so large the spectrum of variables that trigger this syndrome, we have not yet arrived at a real cure, for which the remedy is to seek a possible solution in the development of protocols, preventive or interventive, depending on the case. The effectiveness of these programs is then evaluated and discussed with some frequency, through statistics and published case reports in the med & rehab literature. What emerges from these studies, it has as a common denominator for the efficiency of these protocols, to act according to the global vision of the human body; the athlete must be followed and treated in a holistic view, in the full sense of the term, taking into account all the variables both neuromuscular situations and psychological stress related. According to our experience, the programs carried out in the gym for the rebalancing of posture and muscles; maintain or regain tensegrity (Ingber) body structure is now a milestone in all prevention sport injuries. So the stage for weight lifting muscle, not an end in itself but is pursuing the goal for the development of lean body mass, to increase strength and endurance, which also looks to postural and proprioceptive aspects. For example our protocol (PEC) makes use in this phase of structural rebalancing, in addition to gym working with weights and machines, a various proprioceptive tools: the different Freeman tables, fixed, tilting, rotating, air-cushion, the foam roller, the bars of balance, Swissball, Kibun, trampolines, and all can drive instability. Finally, weights and proprioceptive exercises, will be integrated with compartment and global stretching sessions for kinetic chains - myofascial chains- with appropriate variations of PNF, CRAC, Anderson static, dynamic taistretch, passive-assisted, and so on.

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The holistic view of our protocol, is completed by the systematic checks of the physical-athletic-postural status, with Myofascial Passivattiva Technique treatments (Ronchi), through tests and specific bodyworks to evaluate and for maintain the entire pelvis area. With its joint, coxo-femural, sacro-iliac and the symphysis pubis, is a real iliac shock assorber to the complex architecture of the pelvic girdle (Figure 2), and is well known that these joints, specially for the synphysis, are subjected to stress-induced adaptment or by imbalance of the force load the pelvis (Solere et al.). When the pelvis is not aligned properly numerous biomechanical problems result, which can be painful and debilitating. (Lowe). So relying on both directions of the scientific literature that from our experiences, we have given more importance and priority to use the bodyworks for myotendons inserctions, the fascial-sheath, fascial-sheet expansions of the tendons, aponeurosis and joint capsules, as indicated as the most exposed to overload and the cyclical gestural repetitiveness - overuse - during a workout/performance. These bodyworks are aimed to mobilize both joint and tissue layers, the release of the myofascial adhesions and to stimulate the hyaluronic acid production, with specific technique which have provided us a good feedback both in the prevention, lowering the risk of light the syndrome, which the treatment against pain in the acute phase.

Figure 2

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Here are some examples of the PEC protocols.

Figure 3 Figure 4

Figure 5 Figure 6 We had excellent results in the application of Kinesio Taping to the bodyworks, highly regarded and well tolerated by athletes, become a precious and valuable assistance thanks to the teachings and advice of my dear friend professor Rosario Bellia.

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THE IDEA The idea for the use of synthetic sport leggings is suggested to me by an article published in the Journal of Athletic Studies by FIDAL (Italian Federation of Athletics) at the end of the 1970s. The study described the experience of some USA sprinters, in relation to the use of sport leggings with the aim of countering both accidents that possible triggers inflammation and pain in the pubic-groin area especially for the rectus-abdominal-adductor compartment. At that time I was an athlete, and with the agreement with my coach, I followed the suggestion to wear the sport leggings, both for training sessions and competitions, and, also as a trainer and technical instructor, involving athletes from other sports. To be honest I have no memory who was the author of the article, and I cannot find anything on the web to satisfy my curiosity and to give the right citation in the bibliography. The use of sport leggings became common among professional athletes since the mid '80s (last century), especially for top athletes in the track & field. Old athlete as me can easy remember the past Olympic Games or World Championships, where the sport leggings evolution as semi or totalbody with bright colors dressed by male and female athletes. Perhaps a little of an eccentricity, just think of those used by the USA sprinter Florence Griffith Joyner, but their use was a clear indication result of the studies and the expectations of the sports biomechanics and materials technology researchers. For all other sports the use of leggings, remaining mostly hidden from the suits or competition dress, unfortunately, did not have much echo among the ranks of the sport, apart from cycling. Too bad because I've never noticed about, except the few atlete who have shared the experience with me, that in the sports technical and med staff in Italy there was a great followers, so no developments and studies on their usefulness and potential. During my experience in sports agonist period, from the late 70s to the early 2000, from 100m and long jump to basketball, from judo to climbing/ mountaineering, we were really few athetes wear them methodically. The fact remains that despite having no obvious scientific value, is that neither of the athletes I know, who used sport leggings (some hundred), we never had problems of groin pain, despite these sports often caused overuse/overload to the pelvis area. How I remember well of a very few cases about the common stress and strains problems for quadriceps, hamstrings, adductors, then I though that something truly of effective benefit could be using constantly the synthetic sport leggings.

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EXPERIENCE and APPLICATION The experiential part of this work is based on direct feedback from the athletes that I had followed as bodyworker and trainer since the mid 80s, and the more systematic experience that today we are collecting as medical staff of Seregno Rugby players. Seregno Rugby is a small Italian sport association in the Monza and Brianza province close Milan, which has more than 250 athletes from minirugby to olders, from age 6 until 60. Still without statistical validity, we we have had access to a important number of athletes from the several specialties considered most at risk for this syndrome, in order to draw some considerations. The choice for the use of the sport leggings is that they must be in synthetic fabric (nylon or polyester), a material that are able to generate electrostatic charges and induce a weak current on the underlying anatomical parts in contact, made by the continuos microfriction and rubbing with the skin during movement.

(Figure7) Two important grounds, suggested by our experience, can be observed: the first is that they are worn directly on the skin as underwear; the second involves the use of one or two sizes less to have a good grip and give the right elastic-tighness. The first of these grounds has two reasons, that one is to prevent the cotton underwear worn under the leggings absorb and retain moisture, leaving the unpleasant feeling of damp. But above all it is very important to prevent the wet cotton will become even more abrasive to the skin, especially in the parts subject to continue rubbing or by the fabric seams. So the synthetic sport leggings used as underwear to direct contact with the skin, avoid those annoying redness and the proliferation of fungi responsible for mycosis and smelly in the groin wrinkle. In addition it was noted that the peel shave form pubic-groin area (common for practice for runners), has given more help to lower the abrasive effect due the continual movement which developed rubbing for the groin or inner thigh. It was not easy to involve male athletes, but the results have convinced almost all, a sign that the problem abrasion/mycosis was not so marginal and infrequent. In addition for us bodyworkers is unquestionable functionally when we massage smooth bodies without peel, both to reduce significantly the excesses of lubricants, lowering the possible skin sensitization using these chemicals, and for the best applications of bandages, taping etcetera. The second reason for wearing sport leggings as underwear, is the obvious one of having the more wide surface contact area possible for the mechanical action of micro-friction between skin and synthetic fabric, which is one of the purposes of their use.

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It may also want to avoid the 'shortening' of leggings, to choose those models that come comfortably just above the knee, to prevent that annoying sliding upwards and the continuous pull them down. As regards the use of a two smaller sizes, it is taken into account that are not too constrictors such as to prevent the blood circulation, but have a right and well tolerated compression to support it and, at the same time, to have the feeling of 'bandaged = protected'. To this point we have found a certain subject variability of compressive liking, so it is left to the discretion of the athlete. The elasto-compressive action is not trivial, but it has a precise scientific motivation and well-known, as the ability to induce tissue underlying neuromuscular proprioceptive facilitation stimulus, but also the exteroceptive/psychological, alarm status and sense of security (Marinoni). This effect exerted by the sport leggings, albeit subjective, and more or less influential than an elastic bandage, is making its contribution to the improvement of the general psychological condition of the athlete especially during the pre-competition warm-up. The variable elasto-compressive stimulus action on the muscles, develops also a major mechanical work which facilitate emptying venous during exercises, where exactly in the downturn and increase their volume, the containment action is one of the most effective mechanisms to achieve significant effects on the venous blood flow (Mariani). The elasto-compressive effect also improves the chemical and physical interstitial condition with an important action on the microcirculation, reducing capillary filtration and improving the drainage of the intratissues fluids both intravenously and lymphatic (Aloisi-Round; Bisacci) avoiding excessive accumulation of slag which, as known play an important role in causing fibrillar micro-lesion because of their abrasive properties due to their acid pH. So adherent leggings, even if are not an elastic functional bandage, for their elasto-compressive action are able to offer a number of positive input: support for the micro-compartmental and relaxing effect induced by repetitive tangential skin stimuli, in favor of a normalization of muscle tone, and for the purely psychological aspect of protection, via the exteroceptive action by 'patch' effect (Contigliani).

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BIO-PHYSIOLOGY To try to explain the action and effects that occur as a result from the micro-friction elasto-compressive and electrostatic charges induced between the synthetic fabric and the skin in direct contact, is needed a short bio-physiology introduction, but does not want to be academic, but enough to explain which are the parties involved and the main mechanisms. Collagen is one of the most eclectic components of connective tissue and fascial system. It has the ability to take on shapes and different properties depending on the task that is in charge. Collagen fibers are intrinsically elastic because of the provision in parallel bundles of these crystal setup that behave as true spiral springs. To understand their arrangement may develop different characteristics, take

for example the tendons and ligaments. Despite being made from the same basic component, collagen precisely, they develop different properties because of the different structure, the spatial arrangement and the assembly of the fibers in bundles of fibrillar. The ligaments are structured as ovelapped and crossed layers, this configuration makes them very strong and tenacious with excellent flexibility and foldability, allowing both free articular movement and to maintain a well controlling of the stability of the bone heads, in order of their peculiar inextensibility. This is due to the crossover and not parallel setup of the fibrillar bundles, which tends to neutralize the intrinsic elasticity of the collagen, a characteristic that for the ligaments must to be the last of the qualities. In fact, they do not take part in the dynamism of the joints ROM - range of motion - but only to support the muscle-tendon unit responsible of the movement.

(Figure 8) The tendons instead, remaining structured and arranged in parallel bundles, exploit own twist properties, due the shape of the helical spiral spring develops, allowing a greater extensibility than the ligaments. It agrees that the ligaments are structures with low dynamic, while the tendons, including retinaculae and myofascial expansions are very active. This is because the structure of crystal helical tendon has among its features, to be piezoelectric (Griner-Lee). This property of collagen that, said synthetically, is polarized electrically when subjected to pressure or to a stress such to lead to a plastic deformation. As vice versa, the crystal structure is deformed, expanding and contracting, under the action of an electric field. In practice, the piezoelectricity transforms the electrical current in the work-mechanical action, and the same applies to the reverse. For us bodyworkers this correlation is a key for understanding the mechanisms and effects, which occur by induction effects during the practice of various

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treatments of massage or myofascial manipulation. It also serves to explain how the use of the synthetic sport leggings can interact with the piezoelectric properties of those tissues of the body that have that type of configuration of the collagen: tendons, myo-tendon insertions, myofascial structures and various expansions. At first, as we have seen is right the elasto-compressive action that, despite not having the pressure of a massage, can drive an appreciable proprioceptive mechanical stimulus; the other is the microfriction that generates a weak electrostatic charges. These synergic actions are presumed to be in aid to contrast the development of any inflammation come from micro-lesions. In that regard, clearly explains Claudio Gallozzi that >. Furthermore, the piezoelectric effect resulting mechanical action, restores the extracellular matrix morpho-functional properties resulting as decongestion of connective tissue (Cheng, 1982).

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MECHANISMS Our experience in all these years in the use of synthetic sport leggings, was based on the evident difference of the gestures and in biomechanical movement patterns, inherent to athletes from different sports, which provided us a positive feedback to the low incidence of problems referred to the pubis-groin area. And right for the fact of having worked on a large group of athletes of various sports, which made us to think that some motivation or scientific evidence should be indeed. But all this remain a 'presumption'. In fact asked to Robert Schleip, famous fascial researcher and Rolfer of proven experience, how are moving the research on the interaction between electric currents charges and myofascial tissues, told me that his attempts at stimulation of fascial tissues subjected to different electrical stimuli using a wide range of frequencies and amplitudes, have not given a verifiable immediate effect. Schleip suspect strongly that should be a correlation, given that the (myo)fibroblasts still can be influenced by different and, even if, small electrical gradients, in their directional moves through the extra cellular matrix (ECM), and therefore we must continue to investigate. While in order of the electrostatic stimulation induced by synthetic sport leggings, it believes that the result of this action can often be due to the deeper and longer effects caused by a new different input as with the treatment of myofascial pain syndrome, always referred to the same spinal segment. This, continues Schleip, seems wrapped the activity of the WDR (wide dynamic range neurons) recently discovered. In fact he believe that in order the recent literature in this field, shows how they can be stimulated/modified with small electric charges. Again he ending, makes me aware of how they are now well known powerful effects induced by the needles in acupuncture, although the needle acts on a 'non-meridian' point but referred to the same spinal segment. Exactly the Kovac reflex (with surgical staples) appears to be efficient and probably involves the same neurophysiological dynamics. Currently some operators of acupuncture and trigger points using needles that have an electric charge with an apparent increase of positive results in their treatments. We need however to further studies and research. It is also convinced Carla Stecco, one of the best researchers of the extraordinary fascial world, as it considers besides very scientifically intriguing, that the correlations we should be and therefore we do need further studies. The same opinion is expressed by Will Gibson, researcher and DOMS expert (Delayed Onset Muscular Soreness) convinced that the research for new century will revealing important properties and very fascinating about fascia, and that in the future will bring great news for all activities related the human body, health diagnostics and prevention.

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CONCLUSIONS The experience mainly made to athletes of martial arts and running, of course who for decades have followed this habit to using synthetic sport leggings, did

not detect any particular response to reported pain in the pubic-groin area. Another positive note was about no relevant of the common problems as regards the hamstrings in runners, where there has been a sharp drop of contractures and muscles strains. Certainly these are not sport on the top list of high risk to incurring in the groin syndrome, but according to statistics, in order to the high frequency of training and repetitive movements/patterns, our feedback it seemed therefore good as result and that deserved to be reported as at least as experiential case. (Figure 9)

Instead for the athletes of Seregno Rugby, the systematic use of synthetic sport leggings is since 2008. Not everyone can bear the garment, but it is a very small percentage (15-20%) that constantly being lower. Certainly this practice needed a good dose of determination and perseverance, as in any case it is requires for any prevention protocol. Need a bit of adaptation and endurance, especially in the summer time with the heat. In fact we noticed that about 30% of the players try to avoid wearing synthetic sport leggings in the warm periods. Here need to make a remark very important to us: in this seasonal climate, start our workout preparation and the legue championship. The first phase begins the end of August and throughout September, with hot condition by late summer. Obviously the athletes physical condition is almost at the minus, and therefore easier that some problems might arise, either for lower muscle tone, a little overweight, delay neuromuscolar reactivy and weak aerobic condition. It is right in this phase of preparation that the use of leggings is recommended and where we presume to drive the best preventive action. As it also very important for the late spring time (April to June), where it concludes the league and start several summer trophy. We know well that to be at the end of the competitive season, can drive some different problems that require the same precautions, given that fatigue overload is fertile ground for injuries. The statistics tell us that in the last 3-4 games of the season especially in the last quarter of the game (the final 20mins) there is a greater probability of incurring in potential risks, in fatc is called injury time. Another good reason about using the synthetic sport leggings is the second skin effect. When the game field is in the condition defined as hard, either by frost or excessive dry, leggings intervene to prevent the annoying abrasions from the fall-impact-sliding on the ground, especially for the whole side of the thigh from the ileotibialband of the tensor fascia lata until the area trochanteric hip.

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In conclusion, obviously synthetic leggings are not a panacea, but in our experience certainly help to prevention the groin syndrome and related deseases. Athletes need commitment, and every staff must to lead them to awareness that prevention is the only form of protection for own body, where the care for it must to be a pleasant routine, a kind of investment, not an obligation, to protect both sport career and the future job career. The usual refrain that we repeat to all persons is begin sport activity or who start to approach to rugby: if you have respect for your body, even the relief works that the various operators in the bodyworks sector, will prove to be much more effective. You should not go to the therapist, osteopath or massage therapist only when the discomfort has become a seriuos functional limitation. A good preventive synergic team procedure among all the figures that work around the athlete is the trump card to play and invest in that marvelous machine that is the human body. This is what our experience tells to us. THANKS As in our previous works, I take always the opportunity to say thank you to those who, despite being unknown for the most of the sport team operators, study and researching to detect and unravel the secrets that reside in the most intimate and microscopic folds of our bodies. Datas, advices, skills, explanations of pattern mechanisms, all that become valuable ideas for us sports operators, instructors, coaches, trainers, masseurs, therapists and doctors. It is no longer possible today to develop an exercise program, a protocol of prevention, or a bodyworks treatment, without taking vision of what these scientists provide to us through their publications. Not forgetting also the opportunity given to us for our continuous scientific updating knowledge, in unraveling doubts and satisfy the curiosity that lead us then to develop new way to treat or improving old techniques. Too bad that they must always fight to get those funds needed to continue their researches. To all of them, that I really appreciated their efforts and also to bear me, to me care and dear: Robert Schleip, Carla Stecco, Claudio Gallozzi, Art Riggs, Antonio Stecco, Will Gibson, Rosario Bellia, Erik Dalton, Luigi Stecco, Antonio Dal Monte and the late dear Dave Simons GRAZIE! Disclaimer The information contained in the publication are purely experiential, represent an estimate of in reference to possible problems described. The purpose of the content is educational and informative not replace any intervention or opinion of the doctor and his diagnosis in relation to actual cases. You must contact your doctor or specialist of its indication, to receive diagnostic and therapeutic measures. Use of this work or parts of it is free so it is mentioned the author and source.

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If required all articles are freely available in full digital format. REFERENCES Technical support team: Massimo Terragni, IFBB instructor CobraGym FitnessClub Dr Roberto Galli, medic and IFBB instructor CobraGym FitnessClub Mauro Brambilla, IFBB instructor CobraGym FitnessClub Lorenzo Crippa, sport physioterapist BIBLIOGRAPHY Aloisi D, Ottavi G. Il bendaggio elasto-compressivo (2009) - da http://www.riaonweb.it/documenti/riaom/cartellasonia/ottavi.pdf Bisacci R, Bisacci C. I tessuti elastocompressivi nella patologia venosa degli arti inferiori - Centro Interuniversitario di Ricerca e Formazione in Flebologia- Universit degli Studi di Perugia http://www.societaitalianaflebologia.it Bisciotti GN. La pubalgia dello sportivo: inquadramento clinico e strategie terapeutiche (2006) da http://www.scienzaesport.com/SdS/060703000/bisciotti_101.htm Busquet L. Le catene muscolari volume III - La Pubalgia - Edizione 1998 Marrapese Cheng N, Van Hoff H, Bock E et al. The Effect of Electric Currents on ATP Generation Protein Synthesis, and Membrane Transport in Rat Skin - Clin Orthop and R.R. n. 171 nov/dec 1982 Da http://www.thepibcoa.com Contigliani R. Tesi di laurea in fisioterapia: Distorsione dellarticolazione tibio-tarsica: effetti di due programmi riabilitativi a confronto sul controllo del carico e dellequilibrio statico Universit degli studi di Siena - Anno Accademico 2003/2004 da http://www.riccardocontigliani.it De Paulis F, Cacchio A, Michelini et al. (1998). Sports injuries in the pelvis and hip: diagnostic imaging EUR J. Radiol 27:S29-S59 Gallozzi C. Equilibrio corporeo e tessuto connettivo- Med Sport 2009;62:385-413 - per gentile concessione dell'autore Griner T, Lee T. About Tendons and Ligaments (2006) da http://www.neurosoma.com/ligaments.html Ingber DE. The Architecture of Life - Scient Am Mag1998 da http://vv.arts.ucla.edu/Talks/Barcelona/Arch_Life.htm Jarvinen M, Orava S, Kuyala UM. Groin Pain (Adductor Syndrome) - Operative techniques in Sport Medicine 5(3):133-137; 1997 Lowe Withney, Exploring the Anterior Pelvic Tilt - Massage Today July, 2014, Vol. 14, Issue 07 Mariani F. The Compression Therapy study Group CTG Consensus conference on compression therapy, 2010 Coordinatore Fabrizio Mariani- da http://www.terapiacompressiva.it

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Marinoni Ortopedia: Lezione del Prof. Marinoni 2003 -Autore Sbob Francesca Bianchi - da http://matt7692.altervista.org/Archivio%20Sbobinature%2002-04/sbobinatureX/ortopedia/07.Ortopedia-15.05.2003.doc Meyers, William C.; Yoo, Edward; Devon, Octavia; Jain, Nikhil; Horner, Marcia; Lauencin, Cato; and Zoga, Adam. Understanding "sports hernia" (athletic pubalgia) - The anatomic and pathophysiologic basis for abdominal and groin pain in athletes (2008). Department of Radiology Faculty Papers. Paper 5. da http://jdc.jefferson.edu/radiologyfp/5 Passigli S. Pubalgia e disfunzioni strutturali del cingolo pelvico: valutazione e trattamento 2006 http://www.fisiobrain.com/ Rabe BS. Athletic Pubalgia: Recognition, Treatment, and PreventionAthletic -Training & Sports Health Care | Vol. 2 No. 1 2010 da http://www.slackjournals.com/ Ronchi M. Tecnica passivattiva nello scollamento mio-fasciale: arti inferiori (2008) - www.sportemedicina.it Ronchi M. Tecnica passivattiva nello scollamento mio-fasciale: Tronco e Arti Superiori (2009)- www.sportemedicina.it Ronchi M, Gibin M, Masera J, Polimene F, Zecchinello F. PEC - Propriocettivit, Equilibrio, Coordinazione: programmi di prevenzione, riatletizzazione e sportbodyworks (2010) - FITMEDonline anno 2 n. 11,12 - 2010 ; anno 3 n. 1 - 2011 http://www.professionefitness.com Shortt CP, Zoga AC, Kavanagh EC, Meyers WC. Anatomy, pathology, and MRI findings in the sports hernia. Semin Musculoskelet Radiol. 2008;12:54-61. Solre R, Vaccaro R, Casali D. La pubalgia di origine capsulare coxo-femorale - ReF Italia, conferenza ECM Genova, 3 dic. 2005 - www.ref-italia.org Image 2, for gentle permitt to authors Biscarini Moretti tratto da CINGOLO PELVICO E ARTICOLAZIONI SACRO-ILIACHE. Figure 8, source wikipedia

Maurizio Ronchi, email passivattiva@libero.it Holistic sportbodyworker, divulger and teacher of sportbodyworks techniques as tecnica passivattiva, Seregno Rugby medical staff coordinator, memebr of Associazione Manipolazione Fasciale and Associazione Italiana Taping Kinesiologico, FIDAL trainer (Federazione Italiana di Atletica Leggera), MBT (Masai Barefoot Technology) postural trainer. Member of APODIB - Associazione Professionale Operatori Discipline Bionaturali