Obturator Entrapment Neuropathy

After 19 surgeries¹ and 5 years of searching for the source of my chronic pain syndrome, which started with a sporting injury in 2007, I have been found to have a condition called Obturator Neuropathy — a source of chronic pain affecting athletes.

Unfortunately, many specialists are unaware of this condition and so may not recognise the correct diagnosis, which has been my case. Obturator Neuropathy typically affects those engaged in kicking sports and especially, Australian Rules football. Although I was playing Australian Rules football at the time of my injury, I live in Brisbane, where the sport is less popular than in other cities such as Melbourne and Sydney, where the condition is more recognised. I have recently learned that many more specialists in these cities are aware of this insidious disease, while I have yet to find anyone in Brisbane who even know it exists — I suppose this set of circumstances came together to delay my correct diagnosis for many years.

This article is the first of my writings on this condition, as at this time, it is still currently unresolved. I am planning to meet with many specialists in the next few days to discuss surgical management. Later, I intend to raise greater awareness of this condition in the hope that other athletes, professional or otherwise, needn’t go through the dramas that I have done in these last few years.

My pain is now so severe that I am unable to perform my normal duties for my employer. Thankfully, my employer is awesome and understanding of my plight and I am committed to resolving this matter as soon as possible so that I can contribute back my highest level of performance. I am thankful to others in their understanding and I apologise to those who have sometimes been on “the wrong end of the stick” of my frustrations especially when I am having a “bad day” with pain. I am also usually taking narcotic medication during these times, so my recollection of the events is typically blurry to me.

If you are ever inflicted with this condition, I highly recommend these publications, with most recommended appearing first:

1. Bradshaw, Chris, et al. “Obturator Nerve Entrapment A Cause of Groin Pain in Athletes.” The American journal of sports medicine 25.3 (1997): 402-408. (link)

2. Bradshaw, Chris, and Paul McCrory. “Obturator nerve entrapment.” Clinical Journal of Sport Medicine 7.3 (1997): 217-219. (link)

3. Tipton, John Sison. “Obturator neuropathy.” Current reviews in musculoskeletal medicine 1.3-4 (2008): 234-237. (link)

4. Harvey, Gregory, and Simon Bell. “Obturator neuropathy: an anatomic perspective.” Clinical orthopaedics and related research 363 (1999): 203-211. (link)

5. Busis, Neil A. “Femoral and obturator neuropathies.” Neurologic clinics 17.3 (1999): 633-653. (link)

6. Koulouris, George. “Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings.” American Journal of Roentgenology 191.4 (2008): 962-972. (link)

7. Sorenson, Eric J., Joseph J. Chen, and Jasper R. Daube. “Obturator neuropathy: causes and outcome.” Muscle & nerve 25.4 (2002): 605-607. (link)

8. Kitagawa, Ryan, et al. “Surgical management of obturator nerve lesions.” Neurosurgery 65.4 (2009): A24-A28. (link)

9. Arnold, William David, and Bakri H. Elsheikh. “Entrapment Neuropathies.” Neurologic Clinics (2013). (link)

10. Orchard, John, et al. “Pathophysiology of chronic groin pain in the athlete.” Int J Sports Med 1.1 (2000). (link)

11. Anagnostopoulou, Sofia, et al. “Anatomic variations of the obturator nerve in the inguinal region: implications in conventional and ultrasound regional anesthesia techniques.” Regional anesthesia and pain medicine 34.1 (2009): 33-39. (link)

12. Falvey, Eanna Cian, Andrew Franklyn-Miller, and P. R. McCrory. “The groin triangle: a patho-anatomical approach to the diagnosis of chronic groin pain in athletes.” British journal of sports medicine 43.3 (2009): 213-220. (link)