Groin strain is common in sport, especially hockey, basketball, soccer, tennis, horse riding and karate. They can be very debilitating for a short period or repeatedly troublesome over a long period.

What Is A Groin Strain?

The groin is a complex area involving the abdomen, the hip muscles and the genitals, all of which can be injured.

  • Impact injuries involve a direct blow during contact sports or anywhere where the body can come into contact with an object. Medical advice should be sought if there is any doubt about the severity of the injury.
  • Groin strains (adductor strains) involve a muscle tear at the junction of the muscle to its tendon and can involve the gracilis, iliopsoas and adductor muscles. The adductor longus muscle is the most commonly injured. The muscle-tendon junction has a poor blood supply but a rich nerve supply and this relates to the severe pain people report and the poor healing capacity of these injuries.
  • The hip pointer injury involves a sudden extension of the hip that sprains or pulls off the attachment of the sartorius muscle from the iliac crest.
  • Other groin problems include hernias, Gilmore’s groin, stress fractures, osteitis pubis, bursitis and hip impingement.

Groin Strain Anatomy

Who Gets Groin Strain?

Groin strains and injuries are most common in sports such as hockey or soccer. Sudden movements and changes of direction, especially side to side, can stress the adductor muscles, as can forced abduction of the hips such as partial splits.

The muscles may contract hard as they are lengthening and a tear develops near the tendon junction to the muscle. Athletes who are older and who have weaker adductor muscles may be at greater risk of a pulled groin.

Groin Strain Symptoms

  • Sudden onset of groin pain
  • Pain often severe and very sharp on movement or weight bearing
  • The person is unwilling to move the affected leg out to the side
  • Continuing the sporting activity is impossible

Groin Strain Treatment

Physiotherapy is the main treatment for a groin strain and the physio will manage an acute injury using the PRICE protocol. Crutches may be necessary for a few days if pain is severe, resting from the aggravating activity is vital, and ice and compression bandages may be useful. Control of pain and inflammation are the key factors here to allow healing to occur most quickly.

Physiotherapy treatment is aimed at reducing the pain and inflammation and progressing the patient towards full function as soon as possible. However, it is very important not to overdo the injury by excessive exercise or stretching as this can progress to the problem becoming a chronic groin strain. Chronic strains can be problems for years and severely limit functional activities such as sport.

Treatment is typically dictated by the pain’s response to movement. Rest is followed by gentle active movements and isometric contractions of the adductor muscles. If that is painless, work can progress to resisted movements and gentle stretching, moving on to sliding board movements, plyometrics and sports specific movements.

Strengthening of the abdominal muscles, hip stabilisers and adductor muscles is important, as lack of endurance is a factor in groin strain.

Acute strains may take from a few weeks to three months to rehabilitate, while chronic strains could take up to six months even if they go well.


References:

  1. Groin Pain. Information and Exercise Leaflet for Patients and Carers. East Lancashire Hospitals. http://www.elht.nhs.uk/Downloads-docs/PLIMS/Leaflets/Lower%20Limb/Groin%20Pain%20-%20Patient%20Information%20and%20Exercises%20-%20PHYSIO%20001.pdf
  2. Tyler, Timothy F. et al. “Groin Injuries in Sports Medicine.” Sports Health 2.3 (2010): 231–236. PMC. Web. 25 Nov. 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445110/