Groin injuries most commonly involve the adductor muscles that go from the pelvis to the knee and help to bring the leg in toward the body. These muscles are used during sports that involve sprinting, kicking and twisting such as football and soccer. A strain(tear) in the adductor muscles can occur during these activities.
Symptoms of a groin strain are sudden sharp groin pain,localised bruising or swelling and an inability to squeeze the legs together. In severe cases, walking may be difficult. As with all muscle tears, physiotherapy intervention is always recommended and greatly beneficial.
Physiotherapy treatment for acute groin strains involves the RICE principle (rest, ice, compression, elevation) in the first 48 hours. This is then followed by gentle passive stretching to regain muscle length and flexibility and a gradual strengthening and stabilising programme leading to more functional specific sports related exercises until a full return to sport is achieved.
Left untreated and ignored, an acute groin strain can lead to a more chronic adductor tendinopathy which can prove more difficult to overcome. Intense physiotherapy is necessary to reduce longstanding tissue scarring, inflammation and muscle imbalances that can occur with adductor tendinopathies.
A strain of the iliopsoas muscle is a rare occurrence, but when it does happen groin pain is likely to be felt where the muscle tendon inserts into the top end of the femur (thigh bone). Symptoms include a sudden sharp pain which worsens when you try to flex at the hip (lift your knee up towards your chest). The leg feels weak when you try to raise it, and groin pain is felt when you raise the knee against resistance. This type of groin injury calls for rest, anti-inflammatory treatment and rehabilitation, in a similar manner to adductor strains.
Inguinal hernias can also result in groin pain as the contents of the abdomen protrude through the inguinal canal. Men are much more likely to experience this type of hernia than women. Groin pain is felt during any type of exertion or exercise and when coughing or sneezing. There may be a bulge in the groin or lower abdominal area which disappears when you lie down. Femoral hernias are more common in older and frail women. A femoral hernia manifests itself in a lump in the groin area and pain with exercise, but not as much with coughing or sneezing. Both types of hernia require surgical intervention to correct the defect.
Osteitis pubis was previously used to describe inflammation of the pubic bone from overuse of the adductor muscles, which caused radiating pain around the groin but was more significant in the front. However, in recent studies it has been shown that the pubic bone does not actually become inflamed with muscle overuse so the term is now becoming more obsolete. However with overuse of the adductor muscles there is a chance that the pubic bone may in time sustain stress fractures. Diagnosis is made with an x-ray or MRI and treatment may include steroid injections, rest and physiotherapy rehabilitation of stretching and strengthening the surrounding muscles.
If you experience any of these groin injuries, please call us at Back Pain and Posture Clinic. We can help.
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