Groin Pain in Athletes
Many athletes present to me with groin pain almost all saying they, “pulled [my] groin” and it’s not getting better. What are common causes of groin pain, when should you see a doctor and how is it treated?
Groin pain, that is pain where the abdomen meets the legs, can be cause by acute injury or wear and tear over time. Acute injury happens with direct blows, fall, sudden directional change or acceleration or some other kind of trauma.
More chronic overuse injuries happen with repeated day to day activity that puts stress on the anatomical structures in the groin area.
Groin Pain can also be referred from other parts of the body like the kidneys or intestines or reproductive system, so it is essential that if there is no obvious mechanism for your pain, you have to see your physician.
Ice Hockey, soccer, basketball and cross country skiing are common sports that put you at risk. Many groin injuries are also caused in work or home related injuries or motor vehicle accidents.
Pulled muscles, ligaments and tendons in this area can result of sporting or other causes of injury. Commonly, Injury is to the adductor group which stretches from your pubic bone to the femur. This group that helps pull your leg back in to your side from an outstretched position or from side to side.
If the injury is mild, localized aching pain in the inner thigh and groin can occur. If it’s a severe injury, sudden pain, swelling and bruising may occur as well.
Treatment is dependent on severity and cause. For this post, I’ll focus on the adductor group strain which is the most common. More so that other types of injury, rest is very important for groin strains. Many patients say they start to feel better, go back to the activity that caused it, but they reinjure it, putting them back weeks to months in terms of recovery.
Avoiding these exacerbating activities even when the pain goes away is critical. Icing and heat may also help for swelling and pain relief though heat should not be applied until the acute swelling phase of 48-72 hours is past. Physical therapy to incorporate various treatment modalities (ice massage, electrical stimulation and various exercises) can also help symptomatically in this early stage.
Further out, usually a least a week or two later, once pain free at rest, very gentle stretching exercises can help regain range of motion and flexibility though any pain is a bad sign and stretching should be discontinued.
Groin injuries to the adductor group can be recurrent so preventative hip adductor and abductor stretches and core and pelvic stabilization can help prevent future injuries.
If pain is persistent past a week or two, or if it is a child, it is very important to see a sports physician to rule out a sports hernia or other cause of groin pain.
References:
1) www.Uptodate.com
2) Lacroix V, Kinnear DG, Mulder DS, et al. Lower abdominal pain syndrome in National Hockey League players. A report of 11 cases. Clin J Sport Med. 1998;8:5–9.
3) Fan LJ, Spence RAS. Sportsman hernia. Br J Surg. 2000;87:545–552.
