Groin Pain

If you’re an athlete with ongoing groin pain, it can be an obstacle to training, competing, and achieving your goals. Fortunately, there is help available! 

Physiotherapy can provide relief, accelerate healing, reduce inflammation, and prevent future injuries.

What is groin pain?

During a sporting season, many local teams are bound to have at least one team member experience groin pain and soreness. This discomfort can be debilitating and often leads to long-lasting effects that may even carry over into the offseason without being entirely resolved.

Groin pain in athletes is an umbrella term used to describe pain on the inside of the thigh, often associated with sporting activities that involve kicking, skating and change of direction.

These muscles, known as the adductor muscles, can be injured. 

A muscle strain is another term for a pulled muscle. A groin strain is typically a minor injury but can be more severe.

Common causes of groin pain in athletes

A groin strain is a muscle-tendon injury that may be painful on palpation of the adductor tendons or their insertion on the pubic bone, as well as pain in the adductor region during resistance testing of the adductors.

The following are the distinctions between groin tendinopathy and a groin strain:

To begin with, strains are acute, whereas tendinopathy is more chronic in nature.

The second distinction is that acute injuries often occur at the musculotendon junctions, whereas chronic injuries are more commonly found at tendinous insertions on the pubic bone.

The exact cause of groin pain often falls under one of the following categories:

• Adductor-related groin pain
• Iliopsoas-related groin pain
• Inguinal-related groin pain
• Pubic-related groin pain
• Hip-related groin pain
• Other causes of groin pain

Physiotherapists utilise tests including a range of movement, neuromuscular control, muscle strength, orthopaedic tests, balance, and occasionally diagnostic imaging to assess and differentiate between the various known causes of groin pain.

In the last decade, groin pain has become increasingly demystified. We now have a wealth of evidence that clinical assessment by a skilled physiotherapist can establish an accurate overall picture of what is happening. In most cases, imaging isn’t required, and rehabilitation alone is often sufficient.

Physiotherapy treatment for groin pain in athletes

In sports, groin injuries are common. The diagnosis, treatment, and rehabilitation of these injuries have long been recognised as a complex and challenging area for all clinicians involved in their management.

Because all the muscles that act on the hip and pelvis merge at common attachment points around the pubic bone, managing groin pain can be complicated. This means tightness and weakness in one area can overload and influence other areas, causing pain and dysfunction.

Progressive strengthening and loading the entire groin and hip complex are necessary while considering which anatomical structure is the primary source of pain.

The adductors and hip should ideally interact with an even distribution of force. The adductors are frequently underloaded in groin pain, significantly weaker than the hip abductors, and cannot produce the force required for exercise or activity.

A reassessment of clinical signs of pain is also necessary to guide what loads and rehabilitation are tolerated so as not to upset the structure at fault and rush into running, change of direction, or higher strength loads, which could set the athlete back.

The best management of groin pain in athletes often involves:

• Muscle strengthening
• Supervised training programs
• Load management
• Functional re-training
• Motor control
• Manual therapy

Is it OK to run with a groin strain?

Running and sprinting can be part of the rehabilitation process. Still, a run-walk program is often preferred because you can gradually increase your volume and reduce the risk of overstressing the adductors.

Always begin slowly and only run in straight lines. To determine your recovery, keep track of your pain during, immediately after, and the following day. You will be able to increase your running distance, time, and speed as you recover, and you will be able to incorporate more agility and direction changes into your running.