Long standing groin pain- is it a hernia?

[simonrhurst]

I'm a 29 year old male who is reasonably fit. I play football a couple of times a week and had started going to the gym and playing golf. About three months ago I started to feel pain in my right thigh (in my groin really). I'd rest a week and then it would go but playing again would bring it back...

I went to a physio who said that it would be my lower back causing it and she didn't even lok at my groin. My back turned out to be very tight so I had a couple of treatments on it which made my back incredibly painful. I then had to cancel an appointment for some reason and was in quite a bit of pain- my back felt in needed 'cracking'. This prompted me to see a chiropractor.

This resolved my back pain after about 8 sessions but I still had a pain in my groin. My chiros advice was 'just play' and see what happens. I did and my groin didn't feel right, I could and can play but not full on and I can't really sprint either.

This prompted me to see another physio yesterday. I told him the three month history and my thoughts that after almost three months with no real exercise I would have thought my groin would be better. I explained that it was still sore but not so sore I couldn't actually play. The pain particularly manifests iteself when I squeeze my legs together, its painful on both sides of my thigh/groin.

He asked me to lie down and try to lift my legs up and chest up. This caused pain in my stomach (down low, almost around my bladder area) and down both sides of my groin/thigh. He believes this indicates I have a hernia because:

-Its been ongoing for so long, a groin injury should have cleared up by now

-The exercise mentioned above puts no pressure on the muscle I feel the pain in (upper thigh/ groin - abductor?)

-I felt pain and weakness in my lower stomach

-I never had an actual injury, a moment when I felt something 'go'


He has written a letter to my GP and I have to go for a hernia checkup...

Does it sound like I may have a hernia? I have to admit I do have pain when I sit up from lying down or if I raise my legs whilst lying down. The injury hasn't really got any worse or better since I did it three months ago.

[Heidi]

A hernia is possible. Although usually there would be a small bump around the lower abdomen or top of the groin. Also is there any pain on coughing or sneezing etc? This can be an indication.

The other alternative to consider is gilmores groin. Have a look here:
http://www.sportsinjuryclinic.net/cybertherapist/front/frontthigh/gilmores_groin.htm

My advice is to go along to the appointment and see what happens for now. If you don't have a hernia push your Doctor for further investigations.
Good luck!

[simonrhurst]

Excellent, thank you for that. I actually had a coughing fit this morning as my coffee went down the wrong way and this cause pain in the top of my legs/groin and in my stomach.

I have had a good feel around for any lump and can't seem to find any.

I think it certainly seems like either a hernia or Gilmore's groin, I'm awaiting an appointment with my GP but I cant get in to see him for two weeks!

Is the treatment for Gilmore's groin going to be surgery as well?

[Heidi]

No not necessarily. I believe it can sometimes be treated conservatively with soft tissue techniques and strengthening, especially for the core muscles.

[simonrhurst]

ok... I've been to see an NHS surgeon who said it might be a hernia and referred me for a herniogram. The waiting list for this was too long so I went through BUPA.

I assumed I would have a herniogram there but instead I saw another consultant who was a sepcialist in hernias and abdominal problems.

He examined me and said it was definitely not a hernia. He then suggested it may be a muscle 'imbalance' in the my inner thigh muscles were not as strong as those muscles around them or that there was a weekness in the tendons that attach the muscle to the.. (bone?)

He advised that this was not his area of expertise but his suggestion would be that an operation would not help. He said I could try physio or possibly steroid/local anaesthetic injections but that these would only mask the problem.

His final suggestion was that I give up football altogether!

What can I do from here? Would physio help? Should I give up football?


Looking on the site I'd suggest it could be one of the following:

Adductor muscle rupture/strain
Inflamation of adductor muscle
Ostitis Pubis
Inflammation of the iliopsoas muscle
Gilmores groin...............

[Heidi]

Ok, I still think gilmores groin then if a hernia is ruled out. I think this because of the pain on coughing and in your stomach when you lifted the chest and legs up. Gilmores groin often involves a tear to the attachment of the external obliques: http://www.sportsinjuryclinic.net/cybertherapist/muscles/external_obliques.php

As you can see from this picture this muscle attaches very low down the abdomen at the top of the thigh.

I would suggest implementing a stretching program, for the whole lower body, with emphasis on the gluteals (abductors), groin (adductors) and quads. For stretching ideas have a look here:

http://www.sportsinjuryclinic.net/cybertherapist/stretching/allstretches.php

I would also advise avoiding any football for the time being, and any other sports/activities which involve twisting/side-ways and cutting type movements.

The other important thing with gilmore groin is core stability. For this you could do a number of things, but I think the best would be to see a personal trainer at your gym who has some experience in core training/injury rehab. Get them to devise you a core training program. Either that or join a pilates class.

Also some massage to the upper leg/thigh/groin and glutes may be beneficial.

I hope this helps! Good luck!

[simonrhurst]

Thanks Heidi, very useful!

I appreciate the help.