Buttock, Hip and Groin Pain

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The hip and groin area is one of the most challenging areas of the body to treat by sports injury specialists.  The reason for this is that there are a large number of possible structured that can be injured and cause pain in this area and also because most of the structures are very deep within the groin area (including the hip joint).

The most common sports injury in this area is the acute groin strain and this is frequently seen in twisting and turning sports such as American football, rugby and soccer.  Whereas acute groin strains can take 2 to 3 weeks to recover, chronic groin injuries can take months if not years to clear up.  Again this is due to the multi factorial nature to this injury (several possible causes).

When Should I See a Doctor?

The majority of hip and groin injuries, especially the minor ones, can be treated at home.  However, if you have any of the following symptoms you should seek further medical assistance.

  • Severe pain in or around the hip or groin area, especially during walking.
  • A “giving way” feeling in the hip during walking or going up/down stairs.
  • Altered sensation in the leg – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia).
  • Unable to complete your normal daily activities after the initial 72 hours.

Further medical assistance can be sought through either your local GP or a private clinician such as a physiotherapist, sports therapist, osteopath or chiropractor.

In the first instance, if you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.  Another warning sign is if your hip “gives way” whilst walking and once again, you should consult your doctor or visit A&E.

Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your knee, you are highly recommended to seek advice from a specialist expert - such as a physiotherapist, sports therapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.

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Immediate First Aid for Groin Injuries

Sudden onset groin strains, or any acute muscle injury should be treated with the P.R.I.C.E. principles - protection, rest, ice, compression and if possible elevation.

  • Protection - Protect the injury from further damage. Stop training or competition immediately.
  • Rest - Refrain from exercise and try to reduce the demands of your daily activity to encourage recovery.
  • Ice - Apply ice or cold therapy in the form of a cold wrap or ice pack to help stop bleeding within the muscle itself and assist in reducing the symptoms of pain and inflammation. It should be noted that this is much more difficult to achieve in the hip joint as the hip is located deep within the groin area.
  • Compression - The use of applied pressure and compression bandages or groin supports can can help reduce swelling.
  • Elevation - Raising the injured leg above heart level when possible can improve circulation to the area and help reduce swelling.

Hip and Groin Pain in Children

There are a number of hip/groin conditions that present in the hip and groin area.  The most common is Perthes' disease which usually presents itself between the ages of four and eight years of age, although it can also occasionally occur in younger (toddlers) or older children (teenagers). Parents/guardians should note that if a child complains of stiffness and reduced movement (ROM) in the hip area then Perthes’ must be suspected.  If severe, the child may even walk with a noticeable limp and the affected leg may appear shorter than the other leg.

Hip and groin pain are especially difficult to diagnose in young children and adolescents because, like adults, there are a number of different structures in the hip area that can result in pain.  Children often find it difficult to explain pain and where it is and therefore their pains are often put down to 'growing pains' and this is not true.  If in any doubt it is recommended that parents/guardians seek advice from a medical professional who ideally specializes in paediatrics (the study of children).  It should be noted that incorrect or missed diagnoses of hip conditions in children can have catastrophic consequences in their later life.

Without doubt, severe hip/groin pain experienced by children should always receive urgent medical attention. Apparently minor conditions such as a pulled muscle or tendon strain can cause similar types of pain to a stress fracture, so a professional opinion is vital. Stress fractures in children are medical emergencies, so a correct diagnosis is crucial in children experiencing severe pain.

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Hip and groin anatomy

The hip joint is a ball and socket joint, formed by the head of the Femur (thigh bone) and the acetabulum of the pelvis. The dome-shaped head of the femur forms the ball, which fits snuggly into the concave socket of the acetabulum. The hip joint is a very sturdy joint, due to the tight fitting of the bones and the strong surrounding ligaments and muscles.

Read more on hip anatomy

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