Groin Strain Assessment
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Symptoms of an acute groin strain are usually fairly obvious at the time of injury. Long standing or recurrent groin injuries however often take much longer to assess and treat and often require further investigations such as MRI scans.
An acute groin or adductor strain occurs suddenly and symptoms will include a sudden sharp pain or pull in the groin area. The athlete will often be able to differentiate whether the pain is in the belly of the muscle, at the junction of the muscle and tendon which is much higher or where the muscles tendon attaches to the pelvis.
A groin strain can be very minor where just a few fibers are torn. In this case the athlete may feel tightness in the area of the groin as opposed to actual pain. Movements may be normal although there will often be tenderness in the area of the injury when palpating or pressing onto it. A more severe injury will have additional signs including swelling and bruising which is caused from the internal bleeding of the torn muscle. Over time the bruising may change colour and be visible much lower down the leg towards the knee due to the effects of gravity.
Groin Strain Assessment
A professional therapist will perform a full examination which includes a number of tests;
Range of motion: Testing the range of motion available at the hip joint or stretching the suspected injured muscles may reproduce symptoms. By analysing the pain responses to particular movements or stretches will give the therapist vital information about which muscles/tendons may be damaged. Moving the leg out to the side (away from the body into "abduction") stretches the groin muscles and can give an indication about flexibility. In the healthy athlete both legs should be equal in terms of degree of stretch or flexibility.
Resisted Muscle Tests - These involve the therapist applying resistance as the patient takes the injured leg through a range of movement. If pain is reproduced this gives information to the therapist about the type and location of the injury as well as feedback on muscle strength. Resisted muscle tests should be carried out in different positions to fully test the muscle (i.e. with the leg straight and bent).
How Bad is my Groin Strain?
A Grade 1 groin strain is a minor tear where less than 25% of fibers are damaged. An athlete who has sustained a grade 1 injury feels discomfort in the groin or inner thigh but can often walk with minimal or no pain. He/she are often unable to recall when the injury actually occurred and the pain in the muscle may only be noticed after exercising has stopped. The groin muscles may feel "tight" and there may be an area which is tender to touch. Walking is often normal, discomfort may only develop during more strenuous activities such as running or sudden changes of direction during sport. Pain on stretching the groin muscle may be present, especially when compared to stretching the groin muscles on the opposite leg.
A Grade 2 injury is a moderate tear which involves damage to 25% to 90% of fibres. The athlete will often know when the injury occurred and will feel a sudden/sharp pain in the area of the groin (adductor) muscles during exercise. Bruising and swelling will usually develop over the next few days but this may not be visible to the naked eye. The injured muscle will be weak and painful when attempting to contract the muscle - this is easily tested by squeezing your legs together with a ball between your knees. Pain will also be felt on stretching the groin muscles.
Grade 3 groin strains are the most serious and involve either a complete (100%) or almost complete rupture (90%+) of the muscle. The main symptom of a Grade 3 groin strain is severe pain during exercise (the athlete will definitely be able to recall when the injury happened) and in particular on sudden changes of direction during running and on kicking (such as a ball). The athlete will be unable to contract the groin muscles when squeezing the legs together and this is due to a combination of weakness and pain. Substantial swelling and bruising will usually develop around the inner thigh area and this may become visible within 24 to 48 hours. Finally, pain will also be felt on attempting to stretch the groin muscles and there may be a "gap" or "lump" in the muscle where the muscle has completely torn.