Groin Strain

Groin strain muscles

A groin strain is a tear of the adductor muscles on the inside of the thigh. It is often referred to as a ‘pulled groin muscle’, or a ‘groin pull’. A sudden sharp pain is felt which can range from a mild to very severe. Here we explain the symptoms, causes, treatment, and exercises for a groin muscle strain.

Symptoms

Causes

Treatment



Groin strain symptoms

Groin strain symptoms vary depending on the type and severity of your injury and include:

  • Sudden sharp pain on the inside of the thigh which ranges from mild discomfort, to severe.
  • Symptoms may be felt either in the belly of the muscle or higher up where the tendon attaches to the pelvis.
  • Often pain is felt when sprinting or changing direction quickly.
  • You may or may not be able to play on depending on how severe the injury is.

Groin strains are graded 1 to 3 depend on severity. A professional therapist will perform a number of assessment techniques to help diagnose your groin pain.

More on Groin strain diagnosis


Injuries with similar symptoms

The following injuries have similar symptoms and are sometimes missed:

Gilmore’s groin – first identified in 1980 by Consultant Surgeon Mr. Jerry Gilmore, as a cause of longstanding, chronic groin pain. It occurs at the junction of the leg and the torso and is common in speed/agility type sports.

Groin inflammation/tendonitis – inflammation of the adductor muscle tendons.

Not sure? Try our Symptom Checker.



Causes and anatomy

Adductor muscles - groin mucles

There are five groin (adductor) muscles. Three of them are called the ‘short adductors’ (pectineus, adductor brevis, and adductor longus). The other two are known as the ‘long adductors’ (gracilis and adductor Magnus).


The adductor muscles

The main function of the adductor muscle group is to pull the leg back towards the midline (adduction).

They also stabilize and control the pelvis during walking and running. They are especially important in any sport which requires rapid changes in direction.

The adductor muscles on one side keep the pelvis level while the adductor muscles on the opposite side are used to move the leg.


What causes Groin strains?

Although muscle strains can occur randomly there are factors which can increase the likelihood of sustaining a groin strain. These include:

Groin strains usually occur when sprinting or changing direction quickly. Or from during rapid movements of the leg against resistance such as kicking a ball.

Overstretching the muscle such as in martial arts high kicks can also cause a torn adductor muscle. It is also likely you have damaged more than one structure with sudden onset acute groin strains(1).


Groin strain treatment

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Treatment consists of immediate first aid applying the PRICE principles of protection, rest, ice, compression and elevation. Then a full groin strain rehabilitation program consisting of stretching, strengthening and sports related exercises.


Cold therapy/ice

Groin cold wrap
Groin cold wrap

Apply a cold therapy and compression wrap as soon as possible after injury for at least the first 48 hours. Apply ice for 10 minutes every hour intially, reduce frequency as your symptoms improve.

This will help stop internal bleeding, reduce pain and swelling speed up the healing process. Do not apply ice directly to the skin as it may cause ice burns.


Groin strain strapping/taping

Groin strapping
Groin strapping

Strapping your groin can aid healing by applying compression to the area immediately after injury. This is part of the PRICE principles (protection, rest, ice, compression, and elevation).

It can also protect and support the muscles during rehabilitation and help prevent further damage to the injured muscle.

How to apply groin strapping


Wear a groin support

Groin strain treatment

Wear a groin support (or strapping) in the early stages to help stop internal bleeding, reduce swelling and protect the injured muscle.

Later in the rehabilitation process groin supports and compression shorts are useful for providing support and retaining muscle heat.


Electrotherapy

Electrotherapy modalities such as ultrasound may be used to aid the healing process. Ultrasound transmits high frequency waves into the tissues providing a micro massage effect. It may also help disperse swelling.


Medication

A doctor may prescribe NSAID medication such as Ibuprofen (do not take if you have asthma) to help with pain and swelling.

NSAID’s may be more beneficial in the early acute stages, but less effective later on.


Groin strain massage

video

Sports massage may be beneficial once the acute stage has passed (after 72 hours) by releasing tension in the muscle and encouraging blood flow and nutrients.

Caution is advised as massaging an injury too soon may increase the bleeding and may make the injury worse.


Exercises

After the initial acute stage of the injury has passed, a comprehensive rehabilitation program should begin. This is especially important to avoid recurrent Groin strains.

Exercises should always be pain-free, starting with gentle static stretches where you eases into the stretch and hold. Strengthening exercises aim to gradually increase the load through your muscles, within the limits of pain.

Before returning to full competition fitness, sports related and movement control exercises should be done.

More on Groin strain exercises


References & further reading

  1. Serner A, Tol JL, Jomaah N et al. Diagnosis of acute groin injuries: a prospective study of 110 athletes. Am J Sports Med 2015;43(8):1857–64.
  2. Serner A, van Eijck CH, Beumer BR et al. Study quality on groin injury management remains low: a systematic review on treatment of groin pain in athletes. Br J Sports Med 2015;49(12):813.
  3. Weir A, Brukner P, Delahunt E et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med 2015;49:768–74.
  4. Hölmich P, Uhrskou P, Ulnits L et al. Effectiveness of active physical training as treatment for long-standing adductor- related groin pain in athletes: randomised trial. Lancet 1999;353:439–43.
This article has been written with reference to the bibliography.
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