A groin strain is a tear of an adductor muscle on the inside of the thigh. It is often referred to as a pulled groin muscle and ranges from mild to very severe.
Medically reviewed by Dr Chaminda Goonetilleke, 7th Jan. 2022
Symptoms | Anatomy | Causes | Treatment | Rehabilitation program
Symptoms of a strained groin
Groin strain symptoms occur either in the belly of the muscle or higher up where the tendon attaches to the pelvis. They include:
- Sudden sharp pain in the groin
- Symptoms range from mild discomfort to severe pain
- You may or may not be able to continue playing or training depending on the severity
- Stretching the injured muscle is painful
- Pain contracting your groin muscles (adduction) against resistance
Groin strains are graded 1 to 3 depending on severity. Your doctor or physio performs a number of assessment techniques to help diagnose your groin pain.
- More on Groin strain diagnosis
Download our full Groin strain rehabilitation App. It takes you step-by-step from injury to full fitness.
Anatomy
There is five groin (adductor) muscles, three short (pectineus, adductor brevis, and adductor longus) and two longer muscles (gracilis and adductor Magnus). The short adductor muscles attach above the knee and the long ones insert below.
The main function of the adductor muscle group is to pull the leg inwards towards the midline (adduction).
The groin muscles also stabilize and control your pelvis during walking and running. Therefore they are especially important in any sport which requires rapid changes in direction.
What causes Groin strains?
Although groin muscle strains can occur randomly there are factors that can increase the likelihood of you sustaining a groin strain. These include:
- Not warming up properly.
- Weak adductor muscles.
- Tight adductor muscles.
- Previous injury.
- Lower back injuries/dysfunction.
- Biomechanical factors.
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 may have damaged more than one structure if you experience a sudden onset of acute groin pain(1).
Groin muscle strain treatment
Treatment consists of immediate first aid followed by a full groin strain rehabilitation program. Apply the PRICE principles of protection, rest, ice, compression, and elevation.
Cold therapy/ice for a strained groin
Apply a cold therapy and compression wrap as soon as possible after injury for at least the first 48 hours. This will help stop internal bleeding, reduce pain, and swelling speed up the healing process.
Apply cold therapy for 10 minutes every hour initially, reducing frequency as your symptoms improve. Do not apply ice directly to the skin because it may cause ice burns.
Groin strain strapping/taping
Strapping your groin muscle strain 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.
Wear a groin support
Wear a groin support (or strapping) in the early stages as this helps stop bleeding within the muscle, reduces swelling and protects 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
Your doctor may prescribe NSAID medication. Do not take Ibuprofen if you have asthma.
NSAIDs are thought to be more beneficial in the early acute stages but less effective later on.
Groin strain massage
Sports massage is beneficial once the acute stage has passed. This is usually after 72 hours. Massage by releasing tension in the muscle and encouraging blood flow and nutrients.
Be careful not to use massage too early because you may increase internal bleeding and as a result make your injury worse.
Exercises for pulled groin muscles
After the initial acute stage has passed, you can begin a comprehensive groin strain rehabilitation program. This is especially important to avoid recurrent Groin strains.
Exercises should always be pain-free, starting with gentle static stretches where you relax 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.
Full Groin strain rehabilitation program
Our full Groin strain rehabilitation program has been created by Professional Football Physiotherapist Paul Tanner. It is based on what Paul does with his elite players but adapted for use by anyone.
Criteria-based, we take you from initial injury to full competition fitness. App-based it tells you exactly what treatment and exercises to do each day and automatically records your progress on your mobile device or phone.
Injuries with similar symptoms
Other injuries which have similar groin pain symptoms include Gilmore’s groin and Adductor tendonitis.
References & further reading
- 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.
- Serner A, van Eijck CH, Beumer BR, et al. Study quality on groin injury management remains low: a systematic review on the treatment of groin pain in athletes. Br J Sports Med 2015;49(12):813.
- 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.
- Hölmich P, Uhrskou P, Ulnits L et, al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: a randomised trial. Lancet 1999;353:439–43.
