Groin injuries are some of the most common sports injuries but also very difficult to properly diagnose. One reason for this is the groin is the site of multiple muscle, tendon and bony connections. In addition, multiple nerves run thru the region and entrapment syndromes can lead to groin pain.
Lower abdominal and hip injuries can also refer pain to the groin region. The first step in diagnosing groin pain is for the treating professional to perform a thorough history and physical to better narrow down the exact cause of the groin pain.
In athletes, the most common cause of groin pain is a strain or tear in the adductor muscles that are found in the region between the pubic bone and the top of the lower leg. There are 5 muscles that are considered adductors and a strain in 1 or multiple muscles can lead to groin pain.
A strain in one of these muscles can be caused by sprinting, rapid change in direction or landing after a jump causing excessive stress on the muscles. In addition, a fall on an extended leg of a person engaged in a blocking maneuver can also lead to a sprain or strain of one or multiple muscles. The severity of the injury is related to the amount of damage that the muscle receives at the time of the injury.
Grade 1 – Mild – No to minimal pain during everyday activities, mild pain and discomfort when performing sport specific activities
Grade 2 – Moderate – Moderate pain with everyday activities, in ability to run or jump without significant pain. Minimal swelling, mild bruising at location of muscle injury that resolves in about 1-2 weeks.
Grade 3 – Severe – Pain in groin area even at rest characterized as being a stabbing sharp pain. Significant Swelling and/or bruising that may develop several days up to a week after the initial injury. Loss of upper leg strength with certain movements. Involuntary muscle spasms in the muscles of the inner thigh and in the case of a complete tear of one or multiple muscles a muscle deformity with bulging and firm bruising.
Groin strains are initially treated with RICE – Rest, Ice, Compression and Elevation of the affected leg to a position that does not invoke pain or discomfort at rest. This initial phase is maintained for a minimum of 1 week and then the injury is reevaluated. If the symptoms do not improve with conservative therapy further evaluation maybe necessary.
Once pain has resolved, gradually increasing activities provided there is no recurrence of pain is the initial phase of recovery. Generally a Grade 1 strain takes 1-2 weeks to heal, Grade 2 takes 3-4 weeks and a Grade 3 can take 6-8 weeks or longer to heal.
Groin strains are particularly susceptible to re-injury and in many athletes, the injury will flare with any excessive strain on the muscle which is why these type injuries may become nagging issues for the duration of the season.
If the injury is not showing significant improvement, other sources for the groin pain may need to be investigated by more advanced diagnostic tests like High definition ultrasound and MRI. Give sufficient time for the injury to heal is the number one rule in treating groin strain injuries.
Editor’s babble: Thanks to Dr. Beth Sullivan for her terrific contributions to our blog. You can find Beth on Twitter @GAPeachPolymer.