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Groin Strain

Groin Strain

Groin strain is when you pull or overstretch (tear) your groin muscle. The groin muscles are located in the folds where your belly meets the legs on either side of your trunk. Any strenuous physical activity, like professional sports, can put a strain on your groin muscles. When you lift, push, or drag big objects, this condition may manifest itself. Similarly, when you fall, you could pull a muscle in your groin. The damage to your groin muscle or ligament may be anything from a modest strain to a complete muscle tear.

The groin is a region where thigh muscles like the adductor longus and hamstrings are attached. Sprinting or any other activity requiring a strong movement of the thigh can result in groin strains. Particularly, sports individuals who carry out vigorous movements of their legs are more prone to develop groin strain and its complications. Ten percent of ice hockey injuries and five percent of soccer injuries are groin strains.

In this article, you will get complete information about groin strain and what you can do about it if you are suffering from this condition.

Causes of a groin strain

Professional and amateur athletes both frequently suffer from groin strains. Other causes and risk factors of a groin strain are:

Frequent falls on one side of the body can leave you vulnerable to a groin strain. This often happens in athletes especially soccer players(1). Recurrent physical trauma in the inguinal region weakens your groin muscles and they are more likely to undergo strain.

A hernia is another potential cause of groin strain. This is especially common in males where the loop of the intestine forms a bulge on the groin region and tries to move out of your groin. This stretches your groin muscles and you develop groin strain. And if this condition is running in your family, you are also likely to suffer in the future.

Lifting heavy objects may cause muscle injury and can put you in groin strain. Your groin muscles come into action when you try to stand from a sitting position while lifting heavy objects. This stretches the muscles and even produces small tears in your groin region and you start to feel groin strain. In addition, previous groin injuries may also manifest as groin strain if you don’t take care of them.

Forceful kicking or twisting of your leg can also cause groin strain. Your thigh muscles also play an important role in your groin strain. When you overuse your thigh muscles while jumping or forceful movements of your leg, your groin muscles are stretched and you feel groin strain(2). Your groin region is to support your abdominal wall and transfers the force from the abdomen to the inside of the thigh. However, sudden and strong movements in the groin region can disrupt its internal structures which cause groin strain.

Grades of a groin strain

Grade 1

In grade 1 groin strain, only 5% of your groin muscle fibres are harmed. This happens when you overextend your muscle while jumping or running. Symptoms are not that much worse but you will feel difficulty when you do any physical activity while standing.

Grade 2

A grade 2 groin strain is a tear in your groin muscles that significantly compromises the fibres of the muscle. You will not feel any pain or discomfort while you are resting but when it comes to walking and bringing your thighs together, it could be really uncomfortable for you.

Grade 3

In grade 3 groin strain, a tear develops that penetrates most or all of the muscles of your groin region. At the time when it occurs, you feel excruciating agony. In addition, you will feel pain all the time unless you take some painkillers. You will not be able to stand or perform any work if you have a grade 3 groin strain. Any use of the damaged muscle will cause pain.

Signs and symptoms

Depending on the severity of the injured muscle, groin strain symptoms range from minor to severe. Common symptoms of a groin strain are:

  • Pain: Pain is the first and foremost condition that you will feel if you have groin strain(3). Pain will be on the inner thigh that will exaggerate if you touch it or try to move your thigh. Severe pain occurs when the damage to your groin muscles stimulates the sensory nerves that transmit pain.
  • Decreased strength in the upper leg: You will feel a loss of strength in your thigh if you have a groin sprain. This is because your groin muscles and their nerves are damaged and this greatly reduces the range of motion.  
  • Swelling: Swelling is a sign that something wrong is going on at the site. Swelling occurs after any damage in your body. So if you feel swelling in your groin region, it is highly likely that you have groin strain if it is not the hernia(4)
  • Bruising: Bruising or skin discoloration of the groin region also occurs when you have groin strain. Damage to the groin region also damages your blood vessels and blood moves out of them. The blood pools in the region turning it blue or reddish in color. 
  • Limping or difficult walking: If you have groin strain, you will surely feel difficulty walking. And if you try to walk, your gait will be altered. This happens all the time due to pain unless you rectify your condition properly.

Diagnosis of a groin strain

An accurate diagnosis of your condition is necessary as this affects the treatment directly you are going to take. People also confuse hernia and groin strain commonly.

Only experienced physical therapists or medical professionals can identify groin strain. Typically, they will enquire about what your symptoms are and in what manner your injury is sustained.

Your doctor will also need to know what you actually felt like when you went through this condition for the very first time. The doctor will also inquire about the discomfort while moving the leg, check the swelling after the accident, and ask whether you heard a popping sound when it occurred.

A physical examination will also be a part of the appointment. Your doctor will feel your muscle bulk and gently move your leg to see if there is any physical anomaly. Occasionally, additional testing is also required. To ensure there is no additional injury to the leg or pelvis, you may also undergo an X-ray or an MRI.

Groin strain diagram

Treatment of groin strain

The purpose of groin strain treatment is to lessen pain and swelling as soon as the acute injury occurs. The treatment regimen for any soft tissue injury is followed for the first few days:

R.I.C.E therapy

Conservative therapy involves non-surgical procedures to rectify your condition. This involves R.I.C.E therapy at your injury site. Taking rest is an essential part of the healing process. Apply an ice pack to your groin area as this relieves pain for the time being. Do not apply ice for more than 20 minutes. In addition, the elevation of your leg about the heart level improves the blood supply and this greatly adds to your healing process.

Take anti-inflammatory medications

Take nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen(5) if you feel swelling and bruising in the region of your groin. Also, take painkillers like aspirin if the pain is beyond bearable. However, you need to consult your doctor before taking these medications because these may have side effects on your body.

Physical therapy

Physical therapy is another great thing that you can carry out to boost your healing process. If you feel a weakening of your groin or thigh muscles, then physical therapy is the must thing to do(6). You need to find a good physiotherapist (physio) for this purpose. Physiotherapy improves the strength of your muscles and relieves any muscle tension that ultimately helps in the treatment of your groin strain.

Massage to help a groin strain

Massage your groin region if you experience pain off and on. Regular massaging not only will improve the blood supply but also strengthens the groin muscles which greatly reduces your recovery time. However, do not apply great force to your injury as this can make the condition even worse. Gentle application of oil and hand massage will be great.

Surgical treatment

If the strategies of the conservative treatment do not become fruitful, you may need to undergo a surgical procedure to resolve your medical issue completely. However, do consult the pros and cons of the surgical procedure with your doctor before getting it done. After your surgery is done, do not carry out much physical activity and try to take rest as much as possible.

Prolotherapy

Some of the structures around the groin have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that helps to heal these structures.

Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

Recovery time

The length of recovery from a groin strain injury depends on how severe your damage is.

Your level of pain often serves as a good indicator of how well you are recovering. As your adductor and groin muscles heal, your pain levels start to decrease. As your condition improves, avoid painful activities such as jumping and running. This will boost the recovery time from your injury.

Generally, it takes two to three weeks if your groin strain is of grade 1 type and 2 to 3 months if it is of grade 2 type. However, if you have grade 3 groin strain with a complete tear of the muscles, your recovery time will be much longer and often takes four to six months.

Your level of fitness before injury also affects how long it will take you to heal. Since it differs for each person, there is no set period of time. As a general rule, you should take rest for many weeks after suffering from a groin strain before you are able to resume your normal activities.

How to prevent a groin strain

Although groin strains are not always avoidable, there are certain measures that you can take to avoid their likelihood and improve your healthcare.

  1. Put on supportive footwear that fits properly.
  2. Do regular thigh muscle strengthening exercises, especially if you’ve previously injured the groin region.
  3. Warm up your body before engaging in strenuous physical activity. 
  4. Increase your exercise levels gradually rather than suddenly.

Takeaway

Now you know almost everything about groin strain and what you need to do about it. Groin strain often occurs as a part of sports injuries. Avoid engaging in any activities that make your pain worse while your groin is recovering. The time it takes to fully recover can range from a few weeks to many months. You can gradually resume your other activities once you’ve recovered entirely. Treatment depends on the grade of groin strain you are suffering from. Consult with your doctor to diagnose your condition accurately. Also, keep in touch with your doctor if you feel like worsening of your condition at any point of your treatment.

 

References

  1. Gilmore, J. (1998). GROIN PAIN IN THE SOCCER ATHLETE: FACT, FICTION, AND TREATMENT. Clinics in Sports Medicine, 17(4), 787–793. https://doi.org/10.1016/s0278-5919(05)70119-8
  2. Serner, A., Weir, A., Tol, J. L., Thorborg, K., Roemer, F., Guermazi, A., Yamashiro, E., & Hölmich, P. (2017). Characteristics of acute groin injuries in the adductor muscles: A detailed MRI study in athletes. Scandinavian Journal of Medicine & Science in Sports, 28(2), 667–676. https://doi.org/10.1111/sms.12936
  3. Estwanik, J. J., Sloane, B., & Rosenberg, M. A. (1990). Groin Strain and Other Possible Causes of Groin Pain. The Physician and Sportsmedicine, 18(2), 54–65. https://doi.org/10.1080/00913847.1990.11709972
  4. Mudan, S., & Fajardo-Puerta, A. B. (2013). Swollen and/or Painful Groin. Problem Based Urology, 21–28. https://doi.org/10.1007/978-1-4471-4634-6_3
  5. Brannigan, A. E., Kerin, M. J., & McEntee, G. P. (2000). Gilmore’s Groin Repair in Athletes. Journal of Orthopaedic & Sports Physical Therapy, 30(6), 329–332. https://doi.org/10.2519/jospt.2000.30.6.329
  6. King, E., Ward, J., Small, L., Falvey, E., & Franklyn-Miller, A. (2015). Athletic groin pain: a systematic review and meta-analysis of surgical versus physical therapy rehabilitation outcomes. British Journal of Sports Medicine, 49(22), 1447–1451. https://doi.org/10.1136/bjsports-2014-093715

 

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