Diagnosis: Groin Strain
How Groin Strain Presents
A groin strain or a groin pull is a common injury that occurs while playing sports that require running and jumping.
Common symptoms experienced by patients who have suffered a groin strain are:
- Groin pain and tightness. Pain, tenderness and tightness along the inner thigh and/or pubic region.
- A popping or snapping sound, accompanied by severe, sharp pain at the time of the injury.
- You may feel the same sharp pain when you contract the groin muscles by bringing your legs together, or swinging your thigh across the midline (adduction of the thigh).
- You may also feel the same pain when you stretch the groin muscles by lifting your knee.
- Bruising and swelling may appear around the site of the injury after a few days
How Groin Strain is Diagnosed
Your skilled physiotherapist is able to diagnose for groin strain and rule out similar presenting conditions.
The other conditions that cause groin pain are hip fractures and hip joint pathologies, inguinal hernias, other muscle tears and bursitis, but your physio should be able rule these out.
A positive diagnosis from groin strain is based on:
- A full history of the injury which describes the onset of pain as the result of trauma, and any previous injuries
- Observation for the presence of swelling and bruising in the groin area
- Palpation for tenderness, tightness and pain in the groin muscles. There may be gaps in the muscle belly if there is a significant tear
- Assessment of range of motion at the hip through special tests such as the Thomas Test. The range of motion is usually decreased compared to the unaffected leg, and pain is usually elicited towards the end of range.
- There may be weakness and pain with resisted thigh adduction (pull the leg towards the midline of the body)
Causes of Groin Strain
Groin strain is usually a traumatic injury that occurs commonly in sports that have a lot of repetitive twisting, kicking, turning and sprinting. It is a common injury in soccer and rugby players.
Groin strain is a common injury in soccer and rugby players.. #performbetter @pogophysio Click To TweetYour groin muscles is a group that consists of adductor brevis, adductor longus, adductor magnus, pectineus and gracilis. Fibres of one or more of these muscles and their tendons can be ruptured during a groin strain. The mechanism of injury is usually due to a forceful contraction of the groin muscles while the muscle is being stretched (i.e. a violent eccentric contraction). This creates an enormous amount of tension in these muscles, which may result in tears.
Groin strains can also be the result of gradual build-up of small tears due to overactivity without sufficient rest.
Treatment of Groin Strain
Early physiotherapy for groin strains can help the patient return to sport in a shorter time span, greatly reduce the risk of reinjury and prevent further complications.
A conservative treatment protocol may progress through the following 3 phases:
- Phase 1: Protect the muscle to encourage healing, reduce inflammation and pain, low grade exercises to maintain flexibility
- Phase 2: Progressively regain strength and restore normal full range of motion at the hip. Increase core strength and control for better stability at the hip and thus reducing the risk of reinjury
- Phase 3: Progressive increase in loading and speed of sport specific activities in preparation for returning to sport.
Surgical intervention for groin strains are very rare. They are only indicated for complete ruptures of muscle or tendon.
Wayne Wu
Student Physiotherapist
References
Lahousse, A., Kaat, G., Kiekens, N., Vandervelde, M., & Lievens, L. (2016). Groin strain Retrieved December 04, 2016, from http://www.physio-pedia.com/Groin_strain
Tyler, T. F., Silvers, H. J., Gerhardt, M. B., & Nicholas, S. J. (2010). Groin Injuries in Sports Medicine. Sports Health, 2(3), 231-236. doi: 10.1177/1941738110366820
WebMD Medical Reference. (2014, September 28, 2014). Groin Pull Retrieved December 04, 2016, from http://www.webmd.com/fitness-exercise/groin-pull#1
www.sportsinjuryclinic.net (Producer). (2010, December 04, 2016). Assessment Techniques for Groin Injuries. [Video] Retrieved from https://www.youtube.com/watch?v=VfAKc6_FbLQ
