Groin pain is a common complaint for athletes participating in sports that involve repetitive sprinting, kicking or twisting movements such as Track and Field, AFL and Soccer. However can also present in post-partum women. Symptoms can vary and are often vague and diffuse, extending anywhere from the lower abdomen, down to the inside of the thigh and to the buttocks on one or both sides. There are multiple causes for groin pain and most conditions tend to be multi-factorial. Groin pain is often diagnosed as a single problem or muscle “tear”, however research has found that there are often multiple pathologies co-existing in the same patient. As a result, treatment will often fail, particularly in cases of chronic groin pain (greater than 6 weeks), if the co-existing pathologies are not addressed.
The most common injuries associated with the groin are
- adductor tears/tendinopathies
- osteitis pubis
- hernia (direct and indirect)
- iliopsoas (hip-flexor) related groin pain
All these structures that cause groin pain are intimately related, therefore a comprehensive knowledge of the anatomy of the hip and groin is paramount to diagnosing and treating groin pain. For example, the rectus abdominis (6 pack muscle) shares a common attachment site to the pubic bone as the adductor tendons (on the inside of your thigh). This has implications for treating even the most simplest groin “strain” and is the reason why having pain with a sit-up can be easily mis-diagnosed as a hernia rather than an adductor and or pubic bone problem.
The aggravating factors for different types of groin pain can vary significantly and can include, but is not limited to
- pain with kicking
- pain with side-stepping
- pain when accelerating or sprinting
- pain with stairs
- pain with walking
In most cases, patients will often report only minor pain to begin with or feel a slight “groin pull”, then, as it is left un-treated, can progress to the point where even rolling over in bed or getting dressed in the morning becomes painful (this will most often be the case with osteitis pubis and pubic instability, particularly in post-partum women). Early intervention, for even what may seem to be a small “groin strain”, is the best way to return to your activities quickly and prevent the injury progressing into a chronic, debilitating issue.
Treatment is very much patient specific. There is no recipe for treatment as each patient will be uniquely different. The most common exercises we will prescribe for groin pain will be specific strengthening exercises designed to enhance the groin’s ability to absorb loads and forces through the pelvis optimally and evenly. This will involve varying forms of strengthening exercises for the adductors, abductors, hip flexors, core muscles and glutes in a specific, pain free manner.
The physiotherapists at our clinic are highly qualified in diagnosing and treating groin conditions.
by. Andrew Clark