Groin pain: why it hurts and how to get rid of it quickly

As an active athlete, do you have groin pain and don't know what to do? You don't need to look elsewhere for answers to all your questions about your injury - in this article we will discuss why groin pain occurs and how to deal with it properly .

Why does my groin hurt? Is it really a pulled groin?

Groin pain is a common problem for athletes. It usually stems from the muscles and their attachments . We commonly refer to it as a pulled groin. However, the problem of groin pain is often more complex. Most often , several factors contribute to the pain, the most common of which are stretching or tearing of the abdominal muscles and their fascia , pathology of the inguinal canal , injury to the tendons of the abdominal muscles, or injury to the muscles that pull the thigh (adductor muscles). ^1,2

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Who does a pulled groin affect?

The above-mentioned injuries in the groin area do not occur without a cause. The basis for their occurrence is a very dynamic movement such as jumping , sudden acceleration and changes in direction . Therefore, this injury is typical for athletes , rugby players , football players , hockey players , tennis players and other athletes. It is during such explosive movements that it is easy to stretch or tear one of the many groin structures. ²

How do I recognize a pulled groin?

Typical symptoms of a pulled groin include severe pain (usually on one side) that worsens with movement and goes away with rest . The pain can occur suddenly without any previous symptoms, but more often athletes describe a previous mild groin pain that worsened during sports and prompted them to see a doctor. In addition to the groin itself, the pain may radiate to the lower abdomen or inner thigh. ²

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Should I go to the doctor for a checkup?

If you have groin pain, it is a good idea to see a doctor for surgery, orthopedics or rehabilitation. The doctor's job is to find out if it is really a pulled groin or an inguinal hernia, hip problems and other less likely causes. To find a specific problem, he must feel your groin thoroughly and locate where it hurts. Then he will find out what type of movement your groin hurts with and will probably send you for an X-ray, ultrasound or magnetic resonance imaging . Based on the results of the examination, he will suggest therapy. ²

How is a pulled groin treated and how long does it take?

How a pulled groin will be treated depends on which structure is injured and how seriously it is injured. Usually, conservative treatment consisting of anti-inflammatory medications , massage , stretching , and icing is sufficient. Sports should be restricted for 2 to 8 weeks, followed by gradual weight-bearing . Return to pain-free training at full strength usually takes 10 to 12 weeks. Surgical treatment is very effective in severe cases . Rehabilitation with a physical therapist is absolutely essential for both conservative and surgical therapy, who will train sufficient core strengthening , adductor strengthening and stretching , hip mobility , and other aspects important for returning to sports. ^1,2,3

^{Beware of inguinal hernia}

Some groin pain in athletes may be caused by an inguinal hernia . An inguinal hernia appears as a " bump " of various sizes in the groin area and can also be pushed back in. It is a pouch that is formed by the extrusion of fat or intestinal loops out of the abdominal cavity through a weakened part of the abdominal wall . They arise in situations where intra-abdominal pressure increases (for example, during weightlifting and other strength exercises ) and the abdominal wall cannot withstand it and part of it bulges out .

After a hernia occurs, it is essential to visit a surgeon and agree on the next steps. It is usually recommended to operate on the hernia, because without surgery there is a risk of hernia contents becoming trapped and developing life-threatening complications , but there are cases when a hernia is treated conservatively.

Returning to sports after inguinal hernia surgery can take a different amount of time and it is important to discuss this with your doctor. It will depend on the size of the hernia and whether the surgery was performed laparoscopically or open, as well as complications and the condition of the scar. The return should be gradual and should not be rushed, otherwise the hernia will return. Some people will be able to start training within 2 weeks of surgery, while others may take up to 2 months.

Resources:

1. Zuckerbraun, Brian S et al. "Groin Pain Syndrome Known as Sports Hernia: A Review." JAMA surgery vol. 155.4 (2020): 340-348. doi:10.1001/jamasurg.2019.5863
2. Elattar, Osama et al. "Groin Injuries (Athletic Pubalgia) and Return to Play." Sports health vol. 8,4 (2016): 313-23. doi:10.1177/1941738116653711
3. Charlton, Paula C et al. "Exercise Interventions for the Prevention and Treatment of Groin Pain and Injury in Athletes: A Critical and Systematic Review." Sports medicine (Auckland, NZ) vol 47.10 (2017): 2011-2026. doi:10.1007/s40279-017-0742-y