“Groin” Pain 101

At least once a week I get a question from an athlete, parent, or coach involved in soccer or ice hockey about “groin” pain.  I put groin in quotations because the groin is often referred to as one muscle, although the injuries people refer to as groin strains typically involve several, usually the adductor brevis, adductor longus, pectineus, TFL, and/or iliopsoas complex (although the term “groin” could technically include the adductor magnus and gracilis, these muscles aren’t typically the ones that cause pain).  

Unfortunately, addressing groin pain is far from simple, as it almost never involves isolating a single problematic muscle and strengthening (or lengthening) it.  Typically the pain is a result of a combination of factors including movement impairments, causative or resultant muscle weakness, overly long muscles, and anatomical abnormalities.  Complicating the issue, groin pain can actually be referred from trochanteric (lateral hip), sacroiliac (where the spine meets the hips), lumbar (lower back), and lower abdominal issues, meaning the site of the pain may not be the site of the problem.

This week I’ll go through the things that I look for when an athlete reports with pain in/around the inner thigh or inguinal crease area.  The first step, before moving into any physical analysis, is to get a better idea of the nature of the pain.  A few questions to ask your athletes include:

1. When did the pain/discomfort start? Was there a specific incidence that caused it?
2. Where is your pain located?
3. What does the pain feel like? Dull aching, sharp, radiating, etc. 
4. What types of exercises/movements cause pain?  Is the pain immediate or does it come afterwards? 
5. Describe the intensity of the pain.  On a scale from 0-10, 10 being unbearable excruciating pain, where would you rate your pain when it first comes, a couple hours later, the next day, etc?
6. How long does the pain last?

Getting answers to these questions will provide some insight into the location, severity, and nature of their injury/pain.  If the injury/pain seems sufficiently severe, my recommendation is to not let them practice/play.  Odds are we’re just making the injury worse by allowing them to push through it (albeit-this is very much a judgement call).  I also find these questions make it easier to communicate with athletic trainers and physical therapists, who, when available, should be a go-to resource whenever an athlete reports an injury.  

That’s it for today.  Tomorrow I’ll get into more of the specific physical assessments.  

Happy Monday.