Groin strain

What is a groin strain?

A groin strain (or pulled groin) is an injury caused by putting too much stress on the adductor muscles (including adductor magnus, brevis and longus) in your groin and thigh. If these muscles are tensed too forcefully or too suddenly, they can be over-stretched or torn. A pulled groin can vary in severity from mild to severe.

A groin strain is common in people who play sports that require a lot of running and jumping, especially suddenly jumping or changing direction. A groin strain often occurs in people who play football or hockey. In male football players the adductor muscles are the most commonly injured muscle group.

The symptoms of a groin strain will depend on how badly you've pulled your groin but may include:

• A popping or snapping feeling during the injury, followed by severe pain.

• Pain and tenderness in the groin and the inside of your thigh.

• Pain when you bring your legs together.

• Pain when you raise your knee or try to climb stairs.

• Swelling and bruising.

To diagnose a groin strain, your doctor will ask you several questions (such as what you were doing when the pain started and what the pain is like). They may want to give you a thorough examination of the spine and legs and usually no further tests are needed. However, tests like X-rays, ultrasound scans and magnetic resonance imaging (MRI) scans may be needed to rule out other problems.

A pulled groin will usually heal without any treatment and just needs time and rest. However, you can help the groin to heal more quickly by doing the following:

• Ice treatment for the inside of your thigh to reduce pain and swelling. Put ice or a cold pack on your groin area for 10 to 20 minutes. Place a thin cloth between your skin and the ice/cold pack to avoid an ice burn to your skin. Do this frequently (every few hours during the day if possible) for the first three days or until the swelling goes down.

• Compress your thigh using an elastic bandage or tape.

• Simple analgesia such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, will help with pain and swelling. Note: these should only be used for a short period, such as up to 1-2 weeks.

• Active stretching and strengthening exercises as part of a physical therapy rehabilitation program. You should use the level of pain to guide how much exercise you should do. if the exercises are too aggressive or frequent then further damage may occur.

• Until your groin feels completely better, switch to a different activity that won't put too much stress on your groin muscles. For example, runners could try swimming to stay fit until the groin problem has resolved.

Surgery

Simple conservative treatments as listed above are usually enough to help a pulled groin get better.

However if they don't work very well then surgery may be an option, especially if you are an athlete or other sportsperson and need to be back in training or competing as soon as possible.

While surgery may give you relief, it's still a last resort. Not everyone can return to their previous level of activity after surgery.

The recovery time for groin muscle strains depends on how serious your groin strain is. It often takes about four to six weeks but different people heal at different rates. Whatever you do, don't rush things. If you start pushing yourself before your groin has healed, further injury may occur. Repeated pulled groins may take longer to heal or even become a permanent problem.

• Always warm up thoroughly, including your legs and groin muscles, before any physical activity.

• Wear shoes with good support that fit well.

• Always slowly increase the intensity of your physical activity and build up gradually.

• Stop exercising if you feel pain or tightness in your groin or the inside of your thigh.

• Do regular strengthening exercises for your thigh muscles.

Groin injuries can result from added stress due to weakness elsewhere. Make sure your exercise/training programme addresses all areas, such as ankle, knee and core, and this will help to prevent sports injuries such as a pulled groin.