A groin strain is an overstretch or tearing injury to the muscles of the inner thigh or front of the hip. Groin strains make walking, lifting the knee, or moving the leg away from or toward the body difficult and painful. Groin strains can occur from overuse of the muscles, or from a sudden contraction of the muscles. Pain can range from a dull ache to sharp pain. The pain will often be worse when walking or moving the leg. A person may also experience spasms in the inner thigh muscles. Weak adductors, poor off-season conditioning and inadequate warm up or stretching increase the risk of an adductor strain.

Symptoms

  • Sudden pain in the groin or medial leg sometimes associated with a pop.
  • Pain on palpation of the muscle with possible swelling and bruising.
  • Loss of motion at the hip joint
  • Weakness of the adductor muscles
  • Difficulty putting weight on the affected leg. Crutches may be necessary to move around.
  • If not cared for properly this may become a more chronic situation.

Groin strains are graded with numbers 1 to 3, depending on how serious the injury is:

  • Grade 1 causes some pain and tenderness, but the stretch or muscle tear is minor.
  • Grade 2 causes pain, tenderness, weakness, and sometimes bruising.
  • Grade 3 is a severe tear of the muscle, causing bruising and a lot of pain.

Treatment of groin pain will depend on the severity of the condition. When treating the principles of RICE (rest, ice, compression and elevation) should be initiated.

  • Rest: avoid the activities that produce the pain (jumping, running, going up or down stairs, kneeling and squatting.)
  • Ice: apply ice to the tendon or area of inflammation. It is one of the fastest ways to reduce swelling, pain and inflammation. Apply it right away and then at intervals for about 20 minutes at a time. Do not apply ice directly to the skin.
  • Compression: such as an ace bandage to help take stress off the injured muscle may be useful. When using ice, apply light compression. This is especially helpful if swelling is present.
  • Elevation: elevate the area to help reduce swelling.

How can Physical Therapy Help??

Your physical therapist will perform a thorough evaluation to assess and determine the following:

  • Tendon: a series of tests will be performed to determine which tendon is involved.
  • Strength: resisted testing is performed to determine if there is associated weakness or strength imbalances
  • Flexibility: tight muscles can contribute to poor mechanics and weakness creating imbalances and making the hip more susceptible to tendinitis.
  • Technique: Often it is the way we perform motions (run, jump, cycle or row) that may cause a problem. Discuss and observe the activities you participate in, that may have started the problem to improve technique.
  • Training: review your training program and any sudden changes that may have precipitated or caused the present condition.
  • Alignment or footwear: a physical therapist will assess your leg lengths, foot mechanics and alignment to see if there are any imbalances. Checking for appropriate footwear is a crucial part of balancing the stresses applied to your legs and body.

 

Physical therapy for a groin pain must remain conservative at the onset to avoid aggravating the condition. Emphasis will be on rest, reducing the inflammation and increasing the blood circulation for healing. Once the initial inflammation has been reduced, a program of stretching and strengthening will be initiated to restore flexibility to the muscles involved and improve strength to reduce stress on the tendons and the hip. Taping or strapping to rest and reduce the stress placed on the tendon and promote healing may be necessary. Your therapist is trained in these specific taping techniques.

Common Physical Therapy interventions include:

  • Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve alignment, mobility and range of motion of the knee and hip. Use of mobilization techniques also help to modulate pain.
  • Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen muscles of the knee and lower extremity to support, stabilize and decrease the stresses place on the burse and tendons of the hip joint.
  • Neuromuscular Reeducation (NMR) to restore stability, retrain the lower extremity and improve movement techniques and mechanics (for example, running, kneeling, squatting and jumping) of the involved lower extremity to reduce stress on the burse and tendons in daily activities. Taping, strapping or bracing may be useful to rest the tendon and promote healing.
  • Modalities including the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation of the involved tendon and bursa.
  • A home exercise program that includes strengthening, stretching and stabilization exercises and instructions to help the person perform daily tasks and advance to the next functional level.

In general patients respond well to conservative treatment of a groin pain. It is important that once the pain and inflammation is reduced, and motion and strength are restored, the patient gradually returns to full activities. Instruction in daily activities or sport performance is helpful for reducing a reoccurrence of tendinitis. In most cases, full return to activity will take from 2-6 weeks depending on the severity

Resources:

https://www.medicalnewstoday.com/articles/321007.php

https://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=a718efd4-8b6c-4b7b-af9c-adeb8a5e7745

https://twinboro.com/body/hip/conditions/adductor-groin-strain-nj.html