Groin Strain

Sports-related groin pain is a common condition in athletes. It results from chronic, repetitive trauma or stress to the muscle and tendon portions of the groin or from overuse of the lower abdominal musculature and muscles of the upper thigh. The groin pain usually develops gradually. It can be associated with virtually any sport but most often is encountered in hockey, soccer, rugby and football – sports that require frequent bending or leaning forward.

Anatomy:

The most common culprit of sports-related groin pain is the tearing of the external oblique muscle, with injury to the ilioinguinal nerve that courses through that area. Other causes include inflammation of the pubic tubercle and strain to the adductor muscles.

Diagnosis:

The physician would examine the groin to make sure there is no inguinal hernia present. The pain from groin strain can usually be reproduced by performing simple maneuvers, such as sit-ups or crunches. Ultrasound is often used to evaluate the groin area for any tendon abnormalities. Sometimes, if the inflammation of the pubic tubercle is suspected, an imaging test called a bone scan is ordered to determine if there is inflammation present in that part of the body. X-rays are usually not very helpful in diagnosis.

Treatment:

The most important part of the initial treatment is rest and abstinence from the physical activities that caused the groin strain. Patients who insist on continuing to play the sport despite groin pain will take considerably longer to heal. It is also beneficial to apply ice packs to the sore area three to four times per day for approximately ten minutes. Over-the-counter pain medications, such as ibuprofen, are useful for pain relief. Gentle physical therapy exercises may be helpful in some cases. Unfortunately, the groin pain often tends to return once the sport activity is resumed..

Surgical exploration may also be used in cases of severe and persistent groin pain or when a prompt return to the sport activity is required. This is often performed laparoscopically using a camera inserted through a small groin incision, but sometimes open surgery is required to correct the abnormality. Surgery is not recommended in the cases of adductor muscle strain, which is best treated with physical therapy.

Outcome:

According to studies, long-term improvement is usually seen in 90 percent of surgically treated patients.