Groin strains are an injury to the area of the body where the abdomen meets the leg and the inner thigh muscles attach to the pubic bone of the pelvis. They can be a nagging type of injury that can linger until proper treatment is sought. Groin strains typically occur in the muscles of the upper inner thigh or in front of the hip. They can occur during any type of forceful movement of the leg such as kicking the leg up, jumping, or changing directions while running, which is why they are so prevalent in athletes vs non-athletes. Statistics show that groin strains account for 5% of all soccer injuries and 10% of all hockey injuries. Physical Therapy can significantly help treat groin strains by decreasing pain and increasing leg motion and muscle strength, which helps to increase the overall speed of recovery.
WHAT EXACTLY IS A GROIN STRAIN?
A groin strain occurs when the muscles of the inner thigh or front of the hip are overstretched or torn. They make walking, lifting the knee, or moving the leg toward or away from the body difficult and very painful. They can occur from overuse of the muscle or from a sudden, forceful contraction of the muscles.
When the muscles are either too forcefully contracted or too forcefully overstretched, an injury occurs. Muscles strains are generally graded according to the amount of muscle damage as follows:
Grade 1: A mild stretch or tear of a few muscle fibers. The muscle is sore and painful, but maintains its normal strength. Walking is normal, and use of the leg is not impaired.
Grade 2: A moderate stretch or tearing of a greater percentage of muscle fibers. There is more soreness and pain, a notable loss of strength, and bruising can also be observed. Walking is usually with a limp, and use of the leg is noticeably impaired.
Grade 3: A severe tear of the muscle fibers (and sometimes a complete tear). A “popping” sound may be heard or felt when the injury occurs. Bruising is readily apparent, and sometimes a “dent” may be seen in the muscle under the skin at the site of the tear. Putting weight on the leg is extremely painful, and use of the leg is severely difficult.
When any muscles are strained or torn, muscle fibers and other cells are disrupted. Bleeding can often occur which leads to bruising. Swelling can also occur within a few minutes to a few hours after injury, which causes the injured area to expand and feel tight. Although groin strains occur most often in athletic activities such as soccer, football, and dance, they can also easily occur during normal everyday activities such as slipping while walking, climbing stairs or ladders, or lifting heavy items.
WHAT DOES A GROIN STRAIN FEEL LIKE?
A groin strain causes sharp pain in the groin area. The pain can resolve quickly or it can linger, developing into a throbbing pain at rest with sharp, stabbing pain when you walk or try to move your leg. The muscles can feel weak or tight. Any attempt to lift the leg or knee, or bringing the knees together, can also cause sharp pain. With a groin strain you may experience 1 or more of the following signs and symptoms:
- Pain in the groin area
- Bruising in the groin area
- Swelling in the groin area
- Tightness in the groin area
- Limping when walking
- Weakness in the leg when trying to walk, climb stairs, or move the leg
- Difficulty performing your normal activities that require standing and walking
HOW ARE GROIN STRAINS DIAGNOSED?
Seeing a Physical Therapist first is a great way to be proactive in getting back on the road to recovery following a groin strain. Your Physical Therapist should conduct a thorough, comprehensive evaluation that includes your medical history. Some questions they should ask you are:
- What activity were you performing when you first felt pain?
- Where did you initially feel the pain, and did you feel or hear a “pop?”
- Did you receive a direct hit to your leg or groin area?
- Did you have any swelling within the first 2-3 hours after the injury?
- Do you get pain with walking, lifting your leg, moving your leg away from you, or bringing your knees together?
Your Physical Therapist should also perform special tests to determine if you do, in fact, have a groin strain, such as:
- Passive range of motion to gently move your leg away from your body
- Strength testing to have you resist against the Physical Therapist’s hand as they try to gently push your leg outward
- Palpation along parts of the muscles to determine the specific location of the injury
Your Physical Therapist should also conduct special tests to rule out involvement of the hip and back as well. In severe cases, your Physical Therapist may want to collaborate with an orthopedic surgeon, who may want to order diagnostic tests such as an X-ray or MRI (to confirm the damage and to rule out other potential damage). These tests, however, are not commonly required for a groin strain.
HOW CAN PHYSICAL THERAPY HELP?
Your Physical Therapist should design a specific treatment program tailored to your individual condition to help speed your recovery. This program should include treatments and exercises you can perform at home to help you get back to your normal lifestyle and activities. Within the first 24-72 hours your Physical Therapist may advise you to:
- Rest the area by avoiding walking or any activity that causes pain. You may need an assistive device, like crutches, to reduce strain on the muscles when walking
- Apply ice packs to the injured area for 10-15 minutes every 1-2 hours that you are awake
- compress the area with an elastic Ace wrap
- Consult with another medical professional for additional services such as diagnostic tests or medications
Reduce Pain–Your Physical Therapist can use different types of treatments to control and diminish your pain, including ice, heat, taping, exercises, and Hands-On Physical Therapy such as massage or myofascial release
Improve Range Of Motion–Your Physical Therapist should choose specific treatments and activities to assist in restoring normal movement in the hip and leg. This may begin with passive motions where the Physical Therapist will gently move your leg and hip joint, gradually progressing to active exercises and stretches that you perform yourself.
Improve Strength–Your Physical Therapist should select and instruct you in the appropriate exercises at each recovery stage of your healing in order to steadily restore your strength and agility. These may include using resistance bands, cuff weights, weightlifting equipment, as well as cardio equipment such as stationary bikes and treadmills.
Speed Recovery Time–Your Physical Therapist is trained and experienced in choosing the appropriate treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals quicker and safer than you are likely to do on your own.
Return To Activities–You, together with your Physical Therapist, will collaborate with you to decide on your recovery goals, including your return to work or sport, and will design your treatment program to help you achieve those goals in the quickest, safest, and most effective way possible. Your Physical Therapist should utilize Manual Therapy, such as massage or myofascial release, in addition to teaching you exercises and work retraining activities. If you are an athlete, you should be taught sport-specific techniques and drills to help you achieve your sport-specific goals.
Prevent Future Re-injury–Your Physical Therapist should recommend a home exercise program to stretch and strengthen the muscles around your hip, upper leg, and abdomen to help prevent future re-injury of your groin. These will most likely include flexibility and strength exercises for the hip, leg, and core muscles.
CAN GROIN STRAINS BE PREVENTED?
The following bits of advice can help you to prevent groin strains:
- Always warm up before starting a sport or heavy physical activity
- Increase the intensity of activity or sport gradually, not suddenly. Avoid pushing yourself too hard, too fast, or too soon.
- Wear appropriate shoes for your sport or activity, making sure they are in good condition and fit well
- Use correct lifting techniques
- Follow a consistent strength and flexibility exercise program to maintain good physical conditioning, even in a sport’s off-season.
If you or someone you know is experiencing signs or symptoms of a groin strain don’t wait to take action. Call my office at once at (302)691-9055 or visit my website at www.wildermanpt.com to schedule your FREE 30 minute consultation to see how Physical Therapy can help you. Don’t wait–call now!