Claremont Physio Matt Adamson answers the Top FAQs about Groin Pain
Matt Adamson, Senior Physiotherapist
What causes groin pain?
Pain in the groin can occur for a number of reasons. It can be related to a local problem arising from the joints and soft tissues around the groin itself, or from other areas that can refer pain into the groin area, such as the lower back.
Muscular Problems - The main group of muscles involved in groin pain are called the adductors which act to bring your knees in together and also perform actions like crossing your legs or kicking a ball. Alongside these on the front of your upper thigh are your hip flexors which bring your knee up towards your chest. It is common in sports which involve running in many directions, twisting and turning and particularly football or rugby to have groin strains. These are usually quite simple and resolve with following the RICE (Rest, Ice, Compression, Elevation) routine and gradual return to sports. A simple muscular injury will usually resolve in 2-4 weeks, however, if you return to activities too soon you risk re-injury and taking longer for it to heal. More significant injuries that alter how you walk or cause bruising to your leg should been assessed by your GP or a Physiotherapist. In some cases, people go on to develop chronic recurrent adductor muscle and tendon problems but this can be treated successfully with a specific exercise programme from a Physiotherapist.
Hip Joint Injuries - These can be split up into different areas depending on what the cause of the problem is;
- Ligament/Joint Capsule Injuries - These are fairly uncommon and the hip has very strong ligaments so the capsule is rarely stressed due to the strength of the ligaments. There are 3 main ligaments for the hip that help to protect the joint and also a deep ligament inside the hip joint called the Ligamentum Teres. This acts in a similar way to the cruciate ligaments of the knee and helps to provide stability to the joint.
- Hip Joint - The hip is a very sturdy joint and has complex biomechanics that allow you to move it in many directions and with a lot of force. People will know Osteoarthritis of the hip to be a common cause of pain and there is an article by Mr. Simon Buckley that's worth a read. In recent years, a lot more has been understood about the hip joint and there are other structures within the hip that can be a cause of pain. The labrum is a grisly rim inside the socket of the hip joint that helps provide some lubrication and make sure there is more contact area between the ball and socket. The Labrum can develop tears and become thinner over time, similar to meniscus (cartilage) injuries of the knee and there has been an increase in the diagnosis of Labral injuries in the hip as investigative techniques using MRI have advanced forward. Physiotherapy can help to treat the symptoms of hip joint pain and potentially avoid surgery.
Pubic Symphysis Injuries - The pelvis is essentially 2 half rings that are joined together at the back and front and the the Pubic Symphysis is the joining portion at the front. It is a fibrous cartilage disc, which is designed to be tough and restrict movement. There are various tendons and ligaments that attach to the Pubic Symphysis and as such, it has a great deal of forces pulling on it. It sometimes becomes injured when the forces from your ligaments and tendons pulling on it exceed what it can take. This can often happen if you significantly increase your exercise levels and is often described as an achy, dull or throbbing pain over the pubic bone area.
Hernias - There are many different types of hernias that can occur in the body however the main ones concerning groin pain are Inguinal and ‘Sportsman’s Hernia’. An Inguinal hernia is a protrusion of part of the intestines in the Inguinal Canal and often causes a sharp pain on coughing/sneezing in the lower abdominal area, usually to the left or right but sometimes both. A Sportsman’s hernia (also known as Gilmore’s Groin) is an injury associated with increased strain on ligaments and tendons than a true hernia and is more recently referred to as Inguinal Disruption or Posterior Abdominal Wall Deficiency (PAWD). This also presents in a similar way to an Inguinal Hernia with pain on coughing/sneezing and is also associated with chronic (long-standing) groin strains.
Claremont Physiotherapists are well placed to help with assessing and treating any of these problems and have excellent relationships with Claremont Consultants. We are able to offer a holistic approach to the problem.
To book an appointment with Matt or any of our Physiotherapists, just call the Physiotherapy Department direct on 0114 263 2112 or email firstname.lastname@example.org. You do not need a referral for Physiotherapy and if you don't have health insurance, an initial 1 hour assessment and treatment costs £53 with ongoing 30 minute appointments charged at £38.