Typically, groin injuries occur during sporting activity when an athlete stops suddenly, starts to move suddenly, or makes a sharp change in direction. The force of the sudden movement can overstretch or tear a muscle or tendon. When groin injuries happen, one of the adductor muscles become injured and tendinous. The abductor’s are made up of; adductor magnus, adductor minimus, adductor brevis, adductor longus and gracilis. Adductor muscles are commonly injured in sports where they are required to work hard for example in; football, skiing, horse riding, sprinting, fencing, running hurdles and high jumping. Although these activities are the culprits of groin strain, this injury however can occur in everyday activities such as; lifting, turning and reaching. In the clinic we see recurrent groin strains and for some a previous history of groin injuries may put you at more risk of future injury, especially if your rehab was incomplete and full strength, length and function were not restored.
Groin injuries may be initially acute but, due to the tendinous nature of the area they are prone to becoming longstanding chronic problems.
- Grade 1 groin strains are stretched muscles or tendons that have not torn much of their fibre. This type of injury will cause tenderness and discomfort but there will be no noticeable swelling and no loss of strength.
- Grade 2, there is more injured muscle or tendon fibre and the injured area is tender to touch and swollen. There will be a diminished range of movement and strength.
- More severely, grade 3 is where the muscle or tendon is ruptured. There is a total loss of function in the torn muscle or tendon and it’s very painful.
There are many factors that need to be taken into account when diagnosing groin strain such as; how the injury occurred, the location of the pain or tenderness, when and how it began as well as previous problems. With prompt diagnosis, effective treatment and sufficient healing time, most first time groin strains heal well. However again and again I see groin strains that have not fully resolved.
Recently I have seen two footballers, one high performing teenager who was having recurrent groin strains each time the pain settled he returned to playing and kept re-injuring. I have also seen a recreational footballer in his early 30s, he strained his groin 2 years ago and the pain had been grumbling away since, he was avoiding big kicks as it caused an increase in pain and because of the pain he was beginning to consider the end of his footballing days. Developing chronic groin problems is common and both of these footballers have fairly typical histories of groin strains. The missing element for both players was following through and really working hard on their rehabilitation to restore full muscle/tendon unit strength and function before performing the high loading actions. Both followed a 6-8 week course of fairly intense Physiotherapy and both returned symptom free to football. So being pain free and dealing with the problem, the recreational player didn’t have to give up the kick about as early as he thought.