GROIN PAIN OR INJURIES

A serious road block for athletes

Dr. Arun Rawal, Sports Physio

Groin pain is one of the most common causes of time away from the game and can contribute to poor performance on the field.

Groin pain or injuries are particularly prevalent in sports, especially in contact sports like cricket, running, football, badminton, tennis, and even golf. The incidence of groin pain is notably high in Indian athletics, likely due to insufficient knowledge about preventive strategies, physical overload and often due to inadequate physical or physiological fitness.

The risk of groin injuries varies across different sports disciplines and depends on the intensity of the activity. Sports that are highly prone to groin injuries include cricket, soccer/football, tennis, badminton and running.

The source of groin pain is commonly related to the musculoskeletal system, involving either the pubic/hip joint or the lower abdominal/hip adductor muscles. Rarely, groin injuries may originate from spine injuries or intra-abdominal organs. The most frequently seen groin injuries include:

• Pubic strain/Osteitis pubis: Injury to the pubic symphysis (pelvic pain) due to twisting activities or repetitive loading of the joint with poor hip stability.

• Adductor tendon sprain: Repetitive stress injury to the inner thigh muscles due to poor physical fitness, especially glutes muscles control.

• Lumbar spine: Mobility restriction and neural tissue involvement.  

• Hip joint labral injury: Injury resulting from a major or minor traumatic event involving twisting of the leg during collisions or falls.

• Iliopsoas muscle sprain: Less common, often due to poor physical fitness.

• Inguinal hernia: Rarely seen in contact sports players.
  

DIAGNOSIS: Most groin pain can be identified through physical examination and may not require sophisticated investigations. However, further evaluation especially USG scan or MRI may be necessary if the physical examination does not yield conclusive results or if the desired outcome is not achieved after rehabilitation.

PREVENTION & RECOVERY: Fortunately, most groin pain can be prevented since they are musculoskeletal in nature, requiring appropriate strategies and load monitoring.

Preventive measures:

• Maintain good physical fitness, particularly core stability in the lumbo-pelvic-hip region, involving the lower/upper abdominals, pelvic floor muscles, and hip, as well as lateral and back muscles.

• Load monitoring system avoid overload in training.

• Ensure muscular flexibility and strength in the hip adductors and flexors.

• Gain knowledge of preventive strategies: "If I know something, then I’ll care for it."

• Early detection and complete rehabilitation are crucial steps in preventing disability and ensuring continued participation in the game.
  

Recovery and rehabilitation primarily depend on the stage of recovery and the severity of the injury. Treatment involves off-loading from activity and targeting lower lumbar spine movement and hip and core stability to take away abnormal repetitive stress and allow body part to recover and allow to get stronger once again prior to resuming the sports.

Physiotherapists may employ manual therapy and various mobilization techniques, following scientific principles to achieve early and effective results. Return to play requires the sports specific strength and conditioning for specific timeline guided by your musculoskeletal and sport Physiotherapist.

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