Groin Pain Part 1

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Groin pain is an extremely common presentation in exercise and sports medicine, and is renowned for being a complex issue. It is most common with sports that involve kicking, rapid acceleration and declaration, and sudden change of direction. The anatomy of this region is also complex; the load on this region is extremely high in sports that involve the aforementioned movements, and can also involve the hip joint which is not a superficial joint, making it hard to examine.

Sports Involved with Groin Injury

The two most common sports associated with groin injury and longstanding pain are soccer and Australian Rules football, which require players to run fast and kick across the body. Longstanding groin pain is also a major concern in basketball, American football, rugby, field hockey, skating, tennis, and basketball.

Some studies have reported:

• In the 1997 to 2000 professional Australian Football league (AFL) season, the incidence of groin strains was 3.3 injuries per club per season and accounted for 11.9 matches missed per club per season. (1)
• Over a 2-year period, semi-professional Rugby League players were followed and assessed for groin injury. All 100 players did not have a previous history of groin injury. All 100 players did not have a previous history of groin injury. Calculated risk of groin injury over the 2 years was high, at 23%, with 2.4 per 1000 hour training sessions and/or games missed. Additionally 70% of those injured had a duration of symptoms greater than seven weeks. (2)
• Over one amateur soccer season in Norway, consisting of 508 players, 10% of athletes incurred a groin injury. There was a rate of 0.6 groin injuries/1000 playing hours, and 0.3 groin injuries/1000 training hours. (3)

Risk Factors for Groin Pain

Risk factors for groin pain have been poorly established due to lack of a universal definition of groin pain until recently. A systematic review in 2007 (4) found that they included:

• A previous history of groin injury
• Greater abductor to adductor strength ratios
• Decreased pre-season sport-specific training
• Core muscle weakness
  

Another study found that soccer players with a previous hamstring injury, groin injury and knee joint trauma are two to three times more likely to suffer an identical injury in the following season. (5)

Acute injuries around the groin can settle quickly; however it is the resultant altered biomechanical loads that can predispose the sportsperson to further injury. Rushed or inadequate rehabilitation can increase the risk of re-injury dramatically. The hip joint can be subjected to forces of up to eight times body weight during running (6); therefore a small change in load transfer and acceptance around the pelvis can result in injury. Therefore, altered biomechanics can lead to injury, or increase the likelihood of an existing injury becoming longstanding.

Causes of Groin Pain

There are multiple contributing factors of groin pain, which were outlined in the 2015 Doha Agreement for the terminology and classification of groin pain. You can read more in our next post.

Treatment for Groin Pain

Physio or Chiro treatment for groin pain includes identifying and reducing the sources of increased load on the pelvis with manual therapy, such as lumbar stiffness, hip restrictions, core stability or pelvic imbalances. Treatment also involves improving lumbopelvic stability, strengthening local musculature as well as ensuring exercise is performed without pain for a rehabilitation programme. Untreated groin injuries can commonly lead to chronic exercise-related groin pain, and so must be treated properly to minimise recurrences and return to sport time frames.

If you have any further questions about how we can help with your groin pain, head over to our Contact Us page, or book in now to make an appointment.

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