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Groin Strain Physiotherapy

A groin strain is an injury to the groin—where the body where the abdomen meets the leg and the inner thigh muscles attach to the pubic bone.

Typically, groin strains occur in the muscles of the upper inner thigh near the pubic bone (refer to picture) or in the front of the hip.

This injury tends to be more common in athletes (due to nature of sports) and men; however, certain activities can increase the risk for anyone to experience a groin strain - groin strains can occur during sprinting or any type of activity requiring forceful movement of the leg, such as

• jumping
• kicking the leg up
• or changing directions while running

Groin strains account for 10% of all hockey injuries and 5% of all soccer injuries.

Our senior physiotherapists treat groin strains by

• reducing pain
  
• helping patients improve muscle strength and leg motion and
  
• increase the speed of recovery.

What is a Groin Strain?

A groin strain refers to an overstretch or tearing injury to the muscles of the inner thigh or front of the hip. Groin strains makes it difficult and painful to

• walk
• lift the knee
• moving the leg away from or toward the body

Groin strains can occur from overuse of the muscles, or from a sudden contraction of the muscles.

Groin muscle injuries happens when the muscles are either too forcefully contracted or too forcefully overstretched and they are classified/graded according to the amount of muscle damage that occurs:

• Grade 1: Mild or partial stretch, or a tear of a few muscle fibers. The muscle is tender and painful, but maintains its normal strength. Use of the leg is not impaired, and walking is normal.
  
  
• Grade 2: Moderate stretch, or tearing of a greater percentage of the muscle fibers. There is more tenderness and pain compared to mild version, with obvious and noticeable loss of strength, and sometimes bruising.
  
  Use of the leg is noticeably impaired, and limping when walking is common.
  
  
• Grade 3: Severe tear of the muscle fibers, sometimes a complete muscle tear.
  
  Patients may experience or hear a “popping” sound when the injury occurs. Bruising is apparent, and sometimes a “dent” (like a cave-in) in the muscle may be seen under the skin at the site of the tear.
  
  Use of the leg is severely difficult, and putting weight on the leg is very painful.

When groin muscles are strained or torn, muscle fibers and other cells are disrupted.

Bleeding can occur, which causes bruising. Within a few minutes to a few hours after the injury, swelling can occur, causing the injured area to expand and feel tight and stiff.

Although groin strains most often occur in athletic activities such as

• football
• soccer
• dance

they also can occur during everyday activities, such as lifting heavy items or slipping while walking.

How Does a groin strain Feel like?

A groin strain causes sharp pain or spasms in the groin area or lower abdominal region.

The groin pain can quickly resolve, or it can linger/persist, and can develop into a throbbing pain at rest with sharp stabs of pain whenever you try to move your leg or walk.

A mild lower-grade groin strain can be relatively pain free with everyday activities and walking, but aggravated with quick movements of the legs such as

• cutting
• kicking
• performing sit-ups or
  
• sprinting/running

Higher-grade strains can cause the muscles to feel tight or weak. Simple movements that involve

• trying to lift the leg or knee or
  
• bringing the knees together

can provoke pain, and even cause the groin muscles to spasm. If the groin strain involves a Grade 3 (complete) tear, a "pop" may be felt or heard when the muscle tears at the time of injury, and using the leg at all can be extremely painful.

Signs and Symptoms

With a groin strain, patients may experience one or more of the following symptoms in the groin area or lower abdomen:

• Pain, a deep ache, and/or spasms
• Swelling
• Bruising
• Tightness

You might also experience one or more of the following symptoms:

• Weakness in the leg when trying to walk, climb stairs, or move the leg
• Limping when walking
• Difficulty performing daily activities that require standing and walking

How Is It Diagnosed?

If you see our senior physiotherapists first, we will conduct a thorough evaluation that includes taking your health history. Our first physiotherapy goal is to exclude any other serious conditions causing your symptoms that would warrant a referral to a doctor (we have a medical network).

Since groin pain can be present with other diagnoses involving your hip, pelvis, or lower back, we may ask specific questions or use additional tests to assess the possible contribution of these other regions to your pain.

We may ask you:

• What were doing when you first felt pain?
• Where did you feel the pain?
• Did you hear a “pop” when it occurred?
• Did you receive a direct hit to your leg or groin area?
• Did you notice any swelling in the first 2 to 3 hours following the injury?
• Do you feel pain when lifting your leg, walking, moving the leg away from you, or drawing your knees together?

We will perform special tests to help determine a diagnosis of a groin strain, such as:

• Gently moving your leg away from your body
• Asking you to resist against his or her hand as he or she tries to gently push your leg outward (muscle strength test)
• Gently feeling parts of the muscle to determine the specific location of the injury (palpation)

To provide a final diagnosis, we may collaborate with an orthopedic doctor or other health care provider. The doctor may order further tests—such as an X-ray or magnetic resonance imaging (MRI)—to confirm the diagnosis and to rule out other potential issues.

These tests, however, are not commonly required for groin strain.

how our senior physiotherapists can help

We will design a specific treatment program to speed your recovery. This program will include exercises and treatments you can do at home to help you return to your normal lifestyle and activities.

The First 24 to 48 Hours

Immediately following your consultation, we may advise you to:

• Rest the area by avoiding walking or any activity that causes pain. Crutches may be recommended to reduce further strain on the muscles when walking.
• Apply cold therapy to the area for 15 to 20 minutes every 2 hours.
• Compress the area with an elastic bandage wrap.
• Consult with a doctor for further services, such as medication or diagnostic tests.

We will design an individualized treatment plan for you based on your unique condition and goals. Your plan may include treatments to:

Reduce pain

We can use different types of treatments and technologies to control and reduce your pain, including

• cold therapy
• heat therapy
• ultrasound therapy
• radio-frequency Indiba physiotherapy
  
• electrical stimulation (TENS)
• taping
• exercises
• and hands-on manual therapy, such as massage

These treatments can lessen the need for pain medication, including opioids.

Improve motion

We will choose specific activities and treatments to help restore normal movement in the leg and hip. These might begin with "passive" motions that the therapist performs for you to gently move your leg and hip joint, and progress to active exercises and stretches that you perform yourself.

Improve strength

Certain exercises will benefit healing at each stage of recovery; we will choose and teach you the appropriate exercises to steadily restore your strength and agility. These may include using

• cuff weights
• stretchy bands
• weight-lifting equipment
• cardio-exercise equipment, such as treadmills or stationary bicycles

Speed recovery time

We are trained and experienced in choosing the right treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

Promote a safe return to activities

We 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 reach those goals in the safest, fastest, and most effective way possible.

We will apply hands-on therapy, such as massage, and teach you exercises and work retraining activities. We also may teach you sport-specific techniques and drills to help you achieve any sport-specific goals.

Prevent future reinjury

We can recommend a home-exercise program to strengthen and stretch the muscles around your hip, upper leg, and abdomen to help prevent future re-injury of your groin. These may include strength and flexibility exercises for the leg, hip, and core muscles.

If Surgery Is Necessary

Surgery is rarely necessary in the case of groin strain, but if a groin muscle fully tears and requires surgical repair, we will help you

• minimize pain
• restore motion and strength
• return to normal activities in the speediest manner possible after surgery