groin pain

Groin pain and when to call a doctor

 

Pain in the groin occurs often with other problems such as back or abdominal pain. It is often associated with sports injuries, especially to adductors muscles but, it may also be a sign of other conditions. If your groin has been hurting you for a while, you need to find out why.

Diagnosing groin pain is never easy due to the anatomical complexity of this region. Therapist needs to understand human anatomy well and have the knowledge of potential causes of pain

Pain may indicate problems requiring a simple treatment. Sometimes patients need more serious medical attention .

Pain may originate from or be a result of:

  • Sport injury – sports hernia, inguinal canal injury, adductors injury (very common),
  • Injury or problems with the hip joint
  • Gastrointestinal tract problems
  • Urogenital system – kidney stones, testicular torsion, urinary tract inflammation, cysts
  • Nerve compression in the lumbar region
  • Nerve compression in the groin ( femoral nerve, inguinal nerve, obturatory nerve)
  • Pregnancy

Painful groin in sport

Groin pain with movement may indicate an injury to the musculoskeletal system. Overuse injury, micro-injuries, excessive loads and lack of sufficient rest may all cause problems. The pain should subside within days but returning to sport, especially on a professional level may be difficult and take much longer

The most common cause of groin pain is a muscle, ligament, or tendon strain. This happens to a lot of men who play sports especially football or hockey. The pain may happen right away or build over time. Continuing the sport or activity may make the injury worse. To prevent further damage, rest, or training modification may be required. Depending on the type of injury, anti-inflammatory medications (aspirin, ibuprofen, or naproxen), rehabilitation, and strengthening exercises can be useful.

Inguinal sports hernia

This happens when fat or a part of intestine pushes through a weak spot in the muscles of the lower abdomen (belly). In the beginning you may see a bulge in your groin or scrotum. One quarter of all men will develop this problem sometime during their lifetime. Women are more prone to developing a femoral hernia.

Inguinal hernia is quite common. Obesity and heavy lifting will put you at higher risk of developing it. If the intestine or fat gets stuck in the abdominal muscle wall, its blood supply may get cut off. That’s called a strangulated hernia.

Symptoms can include:

  • Redness or sudden pain near the bulge
  • You can’t poop or pass gas
  • Nausea, vomiting, fever

Groin pain as a result of hip joint condition

All the below conditions, although specifically affecting the hip joint, may also cause pain in the groin

Avascular necrosis

It happens when the top of the femur (the femoral head) doesn’t get enough blood, so the bones dies. Dead bone is weak and can break easily. This may lead to pain in the hip and groin area

Osteoarthritis

This is common condition in older patients aged 60 and over. As you get older, cartilage — which helps the bones in a joint move smoothly — wears away. This can lead to osteoarthritis, which causes painful inflammation in the joint. It is thought that the excessive bone formation (bone spurs) as a result of the condition may actually be the cause of pain. Osteoarthritis oftentimes causes stiffness and pain on standing. Exercises and keeping active may be helpful to many patients.

Bursitis

It happens when the fluid-filled sacs (bursa) that cushion your joints become inflamed. Your hip joint can become painful, tender and swollen. It can usually be treated at home and should go away in a few weeks. The pain may radiate to your groin

Femoroacetabular Impingment (FAI)

is a condition in which there is abnormal contact (impingement) between the hip joint socket and femoral head-neck junction (the bone just below the ball part of the thigh bone), on movement of the hip. The most common movement that brings on pain is hip flexion (moving knee towards chest). Groin pain is common but pain may extend sometimes further down the front of the thigh, side or back of the hip. There may be episodes of clicking in the hip, or the sensation that it is coming out of joint. Certain activities, particularly those which involve hip flexion (e.g. football, dancing, ballet, and aerobics) will make the pain worse. Patients often find that sitting for a prolonged period of time, e.g. a long car journey, will bring on groin pain and they often struggle to move into a more comfortable position

Stress fracture

is an overuse type of injury, it happens when the bones in your hip joint gradually weaken from repetitive movement (such as running). Not diagnosed in time, it eventually becomes a true fracture. The pain increases with physical activity and weight bearing. It often becomes impossible to finish training due to pain.

Labral tear

Labrum is the soft tissue that covers the acetabulum (socket) of the hip. A hip labral tear can have a few causes: an injury, structural problems, or degenerative issues. Symptoms include pain in the hip or stiffness.

Groin Pain in pregnancy

It happens very often and may be results of many hormonal changes and the preparation of the body for the child birth.  Often times, the muscles, tendons and ligaments become highly sensitive. Sometimes, the ligaments loosen too much and quite early in pregnancy (symptoms may start around the middle of pregnancy) causing instability in the pelvic joint. One side might move more than the other when walking or moving legs.

 

Further reading

 

 

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