Groin pain can come from any structure in or surrounding your inner thigh where there are numerous arteries and veins as well as large muscles like the adductor group that attaches to the pelvis. First of all it is important to establish where exactly the groin pain is, this can be a very helpful identifying what structure is causing your pain. Your groin pain can be caused by any of the muscles, tendons, ligaments, nerves, or joints in the groin area, so let’s look at some structures that can cause a problem.
You may have had a minor groin problem at one time or another but in most cases hip movements are rarely painful. Pain in the groin, that is not caused by an injury, maybe coming from other parts of the body which this is called radiating or referred pain. The groin is very close to some of the major organs in the abdomen and pelvis, so we can expect pains spreading towards your groin. You need a trained eye to test all the structures around your groin to determine the damage.
The groin area is located on each side of the body in the fields where the belly joins the legs. The pubic area lies between the two groin areas.
Muscle pain
The Adductor muscle group runs along the inside of your thigh, from your pubic bone all the way to your knee. The adductors is made-up out of 4 muscles that play a very important role stabilizing the hip when you are standing on one leg. Adductor Magnus, Adductor Longus (Long), Adductor Brevis (Short) and the Gracillis muscles can be strained when the leg is pulled sideways or stretched beyond their normal limits.
Groin muscle strains are often called “pulled groin” because of the way the injuries happen, when the muscle tissue stretches until they tear. We determine how bad it is by classifying it from a first to a third degree tear depending on the amount of muscle fibers that are torn. Groin muscle tears can cause quite a bit of problems, click here for more information.
Synchronisation and control of the muscles in the groin and the hip play a very important role provide your leg with a stable base well you are walking or running. The smallest problem in the groin can escalate to cause numerous problems.
Nerve pain
The main nerve supply to the inside of the thigh and the groin comes from the Femoral nerve. Any irritation, compression or impingement of the Femoral nerves and it’s smaller branches will cause nerve pain in the groin. Burning, stabbing feeling or electrical shock, is the type of symptoms that we usually associate with nerve pain. It may even progress to numbness, pins & needles or weakness spreading down the front of your groin.
Tendon pain
Tendons or acts like cables that anchor the muscle to bone. Every muscle has a tendon on either side, the one at the top called the proximal tendon and one at the bottom called the distal tendon. One or multiple tendons can become irritated which is usually due to repetitive movements, finally to cause inflammation in the tendons. A tendonitis of the adductor muscle group is quite common, it can be first sign of a much larger problem. A tendinopathy or even a avulsion fracture (when the tendon rips out a piece of bone) will be the end result of a groin tendonitis that is left untreated.
The Rectus femoris muscle (which is one of the quadriceps) attaches in the front of the pelvis and if this tendon becomes inflamed, it can cause groin pain that radiates along the front of your thigh.
Ligament pain
The inguinal ligament connects the ilium to the pelvis, and lies exactly in the fold between your belly and your leg. This ligament supports the muscles that run to your inner thigh including the Iliopsoas and Pectineus muscles of the hip. It’s also the barrier that keeps your intestines in your pelvic & abdominal cavity, to prevent them from spilling into your leg.
Joint pain
The joints that are most likely to be involved in groin pain include the pubic symphysis, sacroiliac joints, hip joints and your lower lumbar spine. Oteitis pubis is a condition that develops due to excessive stress on the connection between the pubic bones call the pubic symphysis. The connection between the head of the femur and the socket in the hip (acetabulum) can cause problems like femoral acetabular impingement, this is when the femur catches or scrapes the edges of the hip socket.
Hip arthritis and normal aging of the hip joint may give you a deep ache in the groin, compared to a locking feeling of the hip and groin when the labrum is torn. The labrum is a membrane on the inside of the hip socket that provides cushioning for the femur head inside the acetabulum.
Bursitis
A bursa is a fluid-filled disc that prevents excessive friction between structures like tendons, ligaments and bones. Bursas can become inflamed due to various reasons but it will cause the disc to swell and limit the normal movement. If you apply direct pressure onto the bursa you will be able to feel the pain in your groin.
Groin Injuries
Acute Injury
A groin injury may occur from a direct blow, a fall, especially when you land on your leg and it is pulled sideways. This can put excessive strain on the adductor muscles causing them to tear. The groin muscles can be pulled or strained during exercise when the muscle needs to contract outside it’s normal boundaries. The sudden pull or strain on the groin muscles while lifting, pushing, or pulling a heavy object may cause sudden groin pain.
Overuse injury
Overuse injuries occur when too much stress is placed on the groin area. This often happens when you overdue an activity or repeat the same activity over and over again. This type of repetitive strain on the groin muscles may lead to various other problems.
Overuse injuries may put you at risk of developing any one of the following:
- A hairline crack in the thigh bone (stress fracture of the femur)
- Hip bursitis
- Osteitis Pubis – this is a condition that develops from chronic stress on the pubic symphysis
- Hip joint problems
- Avulsion fractures – this occurs when a force causes a tendon or ligament to tear away from a bone and break off a piece of bone.
No injury
It is important to look for other causes of your groin pain when you have not had a specific incident that you can remember, when and where you injured your groin. An inguinal hernia is a condition where a tear develops in your abdominal or pelvic wall causing your abdominal tissue to push through the hole, into the leg, which will result in groin pain that relieves when you are lying down and worse when you’re sitting up.
What causes my groin pain?
To understand where your groin pain is coming from, you’d have to determine how you injured it, or if you can remember when it started. Some are outright obvious like when you slip on the floor or your leg buckles sideways, meanwhile others are subtle and creeps up on you – getting worse day by day. So, it’s easier to establish how your pain started and changed until now. Changes in your groin pain gives us many clues to understand where your pain is coming from.
Our body consists of various types of tissue, some elastic like tendons, or strong like cables (ligaments), some tissue can generate movement & force like muscles. We rely on your groin ligament to keep us stable to stand, tendons to coordinate your hip & groin movements while you walk, and muscles to generate power to run. There are more than 62 structures in your groin that can get injured, some problems are more common than others, but just to be safe – we test them all.
Here’s a breakdown of a few conditions that we frequently see, and how things go wrong to cause your groin pain:
Get to the root of your groin pain
Different structures, cause different types of grain pain, although these are not concrete it’s a good guideline to which structure produces what type of pain
- Muscle — Dull ache or stiffness, sharp pain with contraction
- Nerve — Numbness, tingling, weakness, electrical stabbing feeling
- Tendon — Burning pain with certain specific movements, pain comes & goes
- Joints — Cramp, constant stiff feeling, worse after rest, better with movement
- Fat pad — Pinching pain, pressure increases or decreases pain immediately
- Bursa — Pain only comes on after being active, better with rest, direct pressure brings on pain
- Bone — Constant pain, sharp pain with certain movements
- Arteries — Pins & Needles, dead leg feeling, heavy feeling, throbbing
- Cartilage — Sharp pain when at certain point, painful arch of movement
- Ligament — Pain at the end of range, unstable, clicking
- Referral from other joints — Difficult to pinpoint pain, vague painful area
Causes of Groin pain
Groin pain is one of the most common problems that we see in your practice. Your groin contains some of the larges muscles in your body, not to mention you use them every day to walk. The structures in the groin is very vulnerable to injury especially overuse injuries i.e. repetitive movements like a walking, climbing stairs, kicking and running.
Groin pain may be caused by:
- Trauma – Contusions, fractures and labrum injuries as well as muscle or ligament strains and sprains.
- Overuse – Tendon inflammation, labrum injuries and athritis
- Instability – Impingement of the hip joint (The hip’s socket connection with the femur)
- Autoimmune – Rheumatoid arthritis
- Referral from Joints – Pubic symphysis, sacroiliac joints, hip joints and your lower lumbar spine
- Referral from Nerves – Irritation, compression of the femoral nerves.
- Visceral referral – Hernia of the small intestines, Prostate, Overies, ect.
Size – The larger the area of your groin pain, is better, because muscles in your thigh stretch from your hip to below your groin. Pain tends to radiate along the thigh muscles and affect large areas. Muscles heal easier & recover faster.
Colour – Bruising in & around the outside, back and inside of your groin is quite common after a thigh tear, because of the high concentration of blood vessels in your muscles. These capillaries rupture & leak plasma that pools in your groin. Blue discoloration closer to the front of your groin is more concerning for it involves your groin ligaments.
Swelling – Swelling is your body’s way of healing itself by sending cells to heal the tissue. More swelling could mean more tissue damage, however it’s very rare to see groin injuries swell. Injury to tissue that develops over a few weeks doesn’t swell, because the tissue trauma is continuous and repetitive, so your body stops the inflammatory reaction. A new injury on an old problem is also possible.
Area – Groin pain at the front of your groin are more restrictive during walking, even limits you from climbing down stairs. If your groin pain causes you to limb you must be more concerned. Sharp pain over a small area makes it easier to pinpoint structures near your pain. Vague, dull & deep groin pain can take longer to identify the root cause. Compensatory patterns develop, sometimes it takes a while to just get rid of those.
Motion & sore groin
Stiff – Groin stiffness followed by pain is regressing and getting worse. Seek help. Although, pain followed by stiffness is a good sign of tissue healing, specifically scar tissue formation. Scar tissue is hardening wound tissue that tends to shorten and pull on structures surrounding the injured site. This is more pronounced in muscle strains & tears, where the normal slide of muscles is restricted during a contraction.
Range of movement – Difficult moving your groin through its range is a big problem. A painful arch means the structure injured only takes tension over that specific range i.e Only painful when you bend your hip forwards 10 degrees. Groin pain over a smaller range of movement is not necessarily better. This may point to connecting joint surfaces of your hip being injured. If you feel pain only at the end of your range its less severe and easy to fix, like when you sit cross legged. When your groin pain stops movement completely and too painful to move you should definitely come see us as soon as possible.
Monitor over time:
Intensity – When you grade your pain from 0 – 10. You may think it’s not that bad because it’s not that painful. On the contrary, pain intensity is not a sign of how severe your tissue injury is for example, complete ruptures of ligaments are less painful than partial tears. When fibers are stressed while it’s anchors are completely loose, there’s not much pain, but fibers that are partially torn will produce severe groin pain. People have different pain thresholds, so be careful to ignore your groin injury.
Frequency – Pain that’s fleeting or intermittent, short burst of pain must not become more frequent and constant. This shows that the tissue damage is not getting any better. Pain that only lasts for a few seconds tend to heal faster, so the longer your pain lasts the faster you should get to us.
Latency – If your groin pain lags to come on and builds up over the day you must be very cautious. This is a sign of a relapse of your tissue pathology. It’s difficult to judge what makes it worse, because the pain only comes on a few hours after your activity, and not during.
Loading – Pushing through your groin pain while you are walking, climbing stairs and jogging is not a good idea. Putting compromised tissue under strain is dangerous. Would you tow a car with a partially torn cable? No! Because it just needs that final pull or jerk that could cause catastrophic tissue damage. Loading soft tissue without knowing what it’s able to handle is dangerous & reckless.
Diagnosis of groin pain
Our physiotherapists know and understand the intricacy of the anatomy of your groin. There are many structures to test, and we even consider the complex biomechanics of your hip & groin movements. We’ll accurately diagnose which structures are involved, and to what degree.
During your physiotherapy evaluation, we’ll be stretching & stressing the soft tissue structures like muscles, ligaments, nerves and tendons. This way we can diagnose muscle tears, ligament sprains, tendinitis’s and nerve irritations. We’ll test different aspects like muscle strength, range of motion, flexibility and stability in order to confirm how severe your tissue damage is, which will dictate your treatment plan.
Gathering information through our evaluation allows us to make a diagnosis based on your individual injury. Then we’ll customize the treatment to your specific needs. Therefore our physiotherapists are the best at diagnosing groin pain & groin injuries.
The Process of Diagnosis:
There is a misconception that medical practitioners are able to know exactly that’s the problem the moment we see our patients. People tend to point to their groin and say, “treat it”. As if we already know what’s the problem by just looking at it. Sorry to disappoint, but unfortunately this is not how it works. Let me explain:
Diagnosis is a process of exclusion, not inclusion. Medical professionals are taught a process of elimination and deduction to identify the most possible diagnosis’s for your groin pain. The better you can describe & elaborate on your pain, the better picture you’ll give your Physio to understand what’s happened as well as, what you’re feeling.
The practitioner uses their skills to eliminate diagnosis’s it’s not and zoom in on your problem. This elimination brings us to only a few possibilities to what could be causing your groin pain. Then we test & assess all our possibilities to get to the root cause of your groin pain. In many cases your main problem is not at the site of your pain due to compensation, guarding or it’s just the last straw that breaks (in a chain of movements). We encourage you to be honest and open about what you’re feeling – to clarify, carry on or change your Physio’s approach.
Physiotherapist treatment
We have seen many patients with groin pain and provide the best possible treatment for a faster recovery. Pain and stiffness after a groin injury prevent you to move and you might feel afraid to move, or scared you’ll damage it even more. We know that you’re anxious about the unknown, so that is why we are here to guide you and give you all the answers.
Your groin pain treatment will be tailored according to various factors, but just to give you a broad idea, our focus of our treatments are:
- Determine what structures are injured in your groin
- How bad is it injured?
- Protect it from further injury
- Help accelerate healing
- Re-evaluate to monitor progress
- Change and adapt as you get better
As you can see, these are just a few of the common groin injury sources, so an accurate diagnosis is very important to provide you with the best rehabilitation. With accurate assessment and early treatment, most groin pain responds extremely fast to groin treatment allowing you to quickly get back to life.
If you are suffering groin pain, we highly recommend that you seek our help because we are experienced in the assessment and management of groin pain. It can be very tricky! You wouldn’t want to undergo a hip replacement early in life due to poor management of that pain in your groin.
Cilliers & Swart Experts
Our team of experts can diagnose, test and treat any kind of groin pain. We work together to get rid of your pain as fast as possible. We have the best tools, techniques and machines to make sure you get the best value for your money. Our Physios will test a lot of different possibilities why you’re feeling this groin pain in order to explain what’s going on in your body. It all depends on the results of our tests to determine what needs to be done. All our physios are MSK specialists that can determine the slightest problem coming from your groin, thigh or lower leg, so if you’re uncertain – we can help you.
Our experts determine multiple problems that can be involved, this means that we test movements to see if you may have a muscle imbalance, weakness, instability and much, much more. This is our expertise & what we’re best at. We take on many roles to achieve your goals: Teacher, counselor, trainer and engineer. As a teacher we explain the extent of damage & the intricate details of your groin pain & how it may affect other problems. As a counselor & pain expert, we’ll guide you every step of the way, while as an engineer, we test the structural integrity of your tissue.
Groin pain Treatments we use
- Acute injury treatment
- Ultrasound
- Medications
- Soft tissue massage
- Electrotherapy treatment
- Laser (Low Level Laser therapy)
- Acupuncture & Dry Needling
- Heat packs (Thermal therapy)
- Kinesiology Tape
- Rigid Strapping or taping
- Neurodynamics (Nerve tissue mobilizations)
- Dynamic Strapping
- Strengthening exercises
- Guided loading protocol
- Stretches (Static, dynamic and ballistic)
- Moon boot
- Brace
- Compression Bandage or
- Sleeve
- Supportive strapping and taping
- Biomechanical Analysis
- Gait Analysis
- TENS
Sore groin & Sudden groin pain?
Groin pain is extremely uncomfortable and disrupts the smallest task you must get on with. So, stop the madness. Get your groin looked at and get all the answers you need. Most groin pain don’t start after a fall or injury, but usually develops over time. Yes, it’s more obvious in sports injuries, but you’re required to carry on with work even though you have agonizing groin pain. We know what you’re going through.
If you’re suffering, rather get it checked. Please come visit our physiotherapists if you are feeling any type of groin pain. Rather do something about it than wait with your fingers crossed and hope it goes away. If you’re expecting tomorrow will be any different than today. Stop waiting and act.
An accurate diagnosis is vital to manage your pain and treat it appropriately, because what works for one problem rarely works for another. Some conditions can take many months or even years to heal when the diagnosis is incorrect, or treatment is neglected. You could end up spending a lot more time & money to fix your problem later on. So be warned…
How to Stop chronic, daily annoying groin pain
Without Injections, Without taking Painkillers and
WITHOUT having to wear a Support or Brace…
If you’re living with groin pain what just won’t go away, they’re painful or they ache – it’s very easy to think that it’s “just something that comes with age”, it’s a bit of “wear and tear”, or that it’s nothing and it’ll go away on its own.
You can’t quite point your finger on why you’re feeling the pain in your groin – but it doesn’t seem to be getting any better!
If that’s happening to you, you’re not alone – we hear this type of thing all the time. In fact, groin pain is one of the most common problems that we see in our Physio practice. When it comes to living with groin pain, everybody we see wants to know the answers to these questions:
Why am I still suffering with groin pain that keeps getting worse
Most people think that when they get groin pain, it’ll eventually “ease off” and go away on it’s own. That they’ll wake up one morning and like “magic”, your groin pain will be a thing of the past… But 3 months later you’re still living with the annoying groin pain, often even worse than it was at the start. Does that sound like you?
Another scenario we see all the time in our physiotherapy practice is when people go to their Doctors, and the well-meaning Doctor tells them to “rest”, “try these painkillers” and “come back in 6 weeks if it’s no better” – but then 6 weeks later, they end up going back to the same Doctor again because it hasn’t got any better, only to be given ANOTHER prescription of even stronger pills, and maybe a thigh guard/ support.
Has this ever happened to you?
Maybe you’re confused because you’ve been told different things, by different people. Maybe you think you have to rest because you’ve been told walking makes groin pain worse, or that you should be doing ‘this exercise’ and ‘that exercise’ to make it better. It’s very confusing to know exactly what to do – and that’s just to avoid making your groin pain worse, not to mention getting back to jogging and all the other things you love to do.
And because of this confusion – this often leads people to procrastinate, and put off making a decision about what to do to help fix their groin pain. Worse, many people just end up accepting it as “part of life” – as if it’s normal, as if it “has” to be that way. Is this how you feel?
We are here to tell you – this is NOT what you deserve. You are made for great things, your groin pain is just a bump in the road. Make a decision to help yourself be better.
Why is your groin pain lasting longer than it should?
Does this sound like you?
If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!
We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.
If you’re looking for solid advice on how to start solving your problem, click the link below to book a FREE phone call. The phone call is complimentary and there is no obligation to book any appointments with us after the call is over. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.
What you can do to get rid of your groin pain quickly?
Ask our groin experts
If you would like to know how the Physiotherapy team at Cilliers & Swart can help you, we invite you to book a FREE, no-obligation, risk-free “Call me back” phone call.
Note: This Free Call is a service we offer to people who are nervous or unsure. You might not know if Physiotherapy is the right treatment for you. If you are unsure, please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial obligation or risk on your part. You have nothing to lose except your pain.
Choose to see a Cilliers & Swart Physiotherapist to help you Get rid of your groin pain – in the next few days?
What can we do for you?
In short, our Team at Cilliers & Swart Physio help you get back to living life free from groin pain. For information about costs and availability, click the button below:
Why am I still suffering with groin pain that keeps getting worse
Most people think that when they get groin pain, it’ll eventually “ease off” and go away on its own. That they’ll wake up one morning and like “magic”, your groin pain will be a thing of the past… But 3 months later you’re still living with the annoying groin pain, often even worse than it was at the start. Does that sound like you?
Another scenario we see all the time in our physiotherapy practice is when people go to their Doctors, and the well-meaning Doctor tells them to “rest”, “try these painkillers” and “come back in 6 weeks if it’s no better” – but then 6 weeks later, they end up going back to the same Doctor again because it hasn’t got any better, only to be given ANOTHER prescription of even stronger pills, and maybe a thigh guard/ support.
Has this ever happened to you?
Maybe you’re confused because you’ve been told different things, by different people. Maybe you think you have to rest because you’ve been told walking makes groin pain worse, or that you should be doing ‘this exercise’ and ‘that exercise’ to make it better. It’s very confusing to know exactly what to do – and that’s just to avoid making your groin pain worse, not to mention getting back to jogging and all the other things you love to do.
And because of this confusion – this often leads people to procrastinate, and put off making a decision about what to do to help fix their groin pain. Worse, many people just end up accepting it as “part of life” – as if it’s normal, as if it “has” to be that way. Is this how you feel?
We are here to tell you – this is NOT what you deserve. You are made for great things, your groin pain is just a bump in the road. Decide to help yourself be better.
Why is your groin pain lasting longer than it should?
Does this sound like you?
If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!
We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.
If you’re looking for solid advice on how to start solving your problem, click the link below to book a FREE phone call. The phone call is complimentary and there is no obligation to book any appointments with us after the call is over. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.
What you can do to get rid of your groin pain quickly?
Ask our groin experts
If you would like to know how the Physiotherapy team at Cilliers & Swart can help you, we invite you to book a FREE, no-obligation, risk-free “Call me back” phone call.
Note: This Free Call is a service we offer to people who are nervous or unsure. You might not know if Physiotherapy is the right treatment for you. If you are unsure, please fill out our online form. We will contact you to find out what is wrong and how we can help. There is no financial obligation or risk on your part. You have nothing to lose except your pain.
Choose to see a Cilliers & Swart Physiotherapist to help you Get rid of your groin pain – in the next few days?
What can we do for you?
In short, our Team at Cilliers & Swart Physio help you get back to living life free from groin pain. For information about costs and availability, click the button below:
What your patients say:
Went to Renier with pain that occurred after running and stretching the previous day. He did a thorough review of the hip & groin in all the positions. My Groin was already better the next day after treatment. Highly recommend for sports people that need to recover quickly.
A Swanepoel
I went to see Carli van Dyk and she treated my with absolute care and respect. She was very well educated and informed.
E Black
Extremely thorough and great at what she does. Definitely the best physio I’ve been to, ever! You will be in great hands!They are amazing!
D Nkosi
He certainly goes above and beyond. Far exceeded expectations and that’s considering I’ve only been to one appointment. I’m sure my recovery will be a successful one. As a medical doctor I was a bit sceptic not having a direct referral, but dealing with healthcare professionals for most of my adult life I can assure Renier is competent, knowledgeable, professional and empathetic to say just a few…
T Heard
“The best in the business”
I have been treated by Renier here for a problem that had been bothering me for several weeks. Having seen a few physios before, I can honestly say that this practice has a very high standard for the services that they offer and I have great trust in the work that they do. 100% would recommend.
B Mey
Excellent experience. Friendly service and always prepared to answer questions about my injury. Would recommend to any athlete with an injury.
M Maree
