What is a groin strain?

A groin strain is a tear or rupture to any one of the adductor muscles. There are five adductor muscles, the pectineus, adductor brevis and adductor longus (called short adductors which go from the pelvis to the thigh bone) and the gracilis and adductor magnus (long adductors which go from the pelvis to the knee).

The main function of the adductors is to pull the legs back towards the midline, a movement called adduction. During normal walking they are used in pulling the swinging lower limb towards the middle to maintain balance. They are also used extensively in sprinting, playing football, horse riding, hurdling and any sport which requires fast changes in direction.

A rupture or tear in the muscle usually occurs when sprinting, changing direction or in rapid movements of the leg against resistance such as kicking a ball. This is especially likely if a thorough warm-up has not been undertaken first! Repetitive overuse of the groin muscles may result in adductor tendinopathy.

Grade 1, 2 or 3?

Groin strains, as with all muscle tears, are graded 1, 2, or 3 depending on how bad they are. Grade one is a minor tear where less than 10% of fibres are damaged. Grade 2 is a moderate tear and can be anything from 10 to 90% of fibres torn. For this reason, grade 2 injuries are often termed 2+ or 2-. Grade 3 injuries are the most serious being either partial or full ruptures.

Symptoms of a groin strain

Grade 1

• Discomfort in the groin or inner thigh. This may not be noticed until after exercise stops.
• The groin muscles will usually feel tight.
• There may be an area which is tender to touch
• Walking is normal, discomfort may only be when running or even just on changes in direction.

Grade 2

• A sudden sharp pain in the groin area or adductor muscles during exercise.
• Tightening of the groin muscles that may not be present until the following day.
• There may be minor bruising or swelling (this might not occur until a couple of days after the initial injury).
• Weakness and possibly pain on contracting the adductor muscles (squeeze your legs together).
• Discomfort or pain on stretching the muscle.
• Walking may be affected. Running is painful.

Grade 3

• Severe pain during exercise, often on changing direction suddenly when sprinting.
• Inability to contract the groin muscles (squeeze your legs together).
• Substantial swelling and bruising on the inner thigh within 24 hours.
• Pain on attempting to stretch the groin muscles.
• It may be possible to feel a lump or gap in the muscles.

Groin strain treatment

What can the athlete do?

• Apply R.I.C.E.(Rest, Ice, Compression, Elevation) immediately.
• Use crutches if needed.
• Gently stretchthe groin muscles provided this is comfortable to do so.
• See a sports injury professionalwho can advise on rehabilitation of the injury.
• For a suspected grade 3 strain seek professional help immediately.

What can a sports injury specialist or doctor do?

• Use ultrasoundor laser treatment.
• Tape the grointo take the pressure off the area.
• Use sports massage techniquesafter the acute phase. This is extremely important.
• Operate if the muscle has torn completely.
• Advise on a rehabilitation programme consisting of stretching and strengthening exercises