Groin pain

Groin pain can be caused by several conditions. It’s most often caused by adductor strains, also called groin strains, which are injuries to any of the adductor muscles of the thigh or their corresponding tendons.
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About groin pain

The adductor muscle group comprises six main muscles between the pelvic bone and the femur, called the adductor longus, adductor brevis, adductor magnus, obturator externus, gracilis and pectineus. Their main function is to move the thigh and hip towards the body, also known as adduction. 

Adductor strains are caused by movements that require your muscle to lengthen and contract at the same time, which leads the muscles of the inner thigh or hip to overstretch and tear. They’re commonly sustained during sports or exercise when you make sudden movements such as kicking, as well as twisting to change direction while running or jumping. They can also occur during a range of other activities that subject your groin to intolerable forces.

However, groin pain can also be a symptom of a wide range of underlying conditions that require treatment, including bone fractures, hernias, hip conditions, nervous system conditions, urological conditions, gastrointestinal conditions, and gynaecological conditions. Because there are so many conditions that can cause groin pain, it's important you get checked out by a specialist if you're experiencing it.

At HCA UK, we can diagnose your condition and recommend the most effective treatment.

The London Hip Unit, July 2021

What are the symptoms of a groin strain?

You might experience some or all the following symptoms in the inner thigh or adductor area:
  • A popping or snapping sensation at the time of injury
  • Sudden and sharp pain
  • Aching and tenderness
  • Bruising and swelling
  • Decreased strength in the upper leg
  • Pain when you raise your knee
  • Pain when you bring your legs together
  • Pain when walking or running
  • Pain when you cough or sneeze

What's the process for diagnosing groin injuries?

First, you'll tell your consultant how your injury happened, what symptoms you're experiencing and whether you've had any similar injuries in the past. Your consultant will then perform a physical examination to test your groin's range of motion, find out which movements are painful and better pinpoint the exact location of your injury. They’ll also examine the surrounding areas, including your leg, hip and back.

They will ask you questions to learn more about your condition, including what the pain feels like, what makes it worse and better, whether it radiates to other areas, how it affects your movement, and whether you feel pain when coughing or sneezing.

Next, they might need to carry out some tests to better get to the root of the problem. These could include a CT scan, MRI scan, X-ray or ultrasound of your groin and pubic areas. These tests will be conducted by an expert radiologist to ensure the utmost precision and accuracy.

Your consultant will use all the information gathered through this process to rule out the different possible causes of your groin pain and arrive at a diagnosis for your condition.

What are the different categories of adductor strains?

Groin strains are usually divided into three degrees of severity:

  • Grade one: Mild pain, loss of strength and movement
  • Grade two: Moderate pain, loss of strength and movement, as well as some tissue damage
  • Grade three: Severe pain, loss of strength and function due to a complete tear of the muscle.
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What are the treatment options for managing groin strains? 

The best treatment for a groin strain depends on the cause. Most cases of adductor strains can heal on their own with enough opportunity. But other types of groin pain typically require more complex treatments for the underlying condition.

Initial groin pain treatment

Immediately following a pulled groin injury, treatment focuses on reducing muscle pain and swelling. Your doctor will likely recommend rest, ice, compression and elevation. They may also prescribe you non-steroidal anti-inflammatory drugs.

Further groin strain treatments

Depending on the severity of your groin strain, your specialist may recommend physiotherapy to help you recover from your injury more quickly. This would involve a trained physiotherapist guiding you through gentle stretching and strengthening exercises that restore mobility and promote healing.

If your groin injury is recurring or chronic, further treatment may be needed to address the root cause, such as weakness or instability in nearby muscle groups. Your specialist may suggest an ultrasound-guided corticosteroid injection into your groin if the injury is being caused by adductor tendonitis. This is an anti-inflammatory medicine that helps relieve pain. Using ultrasound allows for the injection to be placed with greater accuracy, improving effectiveness and reducing the likelihood of side effects occurring. It’s important to note that your consultant would only ever recommend this treatment option in addition to a physiotherapy programme, rather than as a replacement. 

Groin pain FAQs

You can expect to rest for at least several weeks after a groin strain. There's no definite recovery time frame, as everyone's injury and circumstances are unique. The most important factors are how severe the injury is and your fitness levels before the injury. 

Below are some rough guidelines for how long recovery could take:

  • Grade one: 2-3 weeks
  • Grade two: 2-3 months
  • Grade three: 4+ months

When your consultant has given you the okay to return to activities, you'll need to do so slowly to ensure you don't re-injure yourself or develop a recurring injury. Repeated groin injuries can take longer to heal or even turn into a chronic condition.

Adductor strains are most commonly experienced by professional and recreational athletes. Sports that involve kicking and quick direction changes are the riskiest, such as football, rugby and tennis.

Although participating in sports is the most common cause of groin strains, they can also occur while performing non-sport exercise like resistance training, as well as while lifting heavy objects or even falling over. There are several factors that can increase the likelihood of you sustaining a groin strain, including:

  • Weak or tight adductor muscles
  • Poor pelvic stability
  • Previous groin, leg or lower back injury
  • Biomechanical factors
  • Sudden increases in in sports activities
  • Poor fitness
  • Not warming up adequately before exercise

Prevention is the best treatment for groin strains, given how painful and debilitating they can be. Your consultant will be able to advise you on how you can prevent them in the future. They might recommend that you:

  • Always warm up before physical activity
  • Wear shoes with good support
  • Do regular stretching and strengthening exercises for your thigh muscles 
  • Increase the intensity of physical activity slowly
  • Stop exercising if you feel pain in your groin

In addition to being an indicator of adductor strains, groin pain is a common symptom of several sports-related injuries, including osteitis pubis, avulsion fractures and femoral neck stress fractures. Yet while adductor pain most commonly occurs as a result of sports injuries, it can be caused by a variety of other, non-sport-related conditions. 

Groin pain can be an indicator of an inguinal hernia, which occurs when an organ pushes through a weak spot in the muscles in the adductor region. The presence of large bumps is the main sign that you have a hernia rather than a groin strain and, in this event, you'd need surgical treatment. 

Moreover, groin pain can be a sign that there's an underlying biomechanical imbalance in the hip and pelvis regions that’s overloading the soft tissues. Hip conditions such as hip impingement, labral tears and osteoarthritis often present with groin pain. Spinal conditions in the lower back, such as herniated discs or spondylolisthesis, can also result in groin pain because the lumbar spine contains nerves that travel to the groin area.

Whatever condition is causing your groin pain, your consultant will make a diagnosis and recommend the most effective treatment.

Why choose HCA UK

Why choose HCA UK for treatments to manage groin pain?

We offer convenient and effective orthopaedic treatment for thousands of people each year. There are many reasons you should choose us to help you, including:

  • Specialist care: With hip and pelvis consultants across our network, we can find you an expert to treat your adductor pain
  • Quick access: Appointments are confirmed within 24 hours and same-day imaging could be booked if needed, impacting your schedule as little as possible
  • Comprehensive imaging: With the help of our diagnostic centres, we'll diagnose your groin injury quickly and accurately before recommending the most effective treatment
  • Orthopaedic leaders: We treat more patients in London than any other orthopaedics specialists, as reported by PHIN (Private Healthcare Information Network)
  • Trusted by patients: In our 2022 patient satisfaction survey, 96% said they'd recommend us to their family and friends.
Mr Angus Lewis, London Hip Unit

Book an appointment with a hip consultant

Our team can help with any enquiries or you can make an appointment with one of our experienced hip consultants by using the link below to choose your consultant and book into their diary directly. 

Our Groin pain locations

Institute of Sport Exercise and Health (ISEH)

Institute of Sport Exercise and Health (ISEH)

170 Tottenham Court Road W1T 7HA London
The Harley Street Clinic

The Harley Street Clinic

35 Weymouth Street W1G 8BJ London
The Portland Hospital

The Portland Hospital

205-209 Great Portland Street W1W 5AH London
The Princess Grace Hospital

The Princess Grace Hospital

42-52 Nottingham Place W1U 5NY London
The Lister Hospital

The Lister Hospital

Chelsea Bridge Road, SW1W 8RH London
The Shard Outpatients

The Shard Outpatients

The Shard, 32 St Thomas Street SE1 9BS London