There are a variety of causes for groin pain, owing to the complexity of the groin region
April 8, 2023
Most people will experience groin pain at some point in their lives. There are multiple contributing factors in causing groin pain due to the complexity of the groin region.
Kicking, fast acceleration and deceleration, and rapid change of direction are all sports that can result in groin pain and trauma. This presentation has been misunderstood because there was no standard definition of athlete groin injury/pain until 2015. We'll go over the significant contributors to groin discomfort in this post and how chiropractic in Sydney can help treat this condition.
First, let’s talk about where is the groin region. The groin region is the area where your abdomen meets your legs. The pelvis is a ring of three bones that are held together by bony congruity, ligaments and muscles. The pelvis sits at the bottom of your spine. It is a place where many muscles attach that help to stabilise the pelvis. These muscles include:
The abdominals (rectus abdominis) are the muscles in your stomach.
Hip adductors (pectineus, gracilis, adductor longus, adductor brevis & adductor magnus) are the muscles on the inside of your hips.
The outer border of the rectus abdominis muscle is close to the superficial inguinal ring. This may explain why people with rectus abdominis problems also have an inguinal hernia symptoms.
Groin pain is a common problem caused by several different factors. It is usual to experience groin pain in male and female individuals who participate in sports. This is often because of the overuse or repetitive motions of the muscles, which can lead to strains or tears. Other causes of groin pain can include arthritis, infection, and even cancer.
In 2015, the Doha Agreement Meeting on the terminology and definitions of groin pain in athletes were divided into three major categories:
These definitions and terminology are based on the history and physical examination of athletes. Let's briefly go through each clinical entity.
Adductor-related groin pain is defined as adductor tenderness as well as pain with resisted muscle testing. The adductor muscles run along your inner thigh, and are associated with lumbar spine stiffness, hip restrictions, core stability or pelvic imbalances especially if they are recurrent.
The early clinical warning signs are:
The iliopsoas muscle is the strongest flexor of the hip joint. It is occasionally injured acutely; however it also frequently becomes tight when there is neural restriction, lumbar, pelvic, and groin pain, limited hip or lumbar mobility, or poor lumbopelvic dynamic stability.
The iliopsoas is often injured during repetitive hip flexion activities such as kicking. The asymmetrical nature of kicking can lead to muscle imbalance and injury, especially since it requires controlled flexion of the hip combined with rotation of the lumbar spine.
Iliopsoas problems include injuries such as tendinosis, snapping tendon, bursitis, tears, and avulsion (when the tendon is torn off the bone). It is often described as a deep, generalised ache around the front of the groin, or a sensation of snapping/clicking on one side of the groin. It can also feel painful and tight on stretch.
The subject of ‘hernias’ as a common cause of groin pain in sportspeople is controversial. While true inguinal hernias are relatively rare, other conditions similar to hernias have been described. These can be associated with the external oblique fascia, inguinal ligament tear, an inguinal hernia, or the rectus abdominis insertion abnormalities. These cases will present with pain and tenderness in the inguinal canal region, as well as aggravated by a cough, sneeze or laughter. These presentations may require surgery depending on the structure involved.
As shown in the image, pubic-related groin pain presents as local tenderness at the pubic symphysis. This can arise from bony stress around the joint at the front of your pelvis where the pelvic ring joins (pubic symphysis), also known as osteitis pubis.
Although not unheard of, less frequent causes of groin discomfort can be severe. It might be caused by arthritis, an infection, or even cancer.
The groin, thigh, or buttock is the source of most hip agony. When performing activities that put strain on your joints (such as walking, standing, or twisting), the discomfort is typically greater. Some patients report "start-up" pain – a severe throbbing sensation that begins when they get up after sitting for a long time.
Kidney infection usually begins when an illness traveling from your bladder to your kidneys causes inflammation in one or both of them. Groin pain for months, frequent urination, and blood or pus in your pee are common symptoms. E. coli bacteria are typically responsible for this condition.
Epididymitis, which is swelling in the tube where sperm is stored, and orchitis, which is swelling in one or both testicles, not only lead to infertility issues but also causes discomfort in the groin area. Both illnesses may develop at the same time.
Prostatitis is an infection or swelling of your prostate gland that makes it difficult to urinate. This can cause discomfort in the region of the groin, as well.
Swollen lymph nodes in the groin are sometimes testicular or penile cancer symptoms. This is similar to an infection. Lymph node swelling isn't always an indication of cancer, so if you have any worries, you should consult your doctor.
Testicular cancer is a rare disease. It typically develops gradually and may worsen when you're driving or sitting in a low chair. If detected early, it is almost always eliminated. It can occasionally lead to hip problems, such as arthritis or another condition that might radiate to your groin area.
At Hyper Health, our team of experts will take a comprehensive approach in treating your groin pain. Groin pain treatment involves analysing the biomechanical forces creating overload onto these structures, such as through the foot, ankle, hip, pelvis and lumbar complexes. These will vary for each individual depending on their daily activities, lifestyle factors and biomechanical tension. Oftentimes, the structure under tension occurs in conjunction with other biomechanical tension in other regions of the body, which may manifest in reduced mobility or pain. Chiropractic treatment may also involve improving lumbopelvic control, core stability and correcting muscular imbalances depending on the forces at play.