Hip & Groin

Groin/ Adductor Strain, Sportsman  s Hernia, Gilmores Groin, Hernias, Osteitis Pubis, Labral tear, Snapping Hip, Osteoarthritis, Trochanteric Bursitis, Slipped upper femoral epiphysis, Perthes

Adductor Muscle Strain:
The muscles on the inside of the thigh and hip act to pull the leg towards the midline. These are the adductor muscles. The muscle is often torn as a result of a sideways strain or in a tackle in football or on kicking the ball awkwardly. When the adductor muscle is damaged this is known as a groin strain.

A groin strain commonly occurs due to a sudden contraction of the groin muscles often when they are in a position of stretch. This typically occurs during rapid acceleration whilst running (particularly when changing direction) or when a footballer performs a long kick.  They are commonly seen in running sports such as football, hockey and athletics (particularly sprinters, hurdlers, and long jumpers) as well as skiing, horse riding and gymnastics. Groin strains tend to occur more commonly in the older athlete and  particularly following an inadequate warm-up.

Treatment for a groin strain
Most patients with  this condition  heal well with appropriate physiotherapy.

Activities placing large amounts of stress through the groin should also be minimized, these include: running (especially with change of directions), kicking and jumping. By avoiding these activities, the body can begin the healing process in the absence of further tissue damage. Once the patient can perform these activities pain-free a gradual return to these activities is indicated provided there is no increase in symptoms.

Ignoring symptoms or adopting a ‘no pain, no gain’ attitude is likely to lead to the  condition becoming chronic. In these instances, the groin strain may develop into other groin conditions such as an adductor tendinopathy or osteitis pubis. Immediate, appropriate treatment in patients with  a strained groin  is therefore essential to ensure a speedy recovery. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times and an increased likelihood of future recurrence.

Diligently following the  R.I.C.E. Regime  in the initial phase of injury (first 72 hours) will greatly assist in improving recovery time. This involves rest from aggravating activities, regular icing, the use of a compression bandage, and keeping the affected leg elevated. Anti-inflammatory medication may also help to reduce inflammation, pain and swelling. The  use of crutches  when walking may be necessary to protect the groin from further damage and to hasten the healing process.

A graduated flexibility and strengthening program guided by a physiotherapist is essential to recondition the groin muscles and reduce the likelihood of injury recurrence following a groin strain. Careful assessment by the physiotherapist to determine which factors have contributed to the development of the injury, with subsequent correction of these factors is essential to ensure an optimal outcome.

A graduated return to running program in the final stages of rehabilitation is required to recondition the muscle for running in a safe and effective manner. This should include the implementation of progressive acceleration and deceleration running drills, as well as change of direction drills.

Now that  s the easy part!!!If only all groin strains were as easy to get better as it says in the soft tissue injury treatment handbook!!

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The Chronic Groin
Groin injuries are often of the overuse type and typically the athlete will have had pain for a considerable period of time. The “holy trinity” of chronic groin injuries are the sports hernia (disruption to the inguinal canal without an apparent hernia), osteitis pubis (inflammation or degeneration of the pubic symphysis) and chronic adductor tendinosis (degeneration or wear at the origin of the adductor tendons of the inner thigh). Athletes may develop one, two or all three of the above. All of these conditions are thought to be caused by repetitive shearing forces acting across the pubic symphysis (the joint at the front of the pelvis where the two pubic bones meet).

At Wicklow Physiotherapy clinic we are skilled in identifying problem around the lumbar spine and pelvis.   What we find in chronic groin pain patients is poor pelvic stability.

They are unable to stabilise the lower abdomen and pelvis whilst performing the twisting and turning movements needed for their sport.

To help correct this imbalance we do alot of work on strengthening core muscles to reduce the stress on the adductor muscles.   This should be started as soon after injury as possible

We aim to start functional sports specific exercises as early as possible and gradually increase the programme to include dynamic exercises.

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