Last Updated on February 2, 2023 by Dr. Saqib Mueed
In athletics, one often overhears the terms groin pull and groin strain. The term Groin Pull is many times used for tearing the skeletal muscles of the thigh upper part which is connected with the trunk. Groin pull usually discusses to slight tears of some muscle threads without a major effect on the core muscle.
Strain means stretching the muscle too far. An acute strain can often cause groin pull is also termed groin strain. The Groin muscle located higher Inner thigh to the inner right overhead the knee. The Groin muscle stretches the legs together and the groin hurts due to the physical imbalance and quick movements and absence of flexibility.
The strain of inner thigh muscle due to the side-to-side movement. The tearing of the muscle threads (sometimes even the entire muscle separates from its bony attachment). A groin strain is a serious setback to a professional athlete and can threaten his or her profession if not handled correctly. This type of injury usually occurs in athlete sportsmen that usually occur when quick acceleration and sudden directional changes in running moving bending type of thigh muscle effect and pain occur quickly.
Grading of the severity of groin strain
The condition is graded according to the severity of the pain and associated symptoms:
Grade I: There is discomfort, usually with the absence of any disability. There is no swelling. Recovery usually takes 2 weeks in this case.
Grade II: There is discomfort associated with the inability to perform strenuous activities such as running. Some swelling or bruising may be evident. About 1 to 2 months may be required for recovery.
Grade III: Severe pain in walking. In severe cases, there may be pain at rest also. Significant swelling and bruising are often present. The patient may also experience muscle spasms. Recovery may take 3 months or more
Anatomy of a groin pull
Essentially, groin pull, or strain means a strain or maybe the tearing of the upper or proximal attachments or the threads of the anteromedial thigh muscles or inner thigh (usually consist of the Skeletal group—6 muscles that stretch from the anteroinferior portion of the hip joint bone to the lineaaspera of the femur, the muscles that start from the groin area down the inner thigh to the internal side of the knee). This skeletal muscle comprises of.
- Skeletal longus
- Skeletal Magnus
- Obturatorexternus
- Skeletal Brevis
- Skeletal gracious
The most communal muscle to be tangled is the skeletal longus. As is clear from the name of the group, the main function of these muscles is to bend the thigh, or to bring the legs near.
Types of Groin Muscle
- Skeletal muscle
- Stomach muscle
- Hip joint flexor muscle
Skeletal muscle
There are five skeletal muscles: (Skeletal longus, Skeletal Brevis, and Skeletal Magnus). Furthermore, the skeletal muscles are accountable for various activities at the hip joint and knee joint, having to assist in bending of the hip joint.
While these skeletal muscles are linked with the core function, which is bending of the hip joint, the Skeletal Magnus also performs the main role in equilibrium the knee when the group of tendon muscles is involved.
If the group of tendon muscles is feeble or delimited, the skeletal will come in to aid with the activities and working of the knee joint the Skeletallongus contain 90% tendon tissue. The total proximal tendon is 7-17cm. The Skeletal Brevis initiates into the lower and after the skeletal longus and also intramuscular tendon partial of the length of skeletal longus. Some muscle threads from the skeletal Brevis in males and the tendinous threads in females and these Skeletal Brevis threads unite with the gracilis this gracilis initiate from the part of the pubic bone.
The Skeletal Mangus has two parts of proximal. The main muscular part is posterior to the ischiopubic ramus and the tendinous.
Stomach Muscles
The stomach muscles produce the anterior and lateral stomach wall and consist of the outer stomach inclined muscles, the inner stomach inclined muscles, the Abdominis rectus, and the Abdominis transverses.
All skeletal muscles produce a durable wall that defenses the viscera aid to sustain the erect position. Additionally, the tightening of these skeletal muscles helps in different body activities such as micturition, respiration (inhalation or exhalation), and giving birth
Hip joint flexors
The hip joint flexors aid in the equilibrium of the posterior hip joint muscles. Three main muscles frequently become constricted and reduced, a consequence of action everyday routine work. These are
Psoas major: The muscles initiates on the frontal area of the abdominal vertebrae and covers the pelvic region. This muscle helps in the movement of hip joint muscles it also helps in the bending of the backbone of the abdominal region.
Iliacus: This muscle thread and above-mentioned muscle threads are frequently termed as the iliopsoas. The skeletal muscle (psoas minor) puts in on the upper part of which at the right angle to the pelvic and mostly cares the anterior concavity in the curvature of the lumbar and cervical spine but is present in only 40 percent peoples.
Rectus femoris: The rectus femoris is situated nearer to the center of the body or the point of attachment or adhesion at the joint at the upper thigh in which the femur is inserted in the joint. If these skeletal muscles are pressed, for a long time: these skeletal muscles become skin-tight and become shorter in length.
This can cause dragging force ahead backbone in the abdomen region, producing a curvature in the vertebral column and causing the hip joint to incline anteriorly. This occurs in the person which works on sitting the chair for a long period, for example, the office worker and computer worker have to sit on a chair for a long time for their work. These people must be provided with much knowledge related to their muscles working.
Analyzing and curing in the hip joint region is not easy for many analysts and patients. Some limitation is there which have to be overcome. Some patients sense this area too private and feel bad when the therapist touches or examines this area moreover, the internal structures such as the intestines, uterus, kidneys, and bladder is also difficult to examine.
So many difficulties are present in examining, diagnosing, and medication of groin pull because the muscles are present in a region which are not likely to be examined for many types of peoples
Causes of a groin strain
Groin strain is usually the effect of one of the following on muscles that are weak or tight, or unconditioned:
- Resisted forceful abduction of the hip joint (outward movement of the thigh) or stretching of the Skeletal excessively (e.g., kicking a football)
- Putting sudden stress on the Skeletal, for example, a sudden change in direction
- Excessive overuse of the Skeletal at a given time, A direct blow (kick or getting hits with a ball) in the groin
- This condition is mostly seen in sports requiring sudden starts or bursts of speed, as in sprinters (due to the fast start), hurdlers, fast bowlers in cricket, footballers, and ice hockey players.
- The causes of groin pain are due to turning quickly running fast and the jumping movements that affect the muscles to contract and to put a stress on the muscle of the thigh.
- Jumping forceful kicking and suddenly changing direction while on running
- When we lift something heavy
- Sportsmanlike footballer athlete is affected by groin pain due to playing that causes groin muscle pull and contract this kind of condition are more severe to sportsman
Symptoms of a groin strain
Pain is the dominant symptom in this condition. This can take the following forms:
- A sudden sharp pain, which is felt during the exercise.
- Tight or sore groin muscles (this symptom could be delayed until the next day)
- Bruising in the groin area
- Swelling in the affected area
- Inflammation occurs on the inner thigh
Pain on
- Walking or movement of the thigh
- Bring the legs together (bending on)
- Stretching the Skeletal.
- Resisted bending
- Resisted hip joint flexion
Diagnoses of a groin strain
Groin strain diagnosed by the doctor and the physical therapist
The doctor during the examining asks some questions to find out the cause of the injury and severity.
Feel and heard the popping sound when injury of the groin occurs
Notice swelling just time passes and after injury
The patient feels pain in the upper thigh region when fast-moving and change its direction the part swells up and cause severe pain and the patient won’t be able to walk
Clinical Examination
- The presenting or main complaint is a pain in the Skeletal area
- Palpation or touching reveals tenderness or pain of the Skeletal muscles
- Provocative test resisted bending or inward movement of the thigh causes pain; sometimes a hip joint flexion or a bending thigh is also painful.
Imaging Studies
In some condition or cases, the doctor asks for a test because the test clarify the diagnoses of injury
X-ray of the upper thigh of legs that is determined by muscle condition
MRI Scan needed to check the leg and hip joints also essential for the scan of the ligaments and muscles.
Treatment option of a groin strain
The injury of groin strain treated quickly after the injury the 24 and 48 hours are important to reduce the pain swelling bleeding and ease the pain to the area
A person should rest their leg after the injury and staying still and trying not to walk
After 48 hours a person raises the leg for example resting this on a fool stool and gentle movements of legs should do.
Firstly, apply ice packs on the injured area if the ice packs not available the bag of ice apply
The ice packs do not apply directly to the skin because this causes ice burns and ice packs held on the injured area for 15 to 20 minutes of 2 hours.
The painkiller should be taken immediately.
The soft tissues injuries groin pulled muscle treatment include
First Aid about a groin strain
Athletes should be trained to recognize the symptoms and apply the RICE protocol: rest, ice, compression, and elevation. Injured athletes should be careful not to strain the muscle further, even if they have to use crutches or a stretcher. They can dress flexible compression bandages on the superior thigh for firmness, but they must be cautious not to cover the bandage too skin-tight. The leg must be kept raised above the equal of the heart for the first 24 hours to avoid swelling. A sports injury specialist should be referred as soon as possible.
Professional Treatment of a groin strain
Treatment varies with the severity of the injury. One or all of the following may be considered.
Initial Treatment
Rest. This is the cardinal principle in any groin injury. Adequate rest is often followed by complete healing of the muscle. The patient should be advised to avoid all activities that are likely to cause pain and even to shorten the stride or use support while walking.
Local cold pack/ice: Using ice or cold packs on the injury during the first 2 days is often very helpful in easing the pain and swelling. Ice should be applied for 15 to 20 minutes four times a day and should be wrapped in a towel to avoid direct application. Ice application can be extended for several days if necessary, and the process can be repeated after activity involving the affected area.
Subsequent Treatment
Stretching: Stretches are employed in both prevention and treatment. Gentle stretching is advisable, although care must be taken not to overdo this as excessive stretching may be counterproductive. A gentle pulling sensation is an aim, but the stretch should not be painful. Stretching should be done in the recovery period and can be done several times a day. Stretches include the following:
Squatting Skeletal stretch: The patient squats with the arms between the legs, the knees should be moved outward by pushing apart with the elbows.
Butterfly stretch: The patient sits with the knees bent and feet together, grasping the feet with the hands and stretching the knees toward the ground.
Skeletal stretch: The patient stands with leg out to the side, bending the knee of the leg under the body to stretch the muscles of the inner thigh of the opposite leg.
Cross-legged stretch: The patient sits in a chair with one leg crossed over the other, pressing the knee of the crossed leg toward the ground.
Local application of heat: While a cold compress is helpful after activity, a hot compress is of benefit before any activity is undertaken (e.g., stretching), to soften the area and reduce any chance of further aggravation of the injury. However, the use of heat should be started in the recovery period, not in the period immediately following the injury.
Physiotherapy: Ultrasound treatment, infrared treatment, specific exercises, and massage by trained physiotherapists under the supervision and guidance of sports injury specialists or rehabilitation specialists are often of value in speeding up the recovery period and preventing complications.
Strengthening exercises: These are added gradually when a fair amount of recovery has taken place, but they must be done under supervision. These include Skeletal and abductor strengthening as well as hip joint stabilization exercises, including lunges, squats, extensions, and so on, and also core strengthening exercises that target muscles that are hard to get to, including the stomach and lumbar stretching. These are usually done with a large exercise ball.
Strengthening exercises: These are added gradually when a fair amount of recovery has taken place, but they must be done under supervision. These include Skeletal and abductor strengthening as well as hip joint stabilization exercises, including lunges, squats, extensions, and so on, and also core strengthening exercises that target muscles that are hard to get to, including the stomach and lumbar stretching. These are usually done with a large exercise ball.
Prevention of groin strain
The most important factor in the prevention of this injury is the proper conditioning of athletes, especially those who participate in sports where groin injury is more likely. To ensure hip joint strength, athletes should warm up properly before any exercise. This is also important to incorporate stretches and strengthening exercises into the preseason training routine. In athletics, one often overhears the terms groin pull and groin strain.[1]https://www.berkshirehealthcare.nhs.uk/media/168337/groin-strain_leaflet.pdf[2]Self-Help-Booklet-For-Groin-Strain.pdf (sandbachgps.nhs.uk)[3]Groin-General-Groin-Strain-min.pdf (theoremhealth.co.uk)
Reviewed by:
Dr. Iqra Chaudhary
MBBS, RMP
Medical Officer, Red crescent hospital, Sargodha
Our reviewers’ details, Click Here
References
| ↑1 | https://www.berkshirehealthcare.nhs.uk/media/168337/groin-strain_leaflet.pdf |
|---|---|
| ↑2 | Self-Help-Booklet-For-Groin-Strain.pdf (sandbachgps.nhs.uk) |
| ↑3 | Groin-General-Groin-Strain-min.pdf (theoremhealth.co.uk) |
