A groin pull or a groin strain is a condition which occurs due to excessive stress on the groin and thigh muscles. Forceful and sudden contraction of these muscles results in them getting over-stretched or torn. Groin pull or Groin Strain commonly occur in those individuals who are involved in sports which require a lot of running and jumping, especially jumping suddenly or abruptly changing direction. People who play soccer and football are more prone to suffering from Groin Pull or Groin Strain
Classification of Groin Pull or Groin Strain
Groin pull or groin strain is usually divided into three degrees of severity:
- Groin Pull or Groin Strain of Grade 1 Severity is termed as Mild: Pain is present with some loss in strength or movement.
- Groin Pull or Groin Strain of Grade 2 Severity is termed as Moderate: Pain is present and there is also some damage to the tissue.
- Groin Pull or Groin Strain of Grade 3 Severity is termed as Severe: Pain is present along with loss of function, and the muscle is completely torn.
Symptoms of Groin Pull or Groin Strain
- One of the symptoms of pulled groin or groin strain is that tenderness is felt in the groin and the inner part of the thigh.
- Pain is felt in the groin area when the patient tries to bring his/her legs together.
- Pain upon lifting the knee up.
- A popping or snapping is felt at the time of the injury which is followed by acute pain can be a symptom of groin pull or groin strain.
Tests to Diagnose Groin Pull or Groin Strain
- Physical exam.
- MRI helps in ruling out other problems.
Treatment of Groin Pull or Groin Strain
Groin pain resulting from pulled groin or groin strain may respond to conservative treatment like rest, ice therapy and heat treatment. Patient may apply medications sold over the counter in most pharmacies. Medications like counter irritant and muscle relaxants, which are sold over the counter in pharmacy can be tried for 3 to 5 days. Groin Pull or Groin Strain, when does not respond to these treatment or pain increases in intensity following such treatment, should be investigated to rule out muscle, tendon or ligament tear. Radiological study is indicated to rule out fracture or bone diseases. The choice of treatments for Pulled Groin or Groin Strain are as follows-
- Ice Therapy for Groin Pull or Groin Strain- Icing the inner region of the thigh helps in relieving pain and swelling due to pulled groin or groin strain. Ice should be applied for 20-30 minutes, every three to four hours for 2-3 days.
- Heat Treatment for Pulled Groin or Groin Strain - Groin pain cause by either muscle tear or muscle spasm can last for prolonged period of time. Spasm could be intermittent or continuous. Spasm or pain may last for few hours a day. Heat treatment gives immediate pain relief and in most cases helps to relieve muscle spasm. Heat treatment for Groin Pull or Groin Strain helps to improve blood circulation and is useful when long standing spasm is relieved by medications or massage therapy.
- Rest- It is important to take rest following groin pull or groin strain as that aids in recovery from a pulled groin.
Massage Therapy for Groin Pull or Groin Strain-
Massage therapy during the spasm is effective in relieving the spasm and pain. Massage therapy is divided in superficial or deep massage. Superficial massage is beneficial when the groin strain or groin pull is associated with muscle spasm. Deep massage may cause increased pain during the muscle spasm. Superficial massage therapy is advised during first 3 to 4 weeks when groin strain results from muscle trauma or tear. Deep massage is essential when muscle injury is healed and groin pain is mostly caused by scar tissue during muscle contraction.
Chiropractic Treatment for Groin Pull or Groin Strain –
Chiropractic therapy is beneficial during initial phase of pulled groin or groin strain to treat pain. Continuation of chiropractic treatment is beneficial to prevent recurrence of groin pain associated with pulled groin or groin strain. Chiropractic manipulation should be avoided if sprain is caused by tear of muscle, tendon or ligaments. The treatment for pulled groin in beneficial once the injured muscle and tendon are healed with scar tissue. Manipulation for prevention of similar pain or pain caused by soft tissue scarring is often combined with massage therapy or application of heat treatment.
Thigh Compression or Braces to Treat Groin Pull or Groin Strain-
Thigh compression or braces are applied to give rest to painful groin muscle and ligament. Groin pull or strain may be caused by pelvic joint ligamental injury or inflammation. Thigh compression or soft braces helps to restrict muscle contractions, which results in less muscular contractions and can be effective in overcoming the pain and discomfort associated with pulled groin.
Medications for Groin Pull or Groin Strain
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for Pulled Groin- NSAIDs helps to restrict inflammation and thus reduces groin pain caused by soft tissue inflammation. Individual suffering with groin strain is often treated with NSAIDs for 2 to 3 weeks. Patient is observed for side effects like stomach pain or abdominal bleeding during treatment. NSAID such as Advil, Aleve, or Motrin helps in alleviating groin pain and swelling associated with Pulled Groin or Groin Strain.
- Treating Groin Pull or Groin Strain with Muscle Relaxants- Therapeutically muscle relaxant is indicated when groin strain is caused by muscle spasm or muscle contraction. Muscle relaxant in few patients causes drowsiness and sleepiness. Individual with these side effects may avoid muscle relaxants or try different muscle relaxants to treat pulled groin. Drowsiness is observed with Baclofen and Flexeril. Skelaxin and Robaxin often cause less drowsiness.
Physical Therapy for Groin Pull or Groin Strain
Physical therapy is prescribed for treatment of groin pain due to pulled groin or groin strain and also to prevent recurrence of groin pain. Physical therapy is performed under supervision of qualified physical therapist.
Trigger Point Injection for Groin Pull or Groin Strain
Pain caused by muscle contraction, ligamental injury, ligamental inflammation and scarring of soft tissue is treated with trigger point injection. Scarring of soft tissue including scar tissue is formed after healing of muscle, tendon and ligament tear or injury. Trigger point injection includes injection of local anesthetics and cortisone next to painful soft tissue or within the painful scar tissue. Technique involves cautious approach to prevent injection of medications in blood vessels or within the nerve fibers.
Surgery for Groin Pull or Groin Strain
Surgical treatment depends on cause of the groin strain. Muscle tear or ligamental tear is treated by simple surgery like suturing tendon or muscles. Alternatively diseased tendon or muscles is excised and normal tendon or muscle is repositioned to maintain normal function of the muscle and tendon.
Prognosis and Recovery Period of Groin Pull or Groin Strain
Prognosis of groin pain due to pulled groin or groin strain depends on cause of the pain. The outcome of treatment of muscle spasm causing groin pain is excellent. The pain relief lasts for prolonged period though spasm may recur depending on triggering factors. Groin pain may continue for several weeks if pulled groin or groin sprain is caused by tear of muscle, tendon or ligaments. Groin pain caused by muscle spasm recovers in 3 to 7 days. Recovery to resume normal work following treatment of muscle and tendon tear is 4 to 6 week after treatment. Overall patient may not be able to recover to resume normal duties for 6 to 8 weeks following muscle or tendon tear. Recovery period depends on type of injury, mild muscle injury and spasm recovers in 2 to 4 weeks.
Preventive Measures for Groin Pull or Groin Strain
- Before commencing physical activity, always stretch your leg and groin muscles to prevent injuries like pulled groin or groin strain.
- Make sure you wear well fitting shoes that have good support.
- Gradually increase the intensity of your workout or physical activity.
- Stop exercising immediately if there is any pain or tightness in the groin or the inside of your thigh.
- If you have already suffered from a previous groin pull or groin strain, then regular strengthening exercises for thigh muscles are beneficial, especially in preventing future groin pull or groin strain.