Groin injuries comprise about 2 to 5 percent of all sports injuries and are more commonly seen in sports such football, soccer, basketball, running, ice hockey, and Lacrosse.
The groin is the junction of the upper and lower body and is vital to almost everything we do. Groin injuries sustained by athletes during sports activity vary based on anathlete’s gender, age, and sport.
Groin injuries may be caused by:
- Sudden trauma (commonly noted while playing football or rugby)
- Sudden starts and stops of the lower body (common in sports such as soccer, ice hockey, basketball)
- Overuse or repetitive stress (commonly observed in sports such as distance running and triathlon training)
Common types of groin injuries that athletes are susceptible to include:
Adductor Strains: In athletes, strains of the adductor muscles are the most common cause of acute groin pain. This is especially true among soccer players which have rates as high as 10 to 18 groin injuries per 100 players. 62 percent of these have been diagnosed as adductor strains.1 The significant risk factor for adductor strains is prior injuries with 32% to 44% of injuries being classified as recurrent.
Sports Hernia: This is a condition caused by weakening of the posterior inguinal wall muscle leading to an occult direct or indirect hernia. Since only the posterior inguinal wall muscle is affected, no clinically detectable inguinal hernia is noted. However, therewill be gradually worsening pain throughout the area and deep groin pain.
Osteitis Pubis: This is a painful, self-limiting condition characterized by inflammation and pain over the symphysis pubis that is exacerbated by activities causing shearing of the pubis like pivoting, cutting, kicking, or rapid accelerations. The onset is normally gradual with athletes complaining of dull aching pain over the symphysis occasionally radiating to lower abdomen, scrotum, testicles, and perineum.
Iliopsoas Bursitis/Strains: This condition is characterized by swelling and inflammation of the bursa (fluid-filled sac) present at the front of the hip. It commonly occurs in sports requiring extensive use of hip flexors such as uphill running, soccer, jumping, hurdling, and ballet. The condition causes deep groin pain, sometimes radiating to the thigh or front hip, often accompanied by a snapping sensation.
Stress Fractures: Pubic bone fractures and femoral (thighbone) neck stress fractures are the two most commonly noted stress fractures centered around the groin area. This is caused by repetitive overuse and overload as seen in distance runners. Contributing risk factors include muscle fatigue, sudden increase in training regimen, changes in training surface or footgear, or osteoporosis in female athletes with hormonal or nutritional imbalances.
Avulsion Fractures: These fractures are commonly noted in adolescent athletes involved in sports such as soccer, jumping, sprinting, and hurdling. These fractures occur when the tendons that connect muscles to bone are torn at the connection site resulting in muscle weakness and pain.
Inguinal Hernia: This type of injury is mostly found in weightlifters. It occurs when the lower abdominal muscles tear or stretch resulting in the formation of a bulge in the groin area as the abdominal organs push through or press against the weakened muscles causing pain, pulling, or dragging sensation in the groin when lifting, stretching, or bending over.
Groin injuries are hard to diagnose and should be treated by a groin specialist. The majority of time, co-existing conditions exist in the complex anatomy of the groin region. Therefore, it is important to get an early diagnosis and proper treatment so that the injury does not become a chronic injury or career limiting.
Dr. Srino Bharam specializes in the treatment of athletic injuries of the groin for teens and adults. Call today to make an appointment if you are an athlete and have experienced a groin injury.
Author:
Dr. Srino Bharam is a board-certified, fellowship-trained sports medicine orthopedic surgeon specializing in the treatment of athletic injuries of the hip and groin. Dr. Bharam has over 30 years of experience in treating injuries and conditions of the hip with the goal of restoring athletes and patients to an active lifestyle.
