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The area most typically referred to as the groin is comprised of the abdominal, iliopsoas and adductor muscles. Groin strains occur when one of the muscles along the inner thigh get suddenly over stretched resulting in injury. These muscle strains or tears are common, and often occur with sport and rapid movements.
Patients typically report a sudden onset of sharp or severe pain during a specific activity that is felt in the groin region or medial inner thigh. Bruising or swelling may be present with these injuries along with point tenderness over the affected area. Often there is an obvious weakness with bringing the leg inwards against resistance (hip adduction) and with passive stretching of the injury muscle.
A thorough history and a physical examination is needed to differentiate groin strains from similarly presenting injuries. A physical examination will assess the location and severity of pain while observing for tenderness. The patient will be put through various resisted movements testing the hip and core, looking for symptom exacerbation. Diagnostic anesthetic injections may also be utilized to determine the primary source of groin pain.
X-ray is helpful in the evaluation and diagnosis of concomitant injury to the bony structures surrounding the adductor muscle group. Magnetic resonance imaging (MRI) is useful in identifying the presence and location of injury to the muscles and tendons while ultrasound can help further visualize the muscles, tendons, ligaments and nerves.
Initial treatment consists of rest, NSAIDs, activity modification and physical therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain relief and physical therapy may be utilized once the injury has begun to heal, to improve strength and flexibility. Formal strengthening programs to increase trunk and lower extremity strength, core stability and address weakness or restriction in the hip, low back and sacroiliac joint can be successful in some patients.
PRP therapy concentrates the growth factors in your own blood, which can decrease inflammation, improve function and control pain. The scientific literature regarding these regenerative injections for groin injury is currently limited, thus further high quality studies are necessary.
Tenex is a minimally invasive procedure that can help eliminate chronic tendon pain by precisely targeting and removing damaged tissue without the need for conventional surgery.
Surgical management is typically reserved for cases that do not respond to conservative measures. There are a number of surgical approaches that may be used to repair the affected area.