The hip and groin can be a pretty scary place. It is the amalgamation of a lot of anatomy and within a 5cm of the pubic symphysis – the bony lump in the middle of your pelvis, there are approximately 85 potential causes of pain and dysfunction.
The powers at be, especially within medicine, like to make things complicated and confusing, so of these 85 problems, there would be a multitude of names to describe the same problem. It’s no wonder it is a scary place for both patients and clinicians alike.
Thankfully, the world’s leading experts sat down in Doha in 2015 and made things a lot easier for us. They agreed that problems around the hip and groin would be referred to as: hip related groin pain, adductor related groin pain, pubic related groin, hip flexor related groin pain, inguinal related groin pain and “other”. We now describe the problem by the structure that is causing it, rather than these long and over-complicated medical terms. Much easier.
How common is adductor related groin pain
The adductors are a muscle group that runs up the inside of the thigh and is made up of the adductor magnus, longus and brevis. These are the most common cause of groin pain, occurring in 61% of cases in an athletic population (Taylor et al 2018). Another research group, Serner et al (2020) found an average number of days lost in a football season was 14-24 days or 8 days per 1000 hours. In layman’s terms, adductor related groin pain cost football club owners a lot of money. And for the rest of us, it gets in the way of our hobbies, activities and sports.
Types of adductor related groin pain
Adductor pain can either be acute or chronic, new or old. The majority of new adductor pain occurs due to injury in the adductor longus, specifically in the junction between the muscle and tendon (the rope-like structure that connects muscle to bone).
In longstanding or chronic adductor related groin pain things can get more complex. Your pain can originate from where the tendon attaches onto the bone or the bone itself is inflamed. Other adjacent structures can also have been injured either at the time of the original injury or have been overloaded due to a continuation of your sport and activity. Rankin et al (2015) found adductor related groin pain rarely occurs in isolation in those with longstanding pain.
What causes adductor related groin pain
The adductors can be injured acutely during hyper hip abduction or flexion (the splits) which can occur during slide tackles in football or rapid change of direction such as a side step in rugby or tennis. The adductor magnus can also be injured during sprinting.
The adductors can also be chronically overloaded. Sports that involve repetitive kicking, running and change of direction are most likely to have chronic adductor related groin pain. Skating, whether or ice on rollerskates, also has a high prevalence.
How to treat groin pain
Rehabilitation of adductor related groin pain has been shown to be the most reliable way to reduce symptoms and return to sport. In acute injuries the focus of your recovery is aimed at returning normal range of motion, regaining strength of the injured musculature and adjacent tissues, addressing any contributing factors and managing a graded return to sport.
In those with acute, first onset of pain, symptoms can improve within 1-3 weeks. If you were an elite sportsperson you would have a team of medical staff trying to get you better as quickly as possible, for the everyday athlete some time off your sport with a gradual reintroduction may be all that is required.
However, long standing problems often take longer than 6 weeks and can be as long as 6-9 months. Whether you have a first onset of adductor related groin pain or if you have a niggling groin that keeps coming back, at PhysioSpace we specialise in helping the elite, recreational and everyday athlete return to their activities and achieve their goals.
