HIP - GROIN PAIN AND SPRAINS

Acute groin pain is usually related to sports activites and most often a muscle tear or sprain of the adductor muscles. This commonly occurs when the groin is forced outwards as in a football tackle. Contusions from direct force onto the groin can also occur. 

Our Physiotherapists can ensure the injury is managed, diagnosed and the best rehabilitation program tailored to the client including a full return to sport progression.
Chronic groin pain, however, can be caused by a numerous factors.

In patients with groin pain it is important to localise the area of abnormality. There are many reasons for groin pain arising from:

  • Adductor (inner thigh) muscles - chronic muscle strain or tendinopathy occur.
  • Gilmore's Groin (Sports Hernia): common in kicking sports.  Pain with squeezing the inner thigh muscles sometimes reproduced with coughing. Sometimes requires surgery but Physiotherapy is often successful including stabilizing and strengthening the pelvic muscles and adductor s.
  • Hip joint - labral tear, synovitis, trochanteric bursitis or a stress fracture of the neck of femur. A condition called femoral-acetabular impingement may also be present.  Further investigations may be needed if any of these conditions is suspected.
  • Pubic bones - osteitis pubis or stress fracture of the pubic ramus. This condition is complicated, often occurring in kicking sports such as soccer.  Recent science and the current methods of treatment have made advances in the management of this painful condition
  • Abdominal muscles - strain of the hip flexors, appendicitis, or an inguinal hernia.
  • Bursitis - there are a number of bursae contained within the groin and many of these are susceptible to overuse and inflammatory change.
  • SIJ (Sacro-Iliac joint) Sacro Iliac joint (SIJ) problems can sometimes refer to the groin, buttock or the back of the thigh although, unlike referred pain from a Herniated Disc, Sacro Iliac joint pain rarely goes below the knee. Our Physios can assess whether this may be the cause and use manual therapy to restore normal joint mechanics then active muscle control and strength work for the approximately 30 muscles which can impact SIJ stability.  These exercises are tailored to the individual by our Physiotherapists.

TREATMENT

Discussing Groin/adductor or iliopsoas muscle strains the following principals are used by our Physiotherapist.
Biomechanical analysis: to determine how this problem integrates into the whole person and possible causes or imbalances in muscles and/or joint structure that could contribute.

Real-time Ultrasound biofeedback to assess and give visual feedback that the deep stabilising muscles of the hip and abdominal cylinder are being recruited synergistically for optimal hip function.

Therapeutic mobilization: of muscle and joints associated to gain the normal joint mechanics.

Pain control modalities: Such as Ultrasound, dry needling as needed for pain and inflammation.

Range of Motion Exercises and stretches- Help you regain normal motion and slowly bring the muscle to the normal length-tension relationship.

Strengthening exercises - Help restore normal muscle strength and prevent re-injury. Also maintains the balance between opposing muscle groups. Abdominal cylinder control -core strengthening is also important.

Specific Sports/activity training exercises- tailored to your individual needs.

A good study on groin rehab exercises comes from Per Holmich (International SportsMed Journal, 1(1), 2000) and investigates the efficacy of a rehabilitation exercise programme for adductor related groin pain.

Sixty-eight males athletes with long-term groin pain injuries were split randomly into two groups. One group received only physiotherapy treatment on the injury, while the other received physio as well as performed a specially designed exercise programme. The results of this study were very positive. Four months after beginning the treatment, 74 per cent of the physio-plus-exercise group were participating in sports with no pain. This compared to just 14 per cent of those in the physio-only group.

At Innovative Physio post-graduate Physiotherapists will ensure the correct exercise program is prescribed to enable hip/ groin injuries and problems to heal.

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