What Is A Pulled Groin?

(Originally posted on bcotoronto.com on Mar 14th, 2013)

Continuing our look at the hip, we will be discussing “Pulled Groin” injuries this week. Of course you are now asking, “What does the groin have to do with this hip Dr. Ben?” Well, that’s what we are here to explore. In sports it is incredibly common to hear about an athlete with a Pulled Groin injury but who runs or skates or jumps with their groin? This misrepresentative nomenclature comes from the pain associated with the injury.

A “Groin Injury” is actually a simple strained muscle of the inner thigh. This strain occurs high up the thigh where the muscle attaches to the pelvis on a region called the “Ischiopubic Ramus”, which as you can see in the picture below, is very close to the genitals. This proximity leads to a lot of referred pain into the groin, specifically the testicles and the labia in men and women respectively. Thus the name.

The Pelvis and Femoral HeadsThe muscles involved are a group called the Adductors and two muscles called the Gracilis and the Pectineus. There are three Adductor muscles called the Adductor Magnus, the Adductor Longus, and the Adductor Brevis. Do you remember the Thigh Master from those commercials in the 90’s (it’s actually still around)? These are the muscles that it was targeting.

The Adductor Brevis and Gracilis MusclesThe Adductor Longus and Pectineus The Adductor Magnus Muscle

So if this is just a simple strained muscle what does that mean for healing this kind of injury? Well, initially we should take it easy and ice the injured area. This will help to reduce the inflammation and swelling. After approximately a day and a half we should switch this up and use heat to relax the tight muscle and increase the blood flow in the area. As well, we should lightly stretch the muscle. This will help to get the muscle to relax as well as increase its ability to contract properly again.

The first stretch we should attempt is a butterfly stretch. Sitting upright on a flat surface (a soft surface like a pillow or mattress might be easier when first trying this stretch), place the bottoms of your feet against each other. Let your knees lower towards the floor and put a light downward pressure on them. Hold this position for several deep belly breaths and then release the pressure on your knees and raise them up again. Repeat this stretch 2-3 times in a set and do 2-3 sets in a day. The closer your feet are to your pelvis, the greater the stretch will be so start with your feet farther out and work them in until you find where your comfortable spot is.

The second stretch is a side lunge. This stretch should not be attempted until we are well on the road to recovery as use of the adductors is necessary to get out of the stretching position and this will hurt a lot if tried too early into recovery. So when you feel like you can manage it stand with your feet flat on the floor and standing straight in a neutral posture. Keep the foot of your injured leg on the floor and with the opposite foot take a large step out to the side. Bend the knee of the uninjured leg and lower your body weight over that leg. This should put you in a position where your injured leg is sticking straight out to the side and the rest of your body is squatting over your other leg. Hold this position for several deep belly breaths and then raise yourself back up to a standing position by straightening your knee and bringing the foot you stepped out with back in. Repeat this stretch 2-3 times in a set and do 2-3 sets in a day.

If you are an athlete you can generally introduce strength training into your recovery when you can perform these stretches without pain.

Thanks for reading,
Dr. Ben

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