Groin Strain

The groin strain is one of the most common injuries in football. The term describes a strain of the adductor muscles that are located on the inside of the thigh. The injury usually occurs when the muscle is forcibly stretched beyond its limits and the muscle tissue tears. A tear in a muscle is referred to as a strain and, depending on its severity, is classified as a first, second or third degree strain.

Injury to the muscles or tendons in the area of the groin where the abdomen meets the thigh. Muscles, tendons and bones comprise units. These units stabilize the pelvis and allow its motion. A strain occurs at a unit's weakest part. Strains are of 3 types:

• Mild (Grade I)-Slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
• Moderate (Grade II)- Tearing of fibers in a muscle, tendon or at the attachment to bone. Strength is diminished.
• Severe (Grade III)-Rupture of the muscle-tendon-bone attachment with separation of fibers. Severe strain requires surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or overstress.

BODY PARTS INVOLVED

• Tendons and muscles of the groin area, including abdominal, pelvic and thigh muscles.
• Bones of the groin area, including the pelvis, spine and upper-leg bone (femur).
• Soft tissue surrounding the strain, including nerves, periosteum (covering to bone), blood vessels and lymph vessels.

Causes

• Prolonged overuse of muscle-tendon unit in the groin.
• Single violent injury or force applied to groin muscle-tendon unit.

Signs & Symptoms

• Pain in the groin with motion or stretching the leg at the hip joint.
• Muscle spasm in the abdomen or thigh.
• Swelling in the groin.
• Loss of strength (moderate or severe strain).
• Crepitation ("crackling") feeling and sound when the injured area is pressed with fingers.
• Calcification of a muscle or its tendon (visible with X-ray).

What other problems can cause similar symptoms?

A pulled groin is usually a very clear diagnosis--most athletes know what the injury is before they seek medical attention. However, there are other conditions that can mimic the symptoms of a groin strain.

One condition that was previously not well recognized is called a sports hernia . Sports hernias have been found in patients who were diagnosed with chronic groin strains. The sports hernia is a condition similar to a regular inguinal hernia , and is due to a weakening of the muscles that form the abdominal wall. The symptoms of a sports hernia are often nearly identical to those of a groin strain.

Treatment

RICE: Rest the finger until Day 5 when you should start gentle motion exercises, apply Ice to finger (not directly onto skin) for 20 minutes up to 3 times a day for 2 days, Compression - Wrap an elastic compression bandage around the finger to limit swelling, Elevate the involved hand above the level of the heart as much as possible for the first few days or until there is decreased swelling (will help drain fluid and reduce swelling). Follow your doctor's instructions. Instructions are supplemental.

• Use ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
• After the first 24 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Support the injured groin area with an elasticized bandage between treatments.

Home Diet

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Participate in a strengthening and conditioning program appropriate for your sport.
• Warm up before practice or competition.