Groin Pulls

by Peter on April 21, 2020

In the last few days I have had questions around what to do for a groin pull. A groin pull or strain is an injury to one or more of the adductor muscles. These are the muscles on the inner side of your thigh (see picture above). Sudden movements can trigger an acute groin pull such as sudden lateral movements, kicking or even excessive stretching. Many of us hear of athletes out with a groin pull and depending on severity it may take a very long time to heal. 

Symptoms can range from mild to severe and can include pain in the inner thigh anywhere from the pubic bone to the knee. Other symptoms can include swelling, bruising, or difficulty walking or running with pain. 

The cause can be quite puzzling. Usually, the pull occurs when the adductors are required to lengthen and contract at the same time causing a tremendous pull on the attachments, mainly at the pubic bone area. However tears can occur in the muscle belly itself. 

So lets look at how to treat this common injury.

How Do We Diagnose Groin Pull

Diagnosis

My first step is to understand when the injury occurred and the movement you were doing at the time. This works well with sudden groin pulls, but I also see chronic groin symptoms that patients have and are unable to pinpoint a certain movement that caused it.

Next I want to palpate the area. This will involve touching and massaging the entire length of the adductor muscles. Because all the adductors attach to the pubic bone I have to feel right up to this area. Most groin pulls occur at the attachment on the pubic bone as the tendon gets “pulled” off the bone. It’s much like tennis elbow where the irritated site is at it’s attachment. I also will follow the muscle in it’s entirety to it’s attachment on the femur and at the knee. 

It is important to assess the severity of the strain, at this point. There are 3 degrees of groin strains.

Grade 1

A grade 1 groin strain occurs when the muscle is overstretched or torn, damaging up to 5 percent of the muscle fibers. You may be able to walk without pain, but running, jumping, kicking, or stretching may be painful.

Grade 2

A grade 2 groin strain is a tear that damages a significant percentage of the muscle fibers. This might be painful enough to make walking difficult. It will be painful to bring your thighs together.

Grade 3

A grade 3 groin strain is a tear that goes through most or all of the muscle or tendon. This usually causes a sudden, severe pain at the time when it happens. Using the injured muscle at all will be painful.

Once I have established the severity of the injury, treatment will begin. The goal of treatment will be to reduce pain and swelling. The first few days after injury will follow the protocol for any muscle injury, that is …

  • rest
  • ice
  • compression
  • elevation
  • anti-inflammatory drugs (see your doctor for this)

So how do I treat this as a Massage Therapist? Keep reading here.

Peter Roach, RMT, CNMT, Laser Therapist

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