Physiotherapy has yet to come up with a definitive answer to groin pain. That’s because there isn’t one! Within our Sports Therapy clinic we’ve seen so many “groin” issues over the years, but yet to see the same thing twice. How can this be? As it turns out most groin pain we see can be easily cured – if you’d like to know how read on.
What Is A Groin?
It’s one of the wooden things that stops the waves from eroding the sand too much isn’t it?! Ha, ha, I’m so funny. Groin is very much a lay persons term and it is unlikely that you’ll here any Physiotherapist or Sports Therapist using such a term when giving you your diagnosis – at least I hope they don’t!
Having consulted the font of all knowledge in the universe that is a Google (what did we do before it existed?!) I have the following definition:
“The area between the abdomen and the upper thigh on either side of the body.”
Well that really help! So groin pain is something that hurts vaguely down there. As a therapist it doesn’t give us much to go on does it. So you can see what we don’t like the term groin.
So What Hurts?
Your head of course! Pain is a multi-system input that is formulated in the brain which gives all of us our unique experience of pain. But that’s for another time, check our post on 50 Shades Of Pain for more info. Let’s focus on the mechanical aspect of groin pain for now. In other words what can go wrong in that region?
- Muscles – ah my favourite subject. So without thinking about it too much we have the adductors (magnus, longus and brevis), rectus adbominis (your 6-pack), iliopsoas (your hip flexors that lift your leg up), obliques and transverse abdominus (one of your core muscles). Any, some or all of these can be tight causing pain in the the groin region.
- Joint – the most common of course if good old osteo-arthritis, then we have labrum issues (the flappy bit around the joint that gives extra stability) and then there’s some nasty stuff which are very rare but will give you agonising pain – GP or A&E is your first port of call!
- Hernias – these are funny things. You can get all kinds of different types. The classic is just a weakness in your 6-pack and you will easily know it as you find something unnatural poking out of your stomach or groin. You can also get Gilmour’s Groin, Sports Hernia and an array of issues with… and bare with me on this one… the conjoint tendon of the internal obliques and transverse abdominis.
What’s Most Likely To Be Causing MY Pain?
Hmmm, well most likely all of the above. One thing affects the other. For example, you may have a slightly abnormality with the way your hip joint is formed. Very common indeed. That may have led to some altered movement patterns over time which leads to tight and tired muscles causing pain which also puts extra strain on your abdominal wall which can lead to a hernia.
Let’s look at it another way. You may have tweaked a muscle 10 years ago. It recovered but never felt quit right afterwards, or even if it did, there will be extra tightness within that muscle/s which change the forces that act across that joint and so affect the way in which the joint functions. In the short term this may give pain and a sensation of tightness in the joint. In the long-term this may lead to more degeneration of the cartilage within joint and the onset of arthritis. Not that arthritis is necessarily symptomatic of course! Read our previous post questioning the relevance of arthritis diagnosis as a cause of pain.
At the clinic we also find that hernias are largely over-diagnosed. Either that or we’re miracle workers. You know which one of those statements is correct! The key to any groin pain is to try to understand what structures are contributing the most to the symptoms and then stop them. In the vast majority of cases (in the region of 90%) we find that it’s not the joint causing the problem – even though you may have been diagnosed or seen on issues on imaging (MRI or X-Ray) issues – but the muscles that affect that act across that joint.
How It’s All Connected
Our regular readers will know that we like to challenge your understanding of the human body. Questioning what you believe to be true. Today is no different, but first check this research which discusses the inter relationship between iliopsoas, rectus adominis and adductors in groin pain. All very exciting for geeks like me but lets look at what it means for you and possibly explain the reasons behind these findings.
Two main biomechanical gems I will share with you today. Firstly, your shoulder is connected to your groin. Just thought I’d throw it out there. Let’s consult Grey’s Anatomy to show that I’m not talking nonsense. Please do so here. Hopefully you can see the continuation of the Latissimus Dorsi (which comes from the arm) continuing and blending with the external obliques and forming the ilioinguinal ligament before attaching onto your pubic tubercle – the source of so much groin pain!
Second gem. The first one is my own… kinda. This one. Completely, shall we say borrowed, it’s so much nicer than stolen, from Dr Thomas Myers. If we have a look at the Deep Front Line as I do so often during my days. You can see the continuation of the adductor muscles which attach in the groin, the hip flexors (which also attach in the groin) and beyond – up to the neck and down to the feet. We simply need to find the area of maximal tension and switch it off. Sounds crazy but it’s very easy to treat and test for immediate improvement.
If you have any groin pain and are concerned there’s no hope for you, fear not. Whether it’s been there a few days or a few years most groin pain can be easily shifted. And if it’s not, we’ll soon point you in the right direction. No excessive exercise programmes just a nice easy long term solution to your problem. Give us a call now if you’d like to discuss your groin pain or any other injury for that matter – .
This article first appeared on our Swindon site.