Groin strain: causes & treatment of a groin strain

A groin strain indicates a strain or tear injury (a tear of a few muscle fibers) to the muscles in the groin area. A groin strain is common in athletes and can be attributed to overuse of certain muscle groups. Various tendons and muscle strands run through the groin, which can cause unpleasant pain if overstimulated. As a result of a groin strain, you may have difficulty performing daily activities that require standing and walking. For athletes, this means a break in training. A groin strain is easy to treat, provided you follow the guidelines of your doctor or physiotherapist. If a groin strain is not taken seriously, serious complications in the healing process can occur.

  • A strained groin
  • Symptoms of a groin strain
  • First symptoms
  • Later complaints
  • Acute injury
  • Complaints that developed gradually
  • Degrees of severity
  • Causes and triggering factors
  • Wrong movement
  • Restrictions in muscle flexibility
  • Wrong shoes
  • Competitive athletes
  • Increasing age
  • Pre-existing disease
  • Examination and diagnosis
  • Interview and physical examination
  • Visual art investigation
  • Disease progression
  • Who does it occur to?
  • Complications and consequences
  • Treatment of a groin strain
  • Prevention of a groin injury
  • Prognosis


A strained groin

When groin muscles are strained or torn, muscle fibers or other cells are disrupted and injured. In general, the adductor muscles, whose main function is to actively move the leg toward the body, are injured due to overuse. This happens due to a fall or a sudden, careless sideways movement. Such a groin injury is relatively common in football players, hurdlers, long-distance runners, swimmers and skiers. A groin strain can occur in varying degrees of severity. From a slight overstretching of a number of muscle fibers or several muscle fibers to a serious tear of the muscle fibers. The first symptoms are sharp pain in the groin and increased pain with various leg movements.

Symptoms of a groin strain

First symptoms

The first symptoms of a groin strain are mainly noticeable in the extensor and extensor muscles. This means that the pain sensation not only affects the groin area, but can also affect other parts of the body depending on the severity of the injury. The first symptoms that appear with a groin strain are:

  • mild to moderate pain during physical exertion
  • muscle pain at rest
  • initial pain in the pubic area
  • pain/cramps in the area around the injury
  • stabbing/pulling pain in the groin area


Later complaints

Complaints that occur a little later are:

  • swelling in the groin area/groin swelling
  • Hemorrhages in the groin area (bruises)
  • Stiffness in the groin area
  • weakness in the leg when open, climbing stairs or moving the leg
  • limping
  • difficulty performing daily activities that involve standing or walking


Acute injury

Depending on the initial situation, a groin injury can feel different. For example, if it is the result of a sudden accident caused by a slip or fall, the injury will be noticeable as follows:

  • you notice an uncomfortable sharp pain on the inside of the thigh
  • extreme pain is felt in the groin area
  • the pain spreads to the abdomen
  • bruising occurs in the area of ​​the injury (thigh/groin)


Complaints that developed gradually

However, a groin injury can also develop insidiously. This especially happens when the body is exposed to recurring overload. Symptoms usually begin with mild pain in the pubic area, which worsens with continued exertion. For example, if you apply pressure to the affected muscle area, the pain will worsen. Athletes notice the same thing with specific leg movements. Lifting and straightening the legs is associated with mild pain that can quickly worsen without proper treatment.

Degrees of severity

A groin strain is divided into three degrees in terms of severity:

Severity level 1

With a grade 1 injury, less than 5% of the muscle fibers and tendons are affected. This involves a mild or partial strain or tear of a few muscle fibers. You only feel a slight pain and the main pain occurs when moving sideways.

Severity level 2

In a grade 2 injury, more than 5% of the muscle fibers and tendons are affected. Muscle fibers may be completely torn. You feel very severe pain and any leg rotation can only be performed to a limited extent or not at all.

Severity level 3

In a grade 3 injury, a large number of muscle fibers are torn. There will be noticeable bruising and swelling in the affected area . The pain is extremely severe and also occurs when the leg is immobilized. A targeted movement of the leg is hardly possible and you are prescribed absolute bed rest.

Causes and triggering factors

A groin strain mainly occurs in athletes and is considered one of the most common sports injuries. An unfavorable sequence of movements can quickly lead to a groin strain. It can also be contracted in everyday life. Slipping on a wet floor or tripping over a step can be enough. There are numerous factors that can lead to a groin strain. It’s not always a bad sequence of moves, but often it’s just a series of unfavorable coincidences. The most common causes are:

  • a wrong move
  • limited flexibility in muscle groups
  • the wrong shoes
  • competitive sports practice
  • age
  • pre-existing disease


Wrong movement

Every movement of the body is based on a series of successive sequences of movements. Different muscle groups are used routinely, always subject to the same sequence. If this routine is interrupted by an incorrect movement, the musculoskeletal system is disrupted and the muscles and sphincter fibers can become unintentionally overloaded or injured

Restrictions in muscle flexibility

Especially when exercising, it is extremely important to warm up your body sufficiently. Muscle and tendon cords that are not sufficiently stretched and warmed up can be very stiff and inflexible. This also applies to the adductor muscles in the hip. Stretching exercises aren’t just for athletes; they are important to everyone.

Running woman / Source:

Wrong shoes

Correct posture starts with the right footwear. Falls, slips and the like can be prevented by wearing good footwear. This applies to running and all other sports.

Competitive athletes

Competitive athletes put more strain on their bodies than regular athletes. When running with obstacles, sprinting, long jumping or playing football, you can quickly sustain injuries. The leg movements here are not fluid, but rather jerky. For example, contact sports such as football, hockey and rugby require a lot of twisting, which can also lead to injuries. Competitive athletes like to go to the extreme and push their limits, which means the risk of injury is high. A groin strain is one of the most common injuries that is often initially overlooked, causing the symptoms to worsen.

Increasing age

Although one may hate to admit it, age plays a major role in the overall risk of injuries and injuries. As you get older, your body changes and so does your susceptibility to injury. As you get older you lose muscle mass and the risk of injuries increases steadily. From the age of 40, the risk of a groin injury increases.

Pre-existing disease

Due to specific pre-existing conditions, some people are more at risk for a groin strain than others. This specifically includes misalignment of the hip or pelvis, which can negatively affect the natural musculoskeletal system. The same applies to a spinal condition or a leg length difference. These conditions or abnormalities can significantly affect the muscle and tendon cords, including in the groin area.

Examination and diagnosis

Interview and physical examination

The doctor will ask questions about your complaints and perform a physical examination. Your doctor will ask how the injury occurred and what exactly your complaints are. He will also inquire about the activity you were doing when the injury occurred and whether you have had a similar injury in the past. Your doctor will then perform a physical examination. This may include stretching your adductor muscles to determine if it hurts and to test your leg’s range of motion.

Visual art investigation

In addition to clarifying your general condition, X-ray examinations can be performed.

Disease progression

First degree injury

The course of the disease with a mild first-degree groin injury is quite short and simple. Medical treatment is not necessary in these cases. When in doubt, a visit to the doctor is always wise. With a mild degree of groin strain, you can continue exercising, but taking your limits into account. You only feel mild pain, but the muscle maintains normal strength and use of the leg is not impaired and walking is normal. With moderate exertion, the injury should be completely healed within 10 days.

Second degree injury

With a second-degree injury, recovery takes longer. The pain is more pronounced and makes even simple walking much more difficult. A larger proportion of the muscle fibers are torn, which significantly prolongs the recovery process. A torn muscle is not something to be trifled with. The leg should be completely immobilized and elevated for a long period of time. Overexertion should be avoided, otherwise the injury could worsen. Use of the leg is considerably limited and with second-degree injuries you also walk with a limp. It is important that you allow enough time for recovery. If the muscles and tendons are used too early, the complaints can recur or worsen and even lead to a chronic course of the disease.

Third degree injury

Third degree groin injury is the most serious form and requires a long healing process. You should immobilize your leg for several weeks and not put any weight on it. Placing weight on the leg is very painful. This often involves not only tearing of the muscle fibers, but sometimes even complete tearing of the muscle. The pain is particularly severe because there are often several tears in the muscle fibers. Freedom of movement is severely limited and you often have to rely on help. Any sporting activity is strictly prohibited. In principle, the course and recovery should be monitored by a doctor.

Who does it occur to?

The majority of those affected are men. Women are less likely to suffer from a groin strain than men. A woman can also sustain a groin injury during childbirth. The muscles must be able to withstand extremely strong pressure during childbirth, which can lead to complaints. The susceptibility to a groin injury is also related to your physical condition. As you get older, the risk of injuries increases. People over the age of 45 are particularly affected by this.

Complications and consequences

If a groin strain has not yet completely healed and the muscle parts are strained too early, this can have unpleasant consequences for you. The groin injury can therefore take on chronic forms, sometimes with long-term or permanent tissue damage and limitations to the musculoskeletal system.

Treatment of a groin strain

Once you have a groin injury, the first 24 hours are extremely important. During this period, worse can be prevented with the right treatment. Rest the injured leg and elevate it. The most important thing is cooling the injured body part. With damp cloths or a so-called cold pack you can minimize the extent of swelling and bruising, which is only beneficial for the further course of the treatment. Cool the painful area immediately with ice or a cold pack for ten to fifteen minutes and repeat this several times a day. Do not place the ice directly on the bare skin, but place a towel between it. Compression bandages are also often recommended for groin strains. This can counteract increasing swelling of the thigh and prevent symptoms from worsening.
Depending on the severity of the injury and your medical history and physical condition, the doctor will recommend further therapeutic measures. Sports are strictly prohibited for the first 10 to 20 days in the event of a groin injury of level 2 and 3. Physical strain on the affected leg area is also strongly discouraged in that case. Crutches may be recommended to avoid straining the muscles when walking. The affected groin area needs a lot of rest in the first few days so that it can heal again. Physiotherapy treatment can then help with recovery. This sometimes includes very simple stretching exercises to slowly retrain the muscle area. Electrotherapy (e.g. ultrasound) or dry needling therapy may also be useful.
If the treating doctor allows it and you feel comfortable again, you can resume exercising carefully after just a few weeks. It is absolutely important to listen to your own body signals. Sports practice should be stopped immediately at the first sign of pain. Otherwise, there is a risk of a recurring injury, which would lead to further complaints and a longer recovery.
Surgery is rarely necessary for a groin strain, but surgical intervention may be necessary for a completely torn groin muscle. During surgery, the associated muscle fibers can be sewn back together and blood removed. This speeds up the healing process. Physical therapy can restore mobility and strength after surgery

Prevention of a groin injury

Groin injuries such as a groin strain mainly occur during sporting activities or as a result of unintentional movements (for example a fall). Athletes must therefore always warm up sufficiently before exercising. The warm-up exercises should always concern the muscle groups that will be used intensively afterwards.
At the first signs of unusual pain, training should be reduced or even stopped altogether. Particularly sensitive areas can even be fixed in advance with a bandage or tape. This gives the body part in question more support. A bandage is of course no guarantee against injuries, but it can stabilize and strengthen sensitive muscle groups.


Mild tension in the groin can be completely healed after 2 to 4 weeks with proper treatment. Second and third degree groin injuries, on the other hand, are much worse and require a longer recovery period. After a long break from sports and undergoing physiotherapy, your mobility and strength will gradually recover and you will be able to return to your normal activities at some point. Extreme or even constant strain on the muscle group should be avoided at all costs. Up to 6 months after the injury, the risk of a recurring injury is extremely high. If surgery is required on the groin, you should expect a recovery period of 3 months before physical exercise can be considered. Physiotherapy is important for recovery.

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