Groin Strain (Pull)

Groin strains are common in any sport that involves running and jumping. Hockey players are especially susceptible to groin injuries.

What is a Groin Strain (or Pull)?

A groin strain is a muscle injury caused by sudden or forceful movement in the front of the hip. It affects either the primary hip flexor muscles, the hip adductor muscles, or sometimes both.

"The adductor (groin) muscles are a group of muscles that primarily adduct the thigh, or bring the thigh closer to the midline (squeezing the legs together)," says Dr. Clifford Rios, an orthopedic surgeon at the Bone & Joint Institute and board-certified in sports medicine. "They are involved in lateral movements primarily, but also play a role in straight-line running. It's important to test agility and strength with cutting and other explosive lateral movements before returning to competition."

The Three Degrees of Groin Strains

Grade 1: A mild strain with overstretched or torn muscle fibers, affecting up to 5% of the muscle. Walking may not be painful, but running, jumping, stretching, and other intense movements will test the injury.

"I've seen athletes on the sideline say, 'I'm good,' even when they have a fracture," says Dr. Rios. "Athletes rarely disclose the full extent of an injury before the medical team has had a chance to evaluate them and create a treatment plan."

Grade 2: A moderate strain with more significant muscle fiber damage due to a tear. Walking may cause pain.

Grade 3: A severe strain with a near-complete or complete tear of the muscle or tendon. This injury causes immediate, severe pain, along with swelling and bruising. Running or jumping is impossible. In extreme cases, you may feel a gap where the muscle fibers have torn.

Symptoms of a Groin Strain

A groin strain can feel like a pop or snap when it happens. Later, you may also experience pain when:

  • Closing your legs
  • Raising your knee

Because other conditions, such as hip bursitis, hip strains, or stress fractures, can cause similar symptoms, it's important to get a proper diagnosis.

Recovery and Treatment

Recovery time depends on the severity of the strain:

  • Mild strain: About three weeks of rest
  • Moderate strain: Up to six weeks of rest
  • Severe strain (complete tear): Requires surgery and up to three months of recovery

Your doctor may also request an MRI to confirm the severity of the injury.

"An MRI can provide objective evidence about the extent of the injury but is not always necessary," says Dr. Rios. "If an athlete can stand and bear weight with little or no assistance, it's a good sign that the injury is mild. An athlete who cannot put weight on the injured leg may have a more severe injury."

The P.R.I.C.E. Treatment Approach

A standard recovery regimen includes:

Protection: Avoid further aggravation. A Grade 2 strain may require crutches.

Rest: Allow time for healing.

Ice: Reduces swelling and relieves pain. Apply ice for 10 to 15 minutes with skin protection, pause, then reapply. Professional athletes may use cold-therapy machines for consistent cooling and compression.

Compression: Supports the muscle and reduces swelling.

Elevation: Helps minimize swelling.

"Icing is important and part of the treatment," says Dr. Rios, "but mobility is also beneficial for muscle recovery. After an acute injury, the muscle will want to tighten up, and early motion can aid in the healing process."

Progressing Through Recovery

As swelling and pain decrease, ice is gradually replaced with heat therapy (moist or dry) to improve circulation and tissue flexibility. Once flexibility returns, stretching exercises can begin.

When full range of motion is restored, functional exercises such as lunges and wall squats help strengthen the hip. The final stage of recovery includes sport-specific exercises before returning to full activity.

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