Groin injuries in athletes

What are groin injuries in athletes?

Groin injuries are injuries in the inner thigh or pelvic area. They most often affect muscles and connective tissues such as tendons and ligaments. Groin injuries can happen suddenly, due to an impact. They can also happen over time, due to repeated movements that cause strain.

Groin injuries in athletes can be minor, such as a muscle, tendon or ligament that stretches too far. Serious groin injuries include partial or complete tears in muscles, tendons or ligaments. Some groin injuries even cause broken bones. Our doctors are experts at diagnosing and treating all types of groin injuries.

What are the different types of groin injuries in athletes?

Some injuries that cause groin pain actually occur in the hip. The types of hip and groin injuries that commonly affect athletes include:

Hip apophysitis

One of the most common causes of hip and groin pain is hip apophysitis. An apophysis is a growth plate that muscles and tendons attach to. Growth plates are cartilage, which is softer tissue at the end of bones. An apophysis can become irritated and painful due to repeated movements of the muscle or tendon pulling on the cartilage.

Pelvic avulsion fracture

An avulsion fracture happens when a small piece of bone breaks away from the main part of the bone. A pelvic avulsion fracture occurs in the pelvis when part of a pelvic bone breaks away. This injury happens when a tendon pulls the bone away due to a forceful muscle contraction.

Groin pull (adductor strain)

A groin pull or strain is a tear or overstretching of the adductor muscles. These inner thigh muscles attach to tendons that connect the pelvis to the thighbone. The adductor muscles help pull the legs together.

Sports hernia (athletic pubalgia)

This injury is a strain or tear of soft tissue, such as a muscle, tendon or ligament, in the lower belly or groin. Sports hernias often occur where the belly muscles and adductors attach (with tendons) to the pubic bone.

Hip labral tear

A tear in the cartilage that lines the hip joint socket can cause pain in the hip that radiates to the groin area. A hip labral tear can result from overuse. It could also be due to a problem with the hip’s structure known as femoroacetabular (hip) impingement.

Stress fracture

A stress fracture is a small crack in a bone. This is a less common cause of groin pain. It happens because of frequent, repeated movements that put pressure on bones. In the groin area, stress fractures usually happen in a pubic bone. They can also happen to the top part of the thighbone, which fits into the hip joint.

Inguinal hernia

This injury happens when tissue inside the belly, such as part of an intestine, pushes through an opening in the muscle wall. An inguinal hernia causes a painful bulge in the lower belly. It can happen in weightlifting when athletes strain as they lift heavy weights. An inguinal hernia is different from a sports hernia, which is a soft tissue injury.

Osteitis pubis

This overuse injury happens because of repeated movements, such as sprinting and kicking. These actions involve the pelvis, hips, groin and pubic bones. Osteitis pubis may feel like a groin pull because it causes pain in the joint between the left and right pubic bones. But it’s a different type of injury.

What are the signs and symptoms of groin injuries in athletes?

Common signs and symptoms of a groin injury include:

• Pain in the groin or lower belly

• Pain in the pelvic area or genitals

• Pain or tenderness that gets worse with pressure or movement

• Pain that goes away with rest

• Swelling, redness or bruising at the injury site

• Muscle weakness in the legs

• Difficulty walking

• Fever, nausea or vomiting due to infections in joints or bones

Sometimes, pain and other symptoms in the groin area can come from an injury in a nearby area, such as the hip.

How are groin injuries in athletes diagnosed?

At the Children’s Health Andrews Institute for Orthopaedics & Sports Medicine, our specialists have extensive expertise in diagnosing groin injuries. We begin with a physical exam of your child and learn more about their symptoms. We also ask you and your child about the injury and how it happened. We’ll review your child’s medical history and any previous treatments.

We can usually diagnose a groin injury during our thorough evaluation. We may order advanced imaging tests to confirm a diagnosis or determine how severe the injury is. Your child may need one or more imaging tests, such as:

• Magnetic resonance imaging (MRI): This test uses radio waves and a powerful magnet to produce images of the inside of the body. It's especially helpful for viewing soft tissues. We often use MRI to look closer at soft tissue groin injuries and check for stress fractures.

• Ultrasound: This test uses sound waves to create images of the inside of the body. It’s helpful in diagnosing soft tissue injuries, such as a sports hernia or hip labral tear.

• X-rays: We may use this common imaging test to check for a pelvic avulsion fracture or stress fracture.

What causes groin injuries in athletes?

Groin injuries can result from a sudden impact, such as players colliding. They can also develop gradually during sports or other activities. Repeated movements cause stress on muscles, tendons, ligaments and bones in the hip and groin area.

Certain factors can increase the risk of a groin injury, including:

• Sudden starts and stops while running or jumping

• Fast changes in direction or motion such as kicking, pivoting or twisting

• Overuse and repeated movements that stress muscles, tendons, ligaments and bones

• Not enough warmup before sports practices or events

• Not enough rest and recovery time after a previous groin or hip injury

Some sports and activities that can lead to groin injuries include:

• Ice hockey

• Soccer

• Football and rugby

• Track and field sports, such as distance running, hurdles and high jump

• Gymnastics

• Basketball

• Dancing and figure skating

• Wrestling

How are groin injuries in athletes treated?

The right care helps your young athlete recover faster from a groin injury. Proper care also helps reduce the risk of future injury or more serious conditions. At Children’s Health, our pediatric orthopedic and sports medicine experts tailor a treatment plan for your child. We offer a full range of treatments and rehab services for athletes. Our goal is to help athletes return safely to their sports and other activities.

Treatments for groin injuries

The doctors and providers at Children’s Health specialize in groin injury treatments including:

• RICE protocol: Rest, ice, compression and elevation of the groin area

• Adequate time away from sports and other activities until symptoms improve

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and swelling

• Use of crutches to take the weight off the lower body while walking

• Orthopedic surgery for severe injuries such as pelvic avulsion fractures, hip labral tears or inguinal hernias

Sports medicine rehabilitation programs

The Children’s Health Andrews Institute brings together all the experts and services an athlete needs to return to play. We offer:

• Sports rehabilitation to build endurance, agility and other sports-specific skills

• Physical therapy to improve strength, flexibility and mobility

• Bridge training via the Sports Performance powered by EXOS program to help athletes get back to activities as they finish physical therapy

• Dance Sports Medicine Program to support the transition back to dance at the end of physical therapy