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Groin Strain
(Pulled Groin; Adductor Strain)

Definition:
A groin strain is a partial tear of the small fibers of the adductor muscles. The adductors are a group of three muscles located on the inner side of the thigh. They start in the groin area and run down the inner thigh to the inner side of the knee.

Causes:
A groin strain can be caused by:
  • Stretching the adductor muscles beyond the amount of tension that they can withstand
  • Suddenly putting stress on the adductor muscles when they are not ready for the stress
  • Using the adductor muscles too much on a certain day
  • A direct blow to the adductor muscles
Risk Factors:
A risk factor is something that increases your chance of getting an injury. Risk factors for a groin strain include:
  • Participation in sports that require bursts of speed, such as:
    • Running
    • Hurdles
    • Long jump
    • Basketball
    • Soccer
    • Football
    • Rugby
  • Fatigue
  • Tight groin muscles
  • Overexertion
  • Cold weather
Symptoms:
Symptoms include:
  • Pain and tenderness in the groin area
  • Stiffness in the groin area
  • Weakness of the adductor muscles
  • Bruising in the groin area (if blood vessels are broken)
  • Popping or snapping sensation as the muscle tears (possibly)
Diagnosis:
The doctor will ask about your symptoms and medical history, your recent physical activity, and how the injury occurred. The doctor will also examine your thigh for:
  • Tenderness and/or bruising directly over the adductor muscles
  • Pain or weakness when contracting the adductor muscles, particularly against resistance

Muscle strains are graded according to their severity:

Grade 1
  • Stretching with some microtearing of muscle fibers.
  • Recovery can be complete in about 2 weeks.
Grade 2
  • Partial tearing of muscle fibers.
  • Recovery can take up to 1-2 months.
Grade 3
  • Complete tearing (rupture) of muscle fibers.
  • Recovery can take more than 3 months.

For severe groin strains, you may have an MRI scan to see the extent of the injury. Professional and collegiate athletes sometimes have MRI scans to help predict the length of recovery.

Treatment:
Treatment depends on the severity of the strain.

Treatment usually includes:

Rest–Do not do activities that cause pain, such as running, jumping, and weightlifting using the leg muscles. If normal walking hurts, shorten your stride. Do not play sports until the pain is gone.

Cold–Apply ice or a cold pack to the groin area for 15 to 20 minutes, 4 times a day, for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.

Pain Relief Medications–Take aspirin, ibuprofen (Advil, Motrin), or acetaminophen (Tylenol) to help relieve pain. Ask your doctor if you have any questions about using these medications. If you still have tenderness in the groin while taking these drugs, do not return to physical activity. First, check with your doctor before returning to activity.

Compression–Wear an elastic compression bandage (e.g., Ace bandage) around your upper thigh to prevent additional swelling. Be careful not to wrap the bandage too tight.

Elevation–Keep your leg higher than your heart as much as possible for the first 24 hours to minimize swelling.

Heat–Use heat only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.

Stretching–When the acute pain is gone, start gentle stretching as recommended by a health care professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times. Stretch several times each day.

Strengthening–Begin strengthening exercises for your adductor muscles as recommended by a health care professional.

Prevention:
To reduce the chance that you will strain your groin:
  • Keep your adductor muscles strong so they can absorb the energy of sudden physical stress.
  • After a short warm-up period, stretch your adductor muscles.
  • Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, including your adductor muscles.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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