Get to know your groin!
The groin consists of six muscles. They are:
- Adductor Magnus
- Adductor Longus
- Adductor Brevis
- Pectineous
- Gracilis
- Obturator Externus – weak adductor1, 2.
All these muscles bring the thigh towards the midline of the body.
How can your groin get injured?
The majority of groin injuries occur through activities like football, ice hockey, and running short and long distances.
This is because these sports require a lot from the muscles on the inside of your thigh, known as the adductor compartment. The problem often lies between the ratios of the muscles from the outside of your thigh, known as the abductor muscle compartment, to the muscles on the inside of your thigh, known as the adductor compartment1.
In addition, another factor is the gluteal muscle. Issues with the gluteal muscles can have a detrimental effect on the adductor compartment, making it more susceptible to injury.
What else could be irritating the groin?
There are many factors that can irritate this area. Here are a few possibilities:
- Possible prolapse of the upper lumbar spine disc around L1–3.
- The ilioinguinal nerve and its cutaneousbranches (branches closet to the surface of the skin), and the genital branch of the genitofemoral nerve could be involved in chronic injuries. The genital branch of the genitofemoral nerve supplies the genitalia. The reason why the genital branch could be affected in chronic injuries is because the muscles on the inside thigh attach to the bone called the pubis. At this point, there is another muscle that only men have, called the cremaster muscle, which originates at the pubis and this muscle is supplied by the genital branch. So any long-term injuries to the groin can affect this nerve.
- Joint issue in the sacroiliac joint (consider my previous article on the twisted pelvis). This could affect the groin due to a pull on one side, either the left or right, leading to localised pain. You could get counter-balance with other muscles around the pelvis because of the twist, leading to low back pain.
- Inflammation of the hip joint capsule, known as capsulitis.
- Referral from the abdomen e.g. fibroids, ovarian cysts etc.
- Athletica pubalgia, also known as the sportsman’s hernia – occurs due to a weakening of the rectus abdominal muscles, better known as your ‘abs’ or the ‘six-pack muscles’. This affects the lower part of the muscle near the inguinal canal and can lead to inguinal hernias.
- Hernia – there are two major hernias in this region and they are known as:
* Inguinal hernia – weakness in the abdominal wall from deep inside the body tissue (known as the peritoneum) , which affects males more than females
* Femoral hernia – occurs more in the thigh and occurs in females more than males.
How do we treat this?
You will first be examined by a professional at Perfect Balance Clinic, either an Osteopath or a Physiotherapist, who will take a detailed case history, followed by an appropriate examination and discussion of an appropriate treatment modality.
Often, MRI can be used as confirmation3 in extreme cases, however, the majority of the time, groin strains are fairly simple to treat and, once identified, the correct treatment modality can be advised by your health professional.
Treatment
Treatment may consist of:
- soft tissue technique – this technique will decrease excessive tone that builds up due to overworking a muscle and it brings back the nutrients to each individual cell in the muscle fibres. The toxins that may have built up will be decreased by promoting nutrients to the local groin region
- articulation of a joint
- Kinesiology taping
- Pilates
- Joe’s rehab, which looks at:
* muscle sequencing
* mis-firing of certain muscles
* overworking of certain muscles (gluteal muscles)
* core stability.
- additional therapy at home with the use of hot or cold packs
- specific tailor-made exercises for each client.
References
- Tyler, F.T., Silvers, H.J., Gerhardt, B.M. et al. (2010). Groin Injuries in Sports Medicine. Sports Health, pp.1–6.
- Platzer, W. (2009). Colour Atlas of Human Anatomy Locomotor System. 6th ed. New York: Thieme Journals, pp.96–100, pp.238–240.
- Ansede, G., English, B. (2011). Groin Pain: Clinical Assessment and the Role of MR Imaging. Thieme Journals, 15(1), pp.3–13.
- OnTennis, http://www.ontennis.com/content/inflammation-adductor-muscle [accessed on 9 May 2012].
Written by Himesh Mistry.
Osteopath Trump Street St Pauls, Osteopath Moorgate, Osteopath Harley Street Physio Harley Street, Physio St Pauls Trump Street
