Groin strain or sports hernia?June 6, 2019
Doesn’t it feel great to get out there and play? Whether it’s basketball, football, hockey, soccer, or whatever sport you enjoy, it feels good to move like you used to. Then one day, while you’re playing, you feel this sharp pain shoot into your groin or down your leg. What is going on? It is a good possibility that you are experiencing a muscle strain. Groin strains most commonly occur in the muscles on the inside the leg, but the strain can also occur in the front of the hip or at the bottom of your abdomen. Another condition that might feel like a groin strain but is something very different is a sports hernia. So how do you tell the difference between a groin strain and a sports hernia?
A groin strain will usually happen when performing a high-speed movement involving the legs. There will be a specific moment in which the strain will be felt. The pain will be sharp and is usually felt in the groin, in front of the hip, or back of the hip. Strains occur when the tension is too much for the muscle to handle. The strain is the result of some tearing of the muscle and can be more or less severe. Recovery time is very much dependent on the severity of the strain. The most common muscle group involved in groin strains are the adductor muscles. This muscle group is made up of multiple muscles on the inside of your leg. They help move your leg in and out. They also help maintain your balance when you stand on one leg. Other less common groin strains affect your hip or abdominal muscles. Signs and symptoms can be different with each individual, but are commonly:
- Groin pain
- Pain with leg movements
- Pain when going from lying on your back to sitting up
- Pain when going from sitting to standing
- Pain when standing on one leg
- Pain with getting in and out of a vehicle
If you have a groin strain or any other strain, it is good to put ice on the area. This injury, if not adequately treated, has a tendency for re-injury. To ensure your best recovery, you should make an appointment with your doctor of physical therapy. They will evaluate your injury, accelerate your recovery, and ensure the safest, best recovery.
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A sports hernia injury happens with similar movements to that of a groin strain. It generally occurs during high-speed activities that involve twisting or rotating the body, like fast changes in direction. Soccer, basketball, and football are all examples of sports that involve these motions. Hockey players have a higher incidence of this injury due to their forward lean while skating. The injury occurs at the base of the abdominal muscles. In this area, the muscles have formed down to a thin sheath, and if weakness is present, an excessive force can result in a tearing of the tissue. Contrary to its name, a sports hernia occurs without a herniation or bulge in the area.
The signs and symptoms of a sports hernia include:
- Pain in the lower abdomen
- Groin pain
- Pain with coughing, sneezing, laughing
- Chronic groin pain that is only felt during exertion
A sports hernia has a similar mechanism of injury and presentation to a groin strain. It can often be difficult to distinguish between the two. If you suspect you might have either of these injuries, it is important to see your doctor of physical therapy. They will perform a physical examination to help determine what your injury truly is.
Treating and Avoiding Strained Groins And Sports Hernias
If you have reason to believe you have a strained groin or sports hernia, it’s a good idea to take preventive measures to avoid worsening the problem. The following methods can help ease your pain and help you avoid future injuries:
- Utilize the RICE treatment: This acronym stands for Rest, Ice, Compression, and Elevation. This method helps reduce inflammation, swelling, and pain.
- Cease movements that cause you pain until you are fully healed: The secret to a short recovery time is limiting aggravating your injury.
- Gently stretch the area: A qualified physical therapist can give you ideas for properly performing stretches that can strengthen your groin as you recover.
- See a specialist for additional guidance: A physical therapist will be able to provide further information, identify your issues, and set you on the right path to recovery.
- Incorporate warm-up exercises before strenuous physical activity: Like stretches, warm-up exercises can help strengthen your muscles and prevent recurring injuries.
- Practice increasing your range of motion and correcting your posture: Sports hernias and groin strains can result from poor form during physical activity. If you can correct your posture, you may be able to reduce the likelihood of reinjuring yourself.
How Can Physical Therapy Help?
When you arrive at physical therapy, the therapist will perform a comprehensive evaluation to determine your diagnosis. They will use the information they gather through strength, range of motion, and balance testing to find areas of limitations. They will also palpate the injured areas. Palpation simply means the therapist uses their hands to feel the immediate and surrounding areas to give them further information about your injury. If your doctor of physical therapy does, in fact, determine that your injury is a groin strain, they will develop a plan of care that is specific to you and your needs.
Early on, physical therapy will focus on reducing pain and promoting healing of the damaged area. They will utilize moist heat to relax the tense tissues. They will perform therapeutic massage to promote proper re-growth of the muscle. Then you can use either ice at therapy or at home to reduce the localized inflammation. While attending physical therapy, your therapist will monitor your progress and, when appropriate, will guide your gradual re-strengthening. They are experienced in determining the proper level of activity to promote healing without further damage.
As therapy progresses, you will begin to receive specific exercises based on your desired activity. The goal will be that once you complete therapy, you will be able to return to your desired sport. You will also receive instructions on how to maintain your tissue strength so you can best prevent a re-injury.
Examples of Physical Therapy Exercises for a Hernia
Though it is always a good idea to follow the advice of a physical therapist who knows your case well, there are a few common physical therapy exercises used to treat sports hernias and groin muscle strains. Some examples of physical therapy exercises for a sports hernia or pulled groin muscle may include:
Side Bend Stretch
The side bend stretch is meant to be gentle on the body during the early stages of your recovery. You can perform this exercise by standing straight with your arms at your side; keep your legs in line with your shoulders. Lift one of your arms above your head and bend the top portion of your body toward the opposite side of your lifted arm. Hold this position for 30 seconds. Do this exercise for both arms. Repeat four times.
Lunge stretches can be especially painful if you’ve recently suffered a sports hernia or groin muscle strain, so it’s essential that you perform this exercise under the supervision of your physical therapist. First, you’ll kneel down on one of your knees. With your opposite leg, form a 90-degree angle and reach between your legs for the floor with your hands. You will feel a slight stretch as you extend your hips towards the floor. Hold this stretch for 15 seconds or longer. Alternate legs and perform this stretch four times per side.
Hip Extension Exercise
Another stretch that tends to be beneficial for treating a sports hernia or groin strain is the hip extension exercise. Many physical therapists will recommend this stretch during the first couple of weeks following your groin injury. This stretch requires you to lay face down on the floor and lift one leg at a time six to eight inches off the floor. Keep your leg as straight as possible and try to hold the position for 30 seconds. Repeat four times for each leg.
Sitting Groin Stretch
The sitting groin stretch can help reduce your pain following a sports hernia or pulled grain. Start by sitting down on the floor. Pull your heels toward your body and grab the soles of your feet with both of your hands. Bring your feet together and bend your upper body toward the ground until you feel a slight stretch. Hold this position for 15 seconds. You can repeat this exercise up to 4 times in a session.
If it is determined you have a sports hernia, your physical rehab will have similar goals to that of a groin strain but will have a different approach. Initially, the therapist will try and relieve pain and promote proper healing to the injured area. To accomplish this, they may utilize modalities as well as tissue massage. As they determine that your tissue is healing, they will begin to reintroduce physical activities. They will start with low load exercises to safely strengthen the abdominal muscles and tissues. As your tissues continue to heal, they will increase the tension applied to the tissues progressively. Therapy will also target strengthening of the hip muscles. They, along with the core muscles, provide stability to the pelvis and connecting bones. When your tissue strength returns and your injury is healed, they will reintroduce dynamic, multi-movement exercises that will improve the tissue strength to tolerate the demands placed upon them during sporting events. This is all designed to get you back to what you love doing.
For more information regarding our services, including physical therapy for sports injuries, reach out to our team today!