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Ouch - Thats gotta hurt...
Ouch Thats Gotta Hurt
Julian Hall
The are a few tyoes of groin injury which we will begin to explore. Groin injury may have varied reasons and in most cases, have more than one reason. Chronic groin pain is attributed to adductor tendinopathy, osteitis pubis or inguinal hernia. It is very common that two or all these conditions coexist at the same time. There are of course many more reasons for groin pain. We will deal with the most common groin injury which is tears/strains of the adductor muscles.
Sports like football or basketball that involve steeping, kicking, twisting and turning strain the adductor muscles. In these kinds of sports, the groin is more susceptible to injury. Injury of groin muscle is normally caused due to excessive stretching and contraction of the adductor muscles. This condition of excessive stretching or contraction may cause the muscle to tear, which in turn may lead to other complications like inguinal hernia resulting in multiple pathological conditions that are a hallmark of groin injuries.
A person or athlete complaining of a groin injury would be in the know of how the injury was caused, while, running, kicking or turning, since a groin injury results in a sharp pain in the adductor attachment or a little below it. The result is functional difficulty. Many a time, the injury is preceded by an abdominal or groin pain or some days or weeks. The injuries that give such indicators are generally caused due to inherent weakness in the posterior abdominal wall or related physiological structure.
Assessment of Groin injuries: The simplest way to test the adductor muscles is to apply the Adductor Squeeze. The patient lies on a table with legs extended, and the examiner puts his clenched fists between the knees. The patient then applies pressure to the examiner's fists using his knees. The patient increases the pressure slowly until he can exert the maximum pressure. Pain points and functional inhibition is physically assessed using this test. The test can be repeated with legs raised to 45 degrees and again with legs raised 90 degrees. This can give an accurate picture of the kind and location of the groin injury.
The groin area is connected to lumbar spine, hip joint and sacroiliac joints by kinematic chains.
Adductor problems are best judged by the hip joint rotation. The direction of the rotation would be the best clue to judge adductor problems. Decrease in rotation signifies osteitis pubis or hernia. This may result in a compensatory stepping up of abduction resulting in exertion of excessive force on abductor muscles leading to injury. It has been observed that an adductor muscle strain is preceded by a restricted lumbar spine for a few days. This is attributed to the kinematic relationship. Controlling the movement of the pelvis and lumbar spine is essential for proper functioning of thigh muscles. This will result in reduction of stress on the spine and consequently the pressure on thigh muscles, easing the groin injury risk.
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