Groin Muscle Strain / Groin Pull

A pulled groin (also termed as "groin strain") is used to describe damage to the muscles on the inside of the upper thigh - near the pubic area. A groin strain/tear can be extremely painful and are nearly always sports related. There are six muscles in the thigh - all of them working together to give you full movement of your leg and hip. One or more of these muscles may be strained or partially torn - if this is the case then you are experiencing a groin strain/tear. When we talk about a pulled groin or some other soft tissue injury to the groin, we are really dealing with a muscle, ligament and/or tendon injury of the hip.

Athletic pubalgia involves severe musculotendinous injuries (relate to muscles and tendons) that result in chronic groin pain and a dilated superficial inguinal ring. Generally a tear in one of your lower abdominal muscles (oblique muscles, rectus abdominus muscle) near the back wall of your inguinal canal (narrow passage through your abdominal wall in the lower region on either side of your pubic area), or in your connective tissues (conjoined tendon, inguinal ligament, transversalis fascia, or aponeurosis) where your muscles meet the bones and other tissues of your pelvis and/or pubic bone will be present. Athletic pubalgia results in a "hidden" hernia that has no visible bumps or lumps but causes pain in your lower abdomen and groin (especially when twisting or turning while running at a high speed). Often you will experience a torn adductor muscle along with this injury. More information about athletic pubalgia here.

Note: An inguinal hernia involves a tear in a body tissue (normally a muscle) that shows a visible bulge or bump in your lower abdomen. Athletic pubalgia has no obvious hernia (bump or bulge).

As you may expect, the hip is quite a complicated joint. The pelvis sustains most of your body weight while also providing 2 joint sockets, enabling your upper legs to attach to the pelvis. Achieving such a substantial range of motion of the torso, back and upper legs require a significant number of muscles; further to this - all nerves and blood flow needed for your lower body flow through the hip. Due to this, the hip has a total of 17 muscles, 5 bones, numerous tendons, ligaments and bursae used to connect your leg bone (femur), pelvis and spine together.

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View more information about relevant muscles for groin pain - the hip adductor muscles, hip flexor muscles, quadriceps & hamstring.

View information about conservative treatment options for a groin pull.

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Common Symptoms of Groin Strain

A sharp pain may be felt in your groin and inner thigh area if you are suffering from a groin / hip pull or strain. You will feel tightness, tenderness and/or muscle spasms when you try to move your groin muscles. Movements you previously took for granted throughout your day become painful and even impossible, such as getting into a car seat. Attempts to try and move your legs or extend / rotate your hip or leg inward can immediately trigger a lot of pain.

You may feel tenderness in the inside of your thigh, especially when you touch/prod the area. Pain may also radiate further down your inner thigh. If you have a chronic injury, you may feel more of a dull ache that lasts for long periods of time. This pain can happen in one area or multiple areas at one time.

You will likely experience stiffness and a decreased range of motion (ROM) in the area as a result of a pulled groin - this will make it difficult to bend and rotate your hip and knee. To test your stiffness and ROM, sit on the floor and put the soles of your feet together. If you have tightness, pain and/or tenderness while doing this, you are likely suffering from a damage to one or more of your hip flexor muscles. You may also feel tightness in your lower abdominal, spine, hip and thigh region. You may also feel pain if you lay down on your back and raise your heels just a slight 15 degrees off the ground.

• Swelling in your groin / hip muscle is a result of muscles and/or tendons becoming inflamed. This normally occurs with a more serious groin pull. Warmth and redness may accompany swelling in severe cases.
• Weakness of the groin muscles may also be experienced as a result of a groin pull. This will make it difficult for you to walk or run and can result in you walking with a limp.
• Occasionally, bruising (broken blood vessels) may appear a few days after your injury in one area of the groin - or or the bruise can span from your groin down to your knees
• A popping or snapping sensation in your hip can often be heard when your hip flexor or hip adductor muscles are tearing.

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How Long for a Groin Strain to Heal?

This is a popular question, but the short answer is that it depends on the grade of strain as well as the age of the person, the type of treatment they receive and their overall health. When considering all factors, a the healing time for a groin strain can range between a couple of days and four to five months. See directly below for a detailed analysis on deltoid strain grades and the accompanying general healing time estimates.

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Three Grades of Groin Strain Severity

This can be classified into 3 grades of groin pull or strain severity:

Minor - Grade 1 Groin Pull

A grade 1 groin pull means you have slightly pulled muscles or very small tears in these muscles. You will generally feel mild cramping which will be a little tender or uncomfortable, but will involve little swelling or loss of strength. If you are resting and careful with activity, a grade 1 groin pull should clear up within a couple of days to a week or so.

Moderate - Grade 2 Groin Pull

Grade 2 pulls are more severe and painful than a grade 1 pull. This will involve a partial tearing of the groin fibers in your muscle, tendon, or where the tendon attaches to bone. You will generally experience pain, along with swelling, decreased range of motion and strength, as well as difficulty walking or running. With a Grade 2 groin strain, your groin muscles will often be painful to the touch. Recovery from a Grade 2 groin strain should occur within about 4 to 6 weeks as long as you are resting and careful not to overdo it.

Severe - Grade 3 Groin Pull

Severe groin pulls involve a complete tear (rupture) of groin muscle fibers - usually where the muscle meets tendon or where the tendon attaches to bone. A grade 3 Strain/Pull is very painful and less frequent than the others. You will tend to experience a burning or stabbing pain, a lot of swelling and significant loss of strength. This may prevent you from walking without assistance and likely make it impossible for you to run. Bruising in the injured area is common a few days after the accident. This type of pull or strain will likely require a surgical repair as there is complete detachment. Post surgical recovery generally takes 6 weeks to 3 or 4 months; the recovery time will depend on many factors, some of them being age, overall health, and the level of adherence to post-surgery conservative treatments prescribed by your surgeon/physician. [ie. physiotherapy, prescribed range of motion stretches, cold compression (for inflammation), etc.]

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If you are experiencing a grade 2 or higher groin strain, you may be interested in reading through our conservative treatments for groin strain page.

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Causes of a Strained Groin

Hip and groin pulls are among the most common of any injuries that occur in the hip and groin. When it comes to sports related injuries:

• People that participate in active sports such as hockey, basketball, soccer, football, rugby, tennis, track & field activities (running, hurdles, long jump) - activities that involve a lot of jumping, kicking, and changing direction at various speeds while running are more susceptible to hip strain.
• Groin strain is obviously more common in sport that places extra pressure on muscles in the groin. Such sports include skiing, skating, karate, weight lifting, gymnastics, ballet dancing and horse-back riding.

Those that participate in sports yet embody poor motion mechanics are more susceptible to muscle and tendon strain as a whole. Poor mechanics in running sports specifically would make a person more vulnerable to hip, leg, lower back, groin, knee, ankle and foot related strain/sprain injuries. Unless the mechanics are corrected, the injuries will most likely persist and become chronic (long term); eventually, the injury may affect gait (the way you walk) permanently.

Outside of sports,

• a hip flexor injury can be caused from a sudden fall or direct hit to the muscle itself.

• any activity that involves twisting or lifting heavy objects while bending can cause hip strain or a groin pull.
• any activity that involves running on a slippery or unstable surface (like grass) can cause hip strain or a groin pull.
• many groin strains occur when one is trying to pull their leg inwards (toward the torso) but something pushes the leg outward (away from the torso), such as kicking against resistance or jumping.
• overstretching, overloading and overuse of your hip flexor and groin muscles can cause hip and groin pulls.

• weakness or a strength imbalance in the hip and groin muscles can cause hip and groin pulls. If your muscles are tight or inflexible, this will make your situation worse.
• a strength imbalance in the lower back and torso can cause groin pulls. If your muscles are tight or inflexible, this will make your situation worse.
• alignment issues with your pelvis can cause hip and/or groin strain.
• overpronation, supination and/or leg length discrepancies can cause hip and/or groin strain.
• lack of exercise and changes in the intensity of your activity without proper preparation (common with weekend warriors), age-related weaknesses and/or degeneration, previous hip muscle injuries, and obesity will also influence your risk of experiencing groin pull.

Overstretching, Overloading & Overuse

This occurs often for "weekend warriors" or sometimes in athletes - especially when training competitively for the high risk sports (listed above), and/or in swimming when using a "swimming breaststroke" (whip kick) on a regular basis. The chances for injury are increased when the person has not warmed-up and/or stretched properfly beforehand. Without proper stretching and warm-up, muscles just aren't ready for the added stress. You are at further risk of a strain or pull if you are performing these activities in cold temperature or if are tired.

Should you seek medical attention?

This is up to your discretion; however any continued discomfort in your thigh area should be investigated. If you continue to experience the thigh muscle related injury symptoms and have tried the suggested conservative treatments for 2 -3 weeks, it is recommended that you seek professional medical attention. It is recommended you seek immediate attention if you:

• hear a "loud pop" in your muscle when injured
• have immediate severe pain, swelling or discoloration in your quadriceps
• experience severe weakness in your hip/groin area and have difficulty walking
• have a temperature over 100.4 degrees F (38 degrees C)
• notice blue toe nails, numbness or coldness below your injury

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Preventing Groin Strains

It is always better to prevent injuries rather than try to fix them after they happen, however that is not always the situation. A thigh muscle strain can be difficult to prevent as your major symptoms may start long after you've had the condition. In any case, there are a number of things you can do to keep yourself healthy and prevent further damage.

Maintain a strong and proper posture, and wear proper footwear and gear for your activity. This will ensure your body is properly aligned, and will prevent against slouching or bad form which will make you more prone to injury. Your equipment should be comfortable and provide enough padding (knee or thigh pads), and your shoes should provide sufficient sole stiffness and arch support.

Avoid doing too much to soon to give your body an opportunity to build up its endurance. This is especially important when participating in a new activity. Gradually increase your participation to prevent overstraining your muscles.

Always warm up your muscles (especially your leg muscles) before working them to prepare your body and to raise your body temperature (15-20 minutes is the recommended time). Recovery from your activity can be enhanced by doing a cool down to lower your body temperature and relax your muscles.

To stabilize your thigh muscles, and increase your range of motion, maintain and build your strength, stability and flexibility of your quadriceps as well as your hamstrings, IT band, lower leg, gluteal, pelvis, low back and core body muscles. Light weights, exercise bands and balls are very beneficial for strengthening your lower body. Core balance training and exercises to develop strength, speed and agility, such as jumping or bounding movements (plyometrics). Yoga, tai chi, or a daily stretching routine will help to keep your muscles and joints supple - avoid sudden twisting and turning motions.

A regular exercise program that focuses on total body fitness and includes low-impact aerobic activity at least 3 days per week, such as walking, swimming or biking will help to keep you healthy overall and will strengthen your body to prevent against further quadriceps injuries.

Proper food and fluid intake prior to and/or during activities will ensure you have enough energy and will help to prevent against fatigue. Ensure you avoid dehydration which can lead to muscle cramping. Weight loss and/or weight maintenance involves eating a balanced diet full of protein, complex carbohydrates, fats, vitamins, minerals, phytochemicals and antioxidants which will help support a healthy system. If you gain just 10 pounds, your joints must bear from 25 up to 100 pounds extra, which can add unnecessary stress to your body. Limiting your caffeine, alcohol and nicotine consumption will also improve your health.

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