Diagnosis and Treatment of Groin Pain in Athletes

Diagnosis and Treatment of Groin Pain in Athletes Blog

Groin pain resulting from athletic injury is fairly common in sports like soccer, hockey, and football that involve rapid twisting, pivoting and directional change, particularly in male athletes. For athletes, chronic groin pain can mean time away from training and competition, and in some cases it may result in a career-ending injury.

The hip, groin and pelvic areas involve a complex network of structures including muscles, tendons, ligaments and nerves that converge to translate movement between upper and lower body actions. During high-velocity sports that involve rapid directional changes, forces of high magnitude must be mediated by the structures of the hip, groin and pelvis.

Causes of Groin Pain

Groin pain can result from a range of injuries to various structures, and there may be considerable overlap of signs and symptoms, posing a challenge for diagnosis and management. Groin injury can be acute (secondary to a single event), or can evolve over time from chronic repetitive trauma or altered biomechanical load during sports.

Common acute groin injuries include:

  • Muscle Injuries: Contusions; tears and strains; avulsion and apophyseal injuries
  • Bony Injuries: Hip dislocation and subluxation; hip fractures
  • Joint Injuries: Cartilage; labrum; femoral acetabular impingement; developmental dysplasia of the hip

Chronic overuse groin injuries include:

  • Groin pain: Athletic pubalgia; common adductor/rectus abdominis injury; osteitis pubis; hernias; snapping hip syndrome; greater trochanter pain syndrome; bursitis

Limited range of motion in the groin area may contribute to soft tissue damage. Athletes whose adductor (inner thigh) muscles are considerably weaker than their abductor (outer thigh) muscles may be at greater risk for groin pain.

Diagnosis and Treatment of Groin Pain

Because pain may arise from injury to any of the structures in the groin and pelvis, accurate diagnosis is critical, and treatment should take into account the specific nature of injury. Imaging like ultrasonography or MRI, along with findings from the clinical exam, can help clinicians more accurately diagnose and manage groin pain so that patients are ultimately able to return to athletic activity.

In most cases, the body’s soft tissues can heal themselves over time, and when coupled with corrective exercises, full function can often be restored. If injury was associated with inadequate range of motion or imbalanced muscle tension, physical therapy can correct those issues to reduce the risk of future injury. Because groin pain is so common in athletes, a great deal of research has been devoted to treatment of the condition.

In one study, 68 athletes with chronic adductor-related groin pain were randomly assigned to one of two groups. The control group was given passive physical therapy for 8 to 12 weeks, while the experimental group participated in physical therapy and an active training program for the same amount of time. The active program included physical therapy and exercises that focused on strength and coordination of core muscles, with emphasis on the adductor muscles in particular. Four months after treatment, 68% of patients in the active training group had returned to sports without groin pain, compared to only 12% in the passive group. An eight to 12 year follow-up revealed that 50% of the active treatment athletes rated their outcomes as excellent, compared with only 22% of the passive treatment group.

Groin Pain Treatment in NYC

If you are an athlete suffering from ongoing groin pain, do not ignore it. Let the groin pain specialists at NYDNRehab help you get to the source of your pain and treat it, to rehabilitate your injury and prevent future injuries. At NYDNRehab, we combine advanced treatment methods with cutting edge technologies to give you the very best treatment available in NYC.


Holmich P, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 1999; 353(9151):439-443.


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