Diagnosis and Treatment of Groin Pain in Athletes


Groin pain is a common complaint in athletes, especially in sports like hockey, soccer and football that involve pivoting, twisting and rapid directional changes. Chronic groin pain can interfere with performance, and can take an athlete out of the game for extended periods of time. In some cases it may become a career-ending injury. Treating groin pain early on is key to healing and preventing further injury.

Hip and Groin Anatomy

The hip and pelvic region is made up of a complex network of muscles, tendons, ligaments, bones and nerves that interact to groin pain.

Causes of Groin Pain

Groin pain often results from a repetitive overuse injury that gradually worsens over time. Acute injuries arising from a single incident can also manifest as groin pain. Subcategories of injuries that may cause groin pain include:

  • Muscle contusions, ruptures or strains
  • Hip dislocation, ligament subluxation or hip fractures
  • Joint injuries including cartilage, labrum, and femoral acetabular impingement (FAI)
  • Sports hernia
  • Adductor injuries
  • Snapping hip syndrome
  • Bursitis

Poor flexibility in the inner thigh and groin area can increase the risk of groin pain and injury. Adductor muscles also increases groin injury risk.

Diagnosis of Groin Pain

Because of the complexity of the hip and pelvic region, accurate diagnosis is fundamental to accurately assess the nature and severity of an injury, and pinpoint the source of pain.

Groin Pain Treatment

Our treatment goals are to play. Treatment may involve some or all of the following:

  • Core stability training
  • Gait analysis and retraining
  • DNS (dynamic neuromuscular stabilization)
  • Physical therapy
  • Red cord therapy

In the best case scenario, the athlete will be able to play with improved performance and reduced risk of future injury.

Groin Pain Treatment in NYC

If you are suffering from sports-related groin pain, do not ignore it or try today, and see why we are the best athletic rehab clinic in NYC.



In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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