|SSM Cardinal Glennon Children's Medical Center|
It was late in the third period of Wayne's fourth hockey game in 5 days, and he was exhausted, but he wasn't going to let it show. He was still going all out and sprinting after every loose puck. But on one play, he was skating fast and tried to make a sudden change in direction when he felt a sharp pain in his right groin and could barely make it off the ice.
The next day Wayne's groin felt tight and painful, and there appeared to be some swelling in the area, so he went to see a doctor. The doctor asked some questions, examined him, and told Wayne he had a grade 2 groin strain.
What Is a Groin Strain?
A groin strain — also known as a groin pull — is a partial or complete tear of one or more of the muscles that help you squeeze your legs together.
There are five of these muscles, called the adductor muscles: The pectineus, adductor brevis,and adductor longus (the short adductors) run from your pelvis to your thighbone. The gracilis and adductor magnus (long adductors) run from your pelvis to your knee.
Groin strains are a common injury in hockey and skiing, as well as sports like football and track and field that require running or jumping. They can range from grade 1, which is a mild injury with few symptoms and a short recovery time, to grade 3, which is a complete or nearly complete tear of a groin muscle.
What Are the Symptoms of a Groin Strain?
The symptoms of a groin strain vary somewhat depending on the grade of the strain. All groin strains will cause pain and tenderness in the affected area, and many will hurt when you bring your legs together or raise your knee. If a strain is severe, you may feel a popping or snapping sensation during the injury and severe pain afterward.
Here's what you'll likely notice for different grades of groin sprain:
How Is a Groin Strain Diagnosed?
If you see a doctor for a strained groin, he or she will ask about your symptoms and what you were doing when the injury happened. The doctor will examine the affected area to check for swelling, bruising, and tenderness — and to rule out another condition with similar symptoms, such as a sports hernia. In rare instances, the doctor may send you for an MRI scan to determine the extent of the tear.
The doctor will grade your strain. Grade 1 means that less than 10% of the muscle fibers are torn. Grade 2 strains are those where 10% to 90% of the fibers are torn. (Because of the big range in grade 2 strains, a doctor might grade strains on a scale from 2- to 2+.) Grade 3 means that the muscle is either completely or almost completely torn or ruptured.
What Causes a Groin Strain?
Groin strains usually happen when the adductor muscles get stretched too far and begin to tear. Strains also can occur when the adductor muscles suddenly have stress put on them when they aren't ready for it (as when someone doesn't go through a proper warm-up before playing) or when there's a direct blow to one of the muscles.
Some of the risk factors that can make a groin pull more likely include:
How Can You Prevent a Groin Strain?
The main thing you can do to help prevent a strained groin is to warm up and stretch before any exercise or intense physical activity. Jog in place for a minute or two, or do some jumping jacks to get your muscles warmed up. Then do some (ask a coach, athletic trainer, or sports medicine specialist to show you how to do this type of stretching).
Some other things you can do to try and prevent groin strains include:
How Should You Treat a Groin Strain?
Most groin strains will heal on their own in time. The key is patience because it can take a while to fully recover. Even if you feel better, a groin strain may not be fully healed, and you risk starting over with the injury if you get back in the game too soon.
Mild to moderate strains will need around 4 to 8 weeks of proper rehabilitation. More severe strains will take longer to heal. Only the most severe muscle tears require surgery. To treat a groin strain, take these steps and be sure to follow your doctor's advice:
In the event of a complete muscle tear, or if the treatments above don't help after a few months, a doctor may call for surgery as a last resort. In this case, a surgeon will either attempt to reattach a torn tendon to a bone or stitch torn muscle tissue back together. Some people are able to return to previous levels of activity after surgery. A doctor will only choose this option as a last resort — and fortunately it's rarely needed.
Most groin strains heal on their own as long as the athlete follows a doctor's or physical therapist's instructions about rest and rehabilitation. The key is patience.
It can be frustrating to wait the full time needed to get back in the game, but this is one kind of injury you don't want to mess with. Get your doctor's signoff for any kind of exercise.
The good news is that once you're fully healed, you should be able to play as you used to.
Reviewed by: Kathleen B. O'Brien, MD