Groin pain is common in kicking and change of direction sports, especially football. For some it may only be mild, but for others it can completely stop them from participating in sporting activities. There are several structures in the groin area that can contribute to pain, however a common umbrella term used is “Osteitis Pubis”. Identifying the specific structures contributing to groin pain is essential in ensuring a targeted rehabilitation program, and a long term solution.
After your physiotherapist has conducted a thorough assessment, groin pain can be differentiated into the following categories:
- Adductor related groin pain
- Involving the adductor muscles or tendons
- Pubic bone related groin pain
- involving the pubic symphysis joint at the front of the pelvis, or the pubic bones
- Hip related groin pain
- Involving the actual ball and socket joint of the hip, the hip joint capsule and surrounding ligaments
- Psoas (hip flexor) related groin pain
- Involving the hip flexor muscles and tendons such as psoas and iliacus
- Inguinal related groin pain
- Involving the structures in the inguinal canal. This is also known as a “sportsman’s hernia”
- Abdominal related groin pain
- Involving the rectus abdominis muscle (or “6 pack” muscle) which inserts into the pubic and groin region
Treatment will depend on the structures involved, but usually focuses on reducing pain, inflammation and/or tension in over-worked muscles, tendons and joints, and strengthening where required around the hip and groin, trunk and pelvis. Aside from strength, coordination of movement is also really important, as kicking and change of direction sports involve transfer of forces across our pelvis. If this is not done in a smooth and coordinated way, then certain structures may get overloaded.
In recent years, focus has also shifted to injury prevention in sport. There are several excellent evidence-based exercise programs that have been developed to help prevent groin pain. The most well-known program is the FIFA 11+, or in Australia, our own version is called the Perform+ program. The aim of these programs is to improve muscle strength, coordination and balance/control, and if completed regularly they have been shown to reduce the risk of groin and hamstring injuries suffered in kicking sports by up to 30%.
If your football team does not include a component of these injury prevention exercises in the warm-up, it might be a good opportunity next season to try something new.
See the exercises below to help bullet proof your adductors and keep those groin niggles away. Check out Perform+ or FIFA 11+ for the full evidence-based programs.