Groin Strain

When an excessive load is applied to one of the adductor or medial rotator muscles in the groin area while it is contracting, or if these muscles over stretch as they lengthen the muscle may tear. As the adductor muscle pulls your leg in, or stabilises the hip while you weightbear on it, and the Medial rotator muscle turns the leg in or stabilises it while you pivot on it, injury to the muscle is most likely to occur while the leg is planted on the ground.

Grade 1 Groin Strain

When there is damage to a small number of muscle fibres – usually less than 5% of fibres  this is a considered to be a mild groin strain.

In this case the pain may be sudden onset pain or just tightness in the groin area, the player might be able to play on, the area will become painful and tender later on, there will probably be no visible bruising or swelling, and the player will be able to walk around without limping.

This could take 2 to 3 weeks rest, however sometimes this is more like a micro-tear with minimal damage, and with good early management the player may return to sport after a week.

Grade 2 Groin Strain

When there is more extensive damage, with a large number of muscle fibres involved, but the muscle is still in tact it is known as a grade 2 groin strain or groin tear.

In this case there will be a sudden onset of pain usually while the player is pushing off from the side, changing direction or twisting on that leg. The player will be unable to play on, there will be a tender mass at the site of injury, there may be bruising which may not appear until the following day, and may be lower than the area of pain. There will be weakness in the muscle and the player may be limping.

The rest period required is usually between 3 and 6 weeks. Good physiotherapy treatment and early management will reduce the recovery period.

Grade 3 Groin Strain

When there is a complete rupture of a muscle it is referred to as a grade 3 groin tear.  There will be a sudden severe onset of pain, and the player may not be able to walk off the pitch.

There will be severe pain in the muscle and severe pain and weakness on resistance. There may be a visible deformity in the muscle where the fibres have recoiled back into a lump. There will be swelling in the area and bruising will be extensive when it appears the following day.

In a sports person this may require surgery to repair the muscle if the fibres have severely recoiled. Even with good physiotherapy and management it may take 3 months to fully recover. This severity of injury in the groin muscles is rare.

All muscle strains should be rested and allowed to heal. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.