Groin StrainDr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
Ranging from very mild pain and discomfort to severe, debilitating pain, a groin strain is an injury to the adductor muscles in the groin area. Specifically, there are five adductor muscles in the groin, three of which are short adductors (pectineus, adductor brevis and adductor longus). The remaining two muscles are long adductors (gracilis and adductor magnus). Groin strain typically occurs with a tear or rupture in the adductor longus muscle.
To better understand the function of the adductor muscle group, consider activities such as walking, running or sprinting. Adduction is the particular movement that pulls the leg back to the body’s midline. Simultaneously, as individuals participate in activities and/or sports, the adductor muscles on one side work to stabilize the pelvis while adductor muscles on the other side control movement of the leg. An acute groin strain can be a sports injury that most commonly occurs during events such as hurdling, soccer, football, riding a horse or any activity in which there are rapid changes of direction or movements. Even so, repeated overuse of the groin muscles or improper stretching or training can also result in injury. This is particularly true with inflammation of the groin, which is often an ongoing, chronic injury.
Depending on the extent of the groin strain, it is graded as a 1, 2 or 3. For instance, a grade 1 groin strain occurs when less than 25% of the muscle fibers are damaged. In many cases, athletes can sustain a grade 1 groin strain without realizing it. This is because symptoms of a grade 1 sprain appear after exercising has stopped. At this point, groin muscles may feel tight and sore. In turn, grade 2 groin strains involve moderate tearing (25%-90%) of fibers in the groin muscles, and athletes are usually aware of the injury at the moment that it happens. Many feel a sudden, sharp pain in the adductor muscles and may experience immediate weakness as they continue to move. As the most severe groin strain, grade 3 injuries are classified as a complete tear or almost complete rupture (90% or more) of the muscle. Without question, athletes will know the moment that this type of injury occurs, and they will not be able to contract the muscle due to the intensity of pain and weakness.
Treatment and Rehabilitation for Groin Strain Injuries
Groin strain injuries are usually noticeable at the time of injury or shortly after exercise. However, other groin injuries may be chronic pain and tenderness from previous injuries or strains that have not been treated. It’s important to note this distinction, as groin strain injuries are much easier to assess and treat in their earliest, most acute stage. Yet, in either case, physiatrists are best positioned to identify and develop a plan for treatment and rehabilitation that reduces pain, promotes healing and maximizes function.
In the case of a groin strain, initial treatment may begin with rest, pain management and reducing inflammation. Cold therapy is often used to reduce pain, inflammation and to stop internal bleeding. A groin support or strap also proves useful for pain reduction and support. After 72 hours, or as directed by the physiatrist, sports massage may help reduce tension and stress within the muscle, while restoring blood flow. In addition, ultrasound therapy works to encourage healing.
When pain and inflammation are managed, patients can tolerate varying levels of rehabilitation, depending on the extent of their injury. Led by the physiatrist, therapists can test a patient’s range of motion. By guiding patients through a series of stretches and movements, the therapist notes the individual’s pain responses, which provide pertinent diagnostic information to the physiatrist. Resisted muscle testing may be performed as well, which includes applying pressure or weight to the injured leg as the patient attempts to complete a series of movements or stretches. Similar to range of motion testing, the resisted muscle assessment provides important clues about the patient’s level of injury, and it provides a framework for individualized rehabilitation.
For patients with groin strains, rehabilitation is centered on stretching and strengthening the muscle and sports-specific exercises tailored to restore and maximize functioning. A comprehensive rehabilitation program, as designed by a physiatrist, proves invaluable as athletes gain pre-injury strength and flexibility. This will make them less prone to a groin strain in the future.
At the Howard Liss, M.D. Rehabilitation Institute in Tenafly, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
If you are suffering from a groin strain injury, Dr. Liss welcomes you to contact the Howard Liss, M.D. Rehabilitation Institute in Englewood today.