Many factors can lead to developing chronic groin pain. These factors range from tightness in the muscles of the hip, back muscles, an abdominal injury / hernia, ligaments and joint damage. Rarely narrowing the cause to one of the above is not common and is more than likely a combination of one or more of the above.
Active individuals tend to suffer the most with groin pain. Typical movements that aggravate the injury include running, twisting movements and kicking. Osteitis pubis now appears to be an umbrella term used to describe chronic groin pain. From my experience treating a number of clients presenting with this diagnosis, I recommended to seek a second opinion if you have been diagnosed with this condition.
If you have been suffering with groin pain for some time now and struggling to make progress with treatment and rehabilitation, some key points missing from your treatment and rehabilitation plans might include:
1. Has your core stability been checked? Pelvic/core stability is required to prevent excessive load on the adductor muscles – the muscles at the inside of your thigh commonly referred to as the groin muscles. Two muscle groups to start strengthening immediately are transverse abdominis and multifidi. Simply enter these two muscle names into Youtube and you’ll find lots of videos to teach you how to strengthen them. Aside from groin strain most of us are weak in these muscles and this weakness can contribute to chronic low back pain.
2. Tight gluteal muscles – trigger points are commonly found in the gluteus medius muscle, creating muscle weakness, tightness and altered hip range of motion. Ensure you release the tightness in the gluteus medius muscle and restore it to its natural length and strength. Acupressure balls are perfect for treating the trigger points and foam rollers are fantastic for lengthening tight myofascial (muscle and connective tissue) structures.
Fig 1. Gluteus medius muscle and associated trigger points
3. If you have not had an MRI of the hip joint, get one! It’s important to rule out anything sinister including tears and impingement syndromes.
4. Iliopsoas / hip flexors – Ensure these muscles have been worked on and normalised by your therapist. They are short and tight in most of us and are constantly traumatised by prolonged sitting at home and in the office. If you have suffered from ongoing back pain these muscles might be responsible.