Hip and groin pain are common symptoms in the acctive population. It can be caused by a problem in different structures around the hip such as muscles or tendons, the hip joint itself or referred from the lower back, the sacro-iliac joint or organs in the lower abdomen or pelvis.
Most commonly, a strain in muscles such as the adductors (on the inner thigh) or hip flexors (on the front of the thigh) can cause groin pain. Pubic groin pain is often experienced by footballers and rugby players due to overload on the pubic symphysis by the hip adductors (osteitis pubis), for example through kicking a ball.1 The sporty population can also develop a sports hernia (athletic pubalgia) caused by a strain or tear in the soft tissue of the lower abdomen.2
On the outside of the hip, a gluteus medius tendinopathy or a bursitis can contribute to pain in the area. Hip joint pathologies such as hip impingement and osteoarthritis are often felt as groin pain, but can sometimes also cause pain on the outer hip and thigh. However, hip arthritis tends to affect the older population and hip impingement often starts in a younger population, usually in their 20s or 30s.
Pain in the lumbar spine and the sacroiliac joint can refer to the hip as can coming from the abdominal and pelvic organs. A thorough subjective and physical examination can help identify the source of pain and treatment will address each problem to help you manage your condition.
Most conditions are managed conservatively and successfully. Treatment can include exercise therapy, mobilisation and self-mobilisation techniques3, soft tissue release and acupuncture where appropriate.
If you had hip problems as a child, for example hip dysplasia or Perthes disease, or previous injuries or fractures, you may be more prone to hip conditions later on in life so it is important to let your doctor or physiotherapist know. Rarely, hip or groin pain can be caused by more serious conditions but your Physiotherapist will be able to assess this and help guide you towards the more appropriate health care practitioners.
1. Angoules A (2015) Osteitis pubis in elite athletes: Diagnostic and therapeutic approach. World J Orthop 6(9): 672-679
2. Brown A, Abrahams S, Remedios D and Chadwick SJ (2013) Sports Hernia: Clinical Update. Br J Gen Pract. e235-e237
3. Reiman MP and Matheson JW (2013) Restricted Hip Mobility: Clinical Suggestions for Self-Mobilisation and Muscle Re-Education. Int J Sports Phys Ther. 8(5): 729–740.