Groin Pain in Athletes: Causes, Risks & When to Seek Help
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Groin pain is a common yet often misunderstood complaint among athletes. It can stem from a variety of injuries
or conditions that affect the muscles, tendons, bones, or internal organs in the pelvic region. While some groin
pain may resolve with sufficient rest and self-care, persistent or severe cases could be indicative of a more
serious underlying issue.
This article explores the common causes of groin pain in athletes,its associated risks, and when it’s time to
consult an orthopaedic specialist.
By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun
What Is Groin Pain?
The term "groin" refers to the area where the lower abdomen meets the upper thighs. Pain in this region can vary
from a dull ache to a sharp, stabbing sensation and may occur suddenly during activity or gradually over time.
Athletes involved in sports that require quick directional changes, sprinting, or kicking (e.g. football,
hockey, martial arts, and track and field) are especially prone to groin injuries.
Groin pain can be broadly classified into muscular, tendinous, skeletal causes, and a thorough assessment is
often required to identify the exact source and cause of the pain.
Common Causes of Groin Pain in Athletes
Groin pain can result from acute trauma or chronic overuse. Some of the most common causes of groin pain include:
1. Adductor Muscle Strain (Groin Pull)
This is perhaps the most frequent cause of groin pain in athletes. The adductor muscles, which run
along the inner thigh, help bring the legs together. Overstretching or tearing these muscles (often
during sudden movements or slips) can result in a groin strain.
Symptoms typically include sharp pain during activity, swelling, bruising, and tenderness along the
inner thigh. Mild strains may heal within a few weeks, but more severe tears could require months of
rehabilitation.
2. Hip Labral Tear
The labrum is a ring of cartilage surrounding the hip socket. Athletes, particularly those involved
in high-impact or rotational sports, may develop labral tears due to repetitive stress or trauma.
Symptoms include deep groin pain, clicking or locking of the hip joint, and reduced range of motion.
A labral tear can mimic other hip and groin injuries, making imaging and clinical assessment
essential for diagnosis.
3. Sports Hernia
Unlike a traditional hernia, a sports hernia doesn’t involve a visible bulge. It occurs when soft
tissue in the lower abdomen or groin area is torn or weakened, usually from explosive twisting or
turning movements.
Athletes with a sports hernia often experience persistent, aching groin pain that worsens with
physical activity and improves with rest. If untreated, the condition may become chronic and
interfere with performance. Surgery may be required in some cases.
4. Iliopsoas Tendinopathy
The iliopsoas muscle group is located deep in the front of the hip and helps lift the leg and flex
the hip. Repetitive hip flexion, especially in runners and dancers, can cause tendinopathy or
inflammation in the tendon.
Groin pain from iliopsoas tendinopathy is often felt when lifting the leg or during prolonged
sitting. It can also be accompanied by a snapping sensation in the hip.
5. Hip Impingement (FAI - Femoroacetabular Impingement)
Hip impingement occurs when abnormal contact between the hip bones causes pain and limits motion. It
is a frequent cause of groin pain in young, active individuals.
Symptoms include stiffness, pain when sitting or rotating the hip, and discomfort during squats or
pivots. Left untreated, this can lead to labral tears or even early arthritis.
6. Osteitis Pubis
This condition involves inflammation of the pubic symphysis, the joint where the two halves of the
pelvis meet in the front. Osteitis pubis is typically caused by repetitive stress from running,
kicking, or rapid changes in direction.
Symptoms include aching pain in the central groin or lower abdomen, tenderness over the pubic bone,
and discomfort during core exercises.
7. Referred Pain from Other Regions
Sometimes, groin pain may originate from areas such as the lumbar spine, sacroiliac joints, or
abdominal organs. Herniated discs, hip arthritis, or kidney stones can also manifest as groin
discomfort. Accurate diagnosis is essential to avoid mistreatment.
Risk Factors for Groin Injuries
Understanding the risk factors of groin pain can help athletes and coaches alike take preventive steps. These include:
Poor flexibility: Tight hip flexors and adductors increase the risk of strain
Muscle imbalances: Over-training certain muscles while neglecting others can lead to abnormal biomechanics
Improper warm-up: Skipping stretches and warm-ups reduces tissue elasticity and readiness for activity
Sudden increases in training intensity: Overloading the body without adequate time to adapt can result in overuse injuries
Previous injuries: A history of groin or hip injuries increases susceptibility to re-injury
Additionally, athletes in multidirectional sports such as football, hockey, and rugby are particularly vulnerable due to the physical demands placed on the hip and groin region.
Symptoms That Should Not Be Ignored
While some soreness is normal after intense training, certain symptoms should prompt one to seek medical attention:
Persistent groin pain lasting more than 1–2 weeks
Sharp pain during specific movements like sprinting, kicking, or changing direction
Pain that interferes with daily activities or sleep
Swelling, bruising, or tenderness in the groin or inner thigh
Audible pops, clicking, or locking of the hip joint
Weakness or instability in the leg
Radiating pain into the lower abdomen or inner thigh
Delaying treatment can worsen the condition and complicate or prolong recovery. Early intervention helps athletes return to activity faster and with a lower risk of recurrence.
Treatment Options for Groin Pain
The treatment of choice will depend on the diagnosis, severity of the injury, and the patient’s activity level. Generally speaking, treatment options include:
Rest and activity modification: Temporary cessation of sports to allow for healing
Physiotherapy: Tailored rehabilitation to strengthen the muscles, improve flexibility, and correct imbalances
Anti-inflammatory medications: This may be prescribed to reduce pain and swelling
Manual therapy: Soft tissue mobilization or dry needling for muscular sources of pain
Corticosteroid injections: This may be used in cases of persistent inflammation
Orthopaedic surgery: This is typically reserved for structural issues such as labral tears or sports hernia that do not respond to conservative treatment
Your orthopaedic specialist will assess your specific situation and identify the best mode of treatment for you.
Return to Sport
The ability to return to sports depends on one’s symptoms (whether they have resolved), degree of
function, and the athlete’s general readiness. A progressive return plan under the guidance of a
physiotherapist or sports orthopaedic specialist helps to minimise the risk of re-injury.
Athletes should be pain-free, have full range of motion, and demonstrate adequate strength and
control before resuming their previous level of sport. Rushing back prematurely can result in
re-injury or chronic issues in the future.
Preventing Groin Injuries
Prevention plays a key role in ensuring an athlete’s long-term performance and joint health. Here are a few tips to reduce the chances of getting groin pain:
Warm up with dynamic movements like leg swings, hip circles, and light jogging
Incorporate strength training for core, hips, and inner thigh muscles
Include mobility work for the hip flexors, adductors, and glutes
Monitor training load and avoid sudden spikes in intensity or volume
Address early signs of tightness or discomfort before they escalate
Athletes and coaches should work collaboratively to build injury-resilient training routines that include recovery and biomechanical assessments.
When to See an Orthopaedic Specialist for Groin Pain
If groin pain persists beyond rest and basic rehabilitation, or if it recurs, it is important to consult a specialist. Early assessment by an orthopaedic surgeon or sports medicine physician can provide clarity and prevent chronic, long-term issues.
For more information, please reach out to our sports orthopaedic clinic today.
With over 18 years of orthopaedic experience, Dr Wang Lushun is a dedicated Senior Consultant Orthopaedic
Surgeon who is skilled in the diagnosis and treatment of avascular necrosis. Having previously led the Hip
and Knee Division at Ng Teng Fong Hospital, patients can rest assured knowing that they will receive the
best possible orthopaedic care tailored to their needs.
Dr Wang Lushun is a pioneer in Enhanced Recovery after Surgery (ERAS), and has pioneered Minimally Invasive
Hip Surgeries such as Direct Superior and Direct Approaches. He has been recognised for superior outcomes in
Joint Replacements and is frequently invited as international faculty for his insights into the latest
treatment options.
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
