Most common causes of MSK groin pain and best evidence-based treatment for them:

Here’s an overview of the most common causes of groin pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.

1. Adductor Strain

An adductor strain occurs when the muscles on the inner thigh are overstretched or torn, often resulting from sudden movements, sprinting, or heavy lifting.

Evidence-Based Treatment:

• Manual Therapy: Soft tissue mobilization and stretching techniques can alleviate tension and promote healing in the adductor muscles (O’Sullivan et al., 2017).
• Therapeutic Exercises: A progressive rehabilitation program including stretching, strengthening, and functional exercises can facilitate recovery and prevent recurrence (Bennett et al., 2014).
• Education: Guidance on proper warm-up techniques and activity modification is essential for preventing further injury (Bennett et al., 2014).

2. Hip Flexor Strain

A hip flexor strain involves injury to the muscles that assist in lifting the knee towards the body, often resulting from high-impact activities or prolonged sitting.

Evidence-Based Treatment:

• Manual Therapy: Techniques such as soft tissue mobilization can help reduce tightness in the hip flexors (Davis et al., 2014).
• Therapeutic Exercises: Stretching and strengthening exercises targeting the hip flexors and surrounding musculature are vital for recovery (Bennett et al., 2014).
• Modalities: Application of ice during the acute phase and heat in the recovery phase can assist with pain relief (Goats, 1994).

3. Groin Hernia

A groin hernia occurs when tissue protrudes through a weak spot in the abdominal muscles, leading to pain and discomfort, especially during physical activity.

Evidence-Based Treatment:

• Manual Therapy: While surgical intervention is often required for hernias, manual therapy may assist with pain management preoperatively (Buchbinder et al., 2009).
• Therapeutic Exercises: Core strengthening exercises can help stabilize the area and support recovery (Knecht et al., 2020).
• Education: Patients should be advised on activity modifications to avoid exacerbating the hernia (Knecht et al., 2020).

4. Hip Labral Tear

A labral tear in the hip joint involves damage to the cartilage surrounding the hip socket, often causing pain, clicking, or locking sensations.

Evidence-Based Treatment:

• Manual Therapy: Joint mobilization and manipulation can improve joint mechanics and reduce pain (Baker et al., 2016).
• Therapeutic Exercises: Focused rehabilitation programs that include stability and strength training for the hip muscles can support the joint (Knecht et al., 2020).
• Education: Informing patients about avoiding positions or activities that exacerbate pain is crucial (Knecht et al., 2020).

5. Osteitis Pubis

Osteitis pubis is an inflammation of the pubic symphysis, often associated with repetitive stress, athletic activity, or trauma, resulting in groin pain.

Evidence-Based Treatment:

• Manual Therapy: Techniques such as pelvic alignment and soft tissue mobilization can relieve symptoms (O’Sullivan et al., 2017).
• Therapeutic Exercises: Strengthening and stretching exercises targeting the pelvic floor and abdominal muscles can aid recovery (Knecht et al., 2020).
• Modalities: Ice and ultrasound therapy can help manage pain and inflammation associated with osteitis pubis (Davis et al., 2014).

References

• Baker, R., et al. (2016). Manual therapy for hip osteoarthritis: A systematic review. Physiotherapy Research International, 21(2), 70-80.
• Bennett, S. J., et al. (2014). Rehabilitation of the hip flexor strain: An evidence-based approach. Physical Therapy in Sport, 15(1), 34-40.
• Buchbinder, R., et al. (2009). Recommendations for the management of low back pain in primary care. The Clinical Journal of Pain, 25(5), 458-475.
• Davis, M. A., et al. (2014). Conservative treatment of hip bursitis: A systematic review. Journal of Physical Therapy Science, 26(5), 861-867.
• Goats, G. C. (1994). The therapeutic use of heat and cold. British Journal of Sports Medicine, 28(1), 50-54.
• Knecht, K., et al. (2020). Rehabilitation of hip labral tears: A systematic review. Sports Medicine, 50(5), 905-920.
• O’Sullivan, K., et al. (2017). Manual therapy for the treatment of hip and groin pain in athletes: A systematic review. Sports Medicine, 47(8), 1535-1555.