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Diagnostic Guide - Hip & Groin Pain

Injuries > Hip & Groin Pain

 

Patients suffering from hip pain or groin pain are often seen in physiotherapy practice. Pain may be caused by local structures within or around the hip or groin, or, may be referred from other sources (such as the lower back, pelvis or sacroiliac joint).

Sudden onset hip and groin pain often occurs in athletes involved in fast moving change-of-direction sports, kicking sports and those sports which involve rapid acceleration and deceleration (such as football, soccer and basketball). These acute injuries usually involve tearing of a muscle or tendon within the region. One of the most common causes of sudden onset pain at the front of the hip is a Hip Flexor Strain (figure 1) whilst the most likely cause of sudden onset groin pain is a Groin Strain (figure 2).

Gradual onset groin pain often occurs in those patients involved in sports or activities that combine high running loads, rapid change-of-direction, and repetitive kicking. One of the most common causes of this exercise related gradual onset groin pain is Osteitis Pubis. In older patients with gradual onset hip or groin pain, the most likely cause of symptoms is degenerative changes in the hip joint, such as Hip Osteoarthritis.

There are numerous other causes of hip and groin pain, some of which present suddenly due to a specific incident, others which develop gradually over time.

Below are some of the more common causes of hip and groin pain with a brief description of each condition to aid diagnosis. Conditions have been organised according to sudden or gradual onset and common or less common conditions for ease of use.

Find out what may be causing your hip and/or groin pain:

Sudden Onset Hip & Groin Pain

Common Injuries

Hip Flexor Strain

Tearing of the hip flexor muscle (iliopsoas - figure 1), typically following a kick on the run or rapid acceleration movement. Associated with localised pain at the front of the hip, difficulty lifting the thigh and often pain on performing a hip flexor stretch (figure 3).

Hip Flexor Stretch

Figure 3 Hip Flexor Stretch

Groin Strain

Tearing of the adductor muscle (figure 2), typically following a forceful kick or change-of-direction movement. Associated with pain on firmly touching the affected region and localised, one-sided groin pain, often aggravated by stretching the affected muscle (figure 4).

Groin Stretch

Figure 4 Groin Stretch

Labral Tear

Damage to the cartilage lining the hip joint (labrum - figure 5). Pain is usually deep, although may present as vague groin pain. A clicking or catching sensation may also be present. Symptoms are usually exacerbated with weight-bearing and twisting activities.

Anatomy of a Labral Tear

Figure 5 Labral Tear Anatomy

Referred Pain

Pain referred to the hip or groin from another source such as the lower back or sacroiliac joint, often associated with symptoms above or below the hip (such as lower back pain or stiffness or pain in the thigh, lower leg, ankle or foot). Typically associated with pain on firmly touching the region responsible for the referred pain. Sometimes in association with pins and needles or numbness in the affected leg or foot.

Less Common Injuries

Femoral Neck Fracture

A break in the upper aspect of the thigh bone, usually due to a fall onto the side of that hip or thigh. More common in elderly patients (particularly women) and those suffering from reduced bone density, such as osteoporosis. Pain is usually quite severe and often results in an inability to weight-bear.

Inguinal Hernia

A protrusion of abdominal-cavity contents through the inguinal canal located at the front of the hip / groin. There may be associated swelling and tenderness on touching the affected area. Pain may be elicited by coughing, sneezing or straining activities.

Gradual Onset Hip & Groin Pain

Common Injuries

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Less Common Injuries

For a description of the less common causes of Gradual Onset Hip & Groin Pain to aid diagnosis Become a Member.

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View the complete article Diagnostic Guide - Hip & Groin Pain (Members Only).

Diagnosis of hip & groin pain

A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose the cause of hip & groin pain. Investigations such as an X-ray, ultrasound, MRI, CT scan or bone scan are often required to confirm diagnosis and rule out other injuries.

Find a Physio

Find a physiotherapist in your local area who can diagnose and treat patients suffering from hip & groin pain.

More Information.

Physiotherapy products for hip & groin pain

Some of the most commonly recommended products by physiotherapist for patients with hip and groin injuries include:

  1. Crutches
  2. Ice Packs
  3. Heat Packs
  4. Spikey Massage Balls (for self massage)
  5. Foam Rollers (for self massage) 
  6. TENS Machines (for pain relief)

To purchase physiotherapy products to assist with rehabilitation click on one of the above links or visit the PhysioAdvisor Shop.

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Return to the top of Hip & Groin Pain.

Anatomy of a Hip Flexor Strain

Figure 1 Hip Flexor Anatomy (Iliopsoas)

Groin Strain Anatomy

Figure 2 Groin Strain Anatomy (Adductors)

 

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