Hip and groin pain is prevalent across the population, from athletes to office workers. There are many factors to be considered in what causes hip and groin pain. As a person ages across the lifespan, the factors contributing to this pain change. In a younger population, muscle and cartilage tears are more prevalent in an athletic population. As you get older, muscle overload, such as tendinopathies, can occur as can osteoarthritic changes to the joint. All of these can be managed alongside a physiotherapist and the vast majority of hip and groin related conditions can be managed conservatively with a combination of manual therapy, exercise and guidance regarding activity.
What Causes Hip and Groin Pain?
The hip is a large ball and socket joint, connecting the femur (thigh bone) to the pelvis. This means the leg can be moved in all directions to a varying degree and provides force transfer between the lower limb and the torso. The hip joint is surrounded by strong ligaments and muscles that assist in stability and movement.
When considering what causes hip and groin pain it is important to look at a variety of factors, including range of movement, strength and lifestyle factors. Outside of acute injuries, what could cause hip and groin pain is often a combination of many factors that all need to be addressed in treatment and management. Hip and groin pain can be influenced by bony or cartilage changes such as osteoarthritis, labral tears or Femoro-acetebular impingement, muscle overload such as iliopsoas or adductor tendinopathies, movement restriction from muscular tightness and pregnancy related changes such as pubic symphysis inflammation.
It is important your Physiotherapists assesses the whole picture when diagnosing and treating hip and groin pain. This way any treatment will have lasting effects not just resolving your symptoms but solving the underlying issue long term.
What are the Symptoms of Hip and Groin Pain?
When determining what causes hip and groin pain, your Barefoot Physiotherapist will undertake an assessment around the joint, carrying out a number of movement and muscle tests, the exact tests will be dependent upon the individual’s presentation. Your Physiotherapist will ask you about what symptoms you are experiencing and if you are experiencing hip or groin pain you may notice:
- clicking or catching in the hip joint
- stiffness in movements
- pain that is worst in the morning
- pain that improves with activity
- referred pain into the buttocks or thigh
- pain that started after an increase in physical activity
- localised pain that increases with single leg activity
- sudden pain after a loaded movement, such as kicking
- an ache around the outer hip, in a “C” shape
These are some of the more common symptoms reported by hip and groin pain and can help your physiotherapist determine priority for treatment.
How Will a Physio Diagnose Hip and Groin Injuries?
When diagnosing a hip injury causing groin pain, your physiotherapist will complete a number of objective assessment tests. At Barefoot Physiotherapy, our treatment framework helps to guide our process so it is thorough and we can get to the root cause of your pain. Some of these tests include palpation of various tissues involved in the hip complex; range of movements such as hip flexion and rotation and lumbar (low back) movement; intra-articular orthopaedic tests; resisted muscle activation; functional movements such as squats or single leg stance.
During these tests, we are looking for restriction in movements, asymmetries in range and strength and pain replication. While these tests are not fully accurate in diagnosing, they can be helpful in creating a picture to guide clinical decision making and management. Once your Physiotherapist has a good idea of what type of hip/ groin pain you are presenting with, they will move on to treatment of the area which will be discussed below.
How to Treat Hip and Groin Injuries:
Regardless of what could cause hip and groin pain, at Barefoot Physiotherapy, a client’s treatment plan typically consists of symptom management, a focus on increasing mobility of the affected area, and targeted functional strengthening of the affected muscle groups.
The initial stage of symptom management may include a reduction of the aggravating activities, utilising pain relief or anti-inflammatory medication, muscle releases and/or low level muscle activation exercises. You may be able to begin initial management independently, however where possible it is best to seek out a health professional’s advice to alleviate pain as quickly as possible.
For long term, sustainable results, it is recommended that you see a physiotherapist to create a management plan that gets you back to enjoying your activities pain free. As you progress on a strengthening program, your Barefoot Physiotherapist can help guide you to ensure you are maximising your exercises with appropriate muscle activation and loading into appropriate movement ranges for your body. At Barefoot Physiotherapy, we also treat any underlying neural irritation that may be contributing to your symptoms or adding to muscle tightness and movement restriction in the area.
The Best Exercises for Hip and Groin Injuries
When working on a rehab program for a hip injury causing groin pain it is important to go back to basics. Your Barefoot physiotherapist will introduce muscle activation and motor control exercises involving the back, hips and lower limb. Examples of this may include pelvic tilts working through comfortable ranges in anterior and posterior tilt positions to improve mobility in the low back, or glute activation exercises to increase muscle fibre recruitment of the glutes i.e. in a squat position, step up or sit to stand.
If appropriate, you may be prescribed stretches for the psoas, glute and thigh muscles to help maintain an increase in movement ranges. Strengthening exercises usually start with double leg dynamic and functional options, such as squats and lunges, and static single leg options to include balance work. An overall lack of abdominal strength and control can be a component of what causes hip and groin pain and therefore exercises targeting these areas will be included in your exercise management program.
As your treatment progresses these exercises can be tailored to more specific activities that you like to do for sports, hobbies, or other recreational activities. For instance, if you are getting back to running, there will be a focus on running drills to further strengthen the hip or if you are wanting to return to heavy lifting your exercises will focus in on technique and form at the gym.
The exercises utilised in your recovery can be continued after your symptoms have resolved, now with a different ratio or focus. You may do less frequent specific activation exercises and start to increase the load used in your strength work. It is important to continue strength and mobility work even after the resolution of initial pain symptoms so that your body is better able to tolerate the activities of your daily life.
Talk to Expert Physiotherapists
As mentioned in the article there are a variety of factors contributing to hip and groin pain. Working with a physiotherapist can help you manage your symptoms and get you back to pain free activities. At Barefoot Physiotherapy, we undergo a thorough assessment and provide an appropriate management plan to get you back on track. If you are suffering from hip or groin pain, you can contact us on 1300 842 850 or book with our Brisbane physiotherapists online.