There are three main injuries that create pain in the groin and anterior hip—strain of the hip flexors, adductor muscles, and lower rectus abdominis muscle. The groin area also hurts when there is osteoarthritis of the hip, but that is the subject of a different article available on this website.
(1) Hip Flexor Strain
Hip flexor pain is usually felt in the groin area and can result from repetitive movements or by a sudden forceful extension of the hip. There are two main muscles involved—the iliopsoas and the rectus femoris, which are the most powerful hip flexors. Three other muscles might be involved—the pectineus, sartorial and tensor fascia latae.
The strain may or may not be felt at the time of injury, but with activity, there will be mild pulling or sharp pain, and as time passes, the pain gets worse with activity and the affected muscle feels like it is tightening up.
There are 3 grades of muscle strain. Grade three is severe and will require the services of an orthopedic physician. Grade 1, mild, and grade 2, moderate, can respond well to acupuncture. A grade 1 strain should improve significantly in 3-5 treatments over a 10-14 day period. Grade two will respond more slowly, perhaps requiring 11-12 treatments over a 6-8 week period. (1)
(2) Adductor Strain
This injury general occurs in sports requiring sudden changes in direction, such as soccer, tennis, basketball, hockey, football, or martial arts. At the time of injury, there may be an acute pain in the groin area, or perhaps the athlete feels nothing at all, but without fail there will be pain and stiffness hours later. (2)
There are 5 muscles involved in hip adduction, and of the five, the adductor longus is the one most commonly injured.
The primary location of injury is close to the tendon insertion site on the pubic bone. There is poor circulation there and an abundance of nerve fibers, meaning the injury hurts a lot and heals slowly. It is important that the athlete not return to activity prematurely or the condition can easily become chronic. (3)
Acupuncture is done to decrease pain and accelerate healing time. For a mild strain, 3-5 treatments over a two-week period may be all that is required for recovery. A moderate strain will usually require a longer treatment period—10-14 weeks with bi-weekly treatments for the first 10 weeks and once per week thereafter. (4)
(3) Lower Rectus Abdominus Pain
The rectus abdominus is an abdominal muscle, as its name suggests, the muscle that gives us a six-pack when we lose enough weight, so why am I including it in an article on hip and groin pain? Because a lower strain where the muscle attaches to the pubic bone will cause pain in the groin.
The injury can occur in sports that require a strong rotational movement, such as batting in baseball, or from a sudden trunk hyperextension, which can occur during a fall, in certain gymnastics movements, or in wrestling or jiujitsu.
The goal of acupuncture is to relieve pain and speed up healing. The degree of a strain can range from mild to serious. For a mild strain, 3-5 acupuncture treatments over 2 weeks may be all that is needed. A moderate strain will require more treatments over a longer period of time. A serious strain might require the services of an orthopedic physician.
It is a good idea to start stretching exercises within a pain-free range of motion once the injury has healed to the point where this is possible. Stretching will help to minimize the effect of scar formation. When scar tissue is created to heal a tear, the collagen fibers can be disorganized, deposited in random directions rather than being aligned with normal tissues. This can predispose the athlete to future injuries in the same area and also cause pain with movement. (5)
(1) Matt Callison, L.Ac., Sports Medicine Acupuncture, San Diego, CA. Acusport Education, 2019, p 720
(2) ibid., p 721
(3) Ibid., p 722
(4) ibid., pp 724
(5) ibid., p 728