PT Weekly: Groin and Hamstring Injury in an Athlete; Physiotherapy Focus
A groin strain is an overstretch or tearing injury to the muscles of the inner thigh or front of the hip which is more common in athletes than non-athletes. Groin strains can occur during any type of forceful movement of the leg, such as jumping, kicking the leg up, or changing directions while running. Groin strains make walking, lifting the knee, or moving the leg away from or toward the body difficult and painful.
A muscle strain can be graded according to the amount of muscle damage:
Grade 1: Mild or partial stretch or a tear of a few muscle fibers. The muscle is tender and painful but maintains its normal strength. Use of the leg is not impaired, and walking is normal.
Grade 2: Moderate stretch, or tearing of a greater percentage of the muscle fibers. There is more tenderness and pain, noticeable loss of strength, and sometimes bruising. Use of the leg is noticeably impaired, and limping when walking is common.
Grade 3: Severe tear of the muscle fibers, sometimes a complete muscle tear. A “popping” sound may be heard or felt when the injury occurs. Bruising is apparent, and sometimes a “dent” in the muscle may be seen under the skin at the site of the tear. Use of the leg is severely difficult, and putting weight on the leg is very painful.
When groin muscles are strained or torn, muscle fibers and other cells are disrupted. Bleeding can occur, which causes bruising. Within a few minutes to a few hours after the injury, swelling can occur, causing the injured area to expand and feel tight and stiff.
How does it feel?
With a groin strain, you may experience signs and symptoms such as pain and spasms in the groin area, swelling in the groin area, bruising in the groin area, tightness in the groin area, weakness in the leg when trying to walk, climb stairs, or move the leg, limping when walking, difficulty performing daily activities that require standing and walking.
How Is It Diagnosed?
Your physical therapist will conduct a thorough evaluation that includes taking your health history and ask you:
- What you were doing when you first felt pain
- Where you felt the pain and if you heard a pop when it occurred
- If you received a direct hit to your leg or groin area
- If you noticed any swelling in the first 2-3 hours following the injury
- If you experience pain when lifting your leg, walking, moving the leg away from you, or drawing your knees together
- Gently moving your leg away from your body
- Asking you to resist against his or her hand as he or she tries to gently push your leg outward (muscle strength test)
- Gently feeling parts of the muscle to determine the specific location of the injury (palpation)
How Can a Physical Therapist Help?
Your physical therapist will design a specific treatment program to speed your recovery. This program will include exercises and treatments you can do at home to help you return to your normal lifestyle and activities.
The First 24-48 Hours
Your physical therapist may advise you to:
- Rest the area by avoiding walking or any activity that causes pain. Crutches may be recommended to reduce further strain on the muscles when walking.
- Apply ice packs to the area for 15-20 minutes every 2 hours.
- Compress the area with an elastic bandage wrap.
Your physical therapist can use different types of treatments and technologies to control and reduce your pain, including ice, heat, ultrasound, electricity, taping, exercises, and hands-on therapy such as massage.
This can be achieved using specific activities and treatments to help restore normal movement in the leg and hip. These might begin with “passive” motions that the therapist performs for you to gently move your leg and hip joint, and progress to active exercises and stretches that you perform yourself.
Certain exercises will benefit healing at each stage of recovery; your physical therapist will choose and teach you the appropriate exercises to steadily restore your strength and agility. These may include using cuff weights, stretchy bands, weight-lifting equipment, and cardio exercise equipment such as treadmills or stationary bicycles.
Return to Activities
Collaboration with you to decide on your recovery goals, including your return to work or sport, and will design your treatment program to help you reach those goals in the safest, fastest, and most effective way possible. Additionally, if you are an athlete you will be taught sport-specific techniques and drills to help you achieve your sport-specific goals.
Prevent Future Reinjury
Certainly will recommend a home exercise program to strengthen and stretch the muscles around your hip, upper leg, and abdomen to help prevent future reinjury of your groin.
Hamstring injuries are a tear or strain to the muscle or tendon structure in either of the three hamstring muscles ( Bicep Femoris, Semitendinosus or Semimembranosis). They are common and continue to increase in sports despite extensive research and investigations. They usually occur during a deceleration action during sprinting and most likely towards the end of playing time.
The most significant risk factor for injury is a previous hamstring injury.
Previous injury is associated with, Formation of scar tissue, Reduced flexibility, Reduced eccentric strength, Altered movement patterns and lower limb biomechanics.
Hamstring strains vary greatly. You can have a mild strain, up to a grade 3 muscle tear. The symptoms are variable. You may experience a very sharp intense pain with running, or just a dull ache that builds up. Some people describe a pinching sensation. Either way, you will feel a loss of power, loss of explosiveness, pain on resisted muscle use and poor athletic performance.
Treatment can be focused on but limited to the following factors as part of the rehab program:
- Correcting abnormal movement patterns
- Hamstring strength, specifically eccentric strength
- Flexibility in the hamstring and surrounding musculature
- The imbalance between quads and hamstring strength
- Altered biomechanics
- Overload in training programs
- Returning to high speed running
For people with persistent hamstring pain and dysfunction that is not resolving within 4-8 weeks, at Physio Centers of Africa, we would advise appropriately as to what our client should do.