19/12/2020
A groin strain is an injury to the muscle-tendon unit that produces pain on palpation of the adductor tendons or its insertion on the p***c bone with or without pain during resisted adduction
The underlying injury is most often a muscle or tendon strain at the insertion of the tendon of the adductor muscle to the bone.The adductor longus is most commonly injured.
The difference between groin tendinopathy and strain are:
First of all, strains are acute and tendinosis is chronic. Tendinosis is a repetitive strain.
The second difference is that acute injuries are more often localized in the myotendon junctions and chronic injuries are localized at the tendinous insertions on the p***c bone.
Groin strains are common amongst athletes who compete in sports that involve repetitive twisting, turning, sprinting and kicking.Strain injuries to the groin are among the most common groin injuries in adult male soccer players.
Groin strains are also known from other sports such as ice hockey, running, tennis, rugby, American football, basketball and others
Injury mechanism can be divided into 3 groups:
1:Direct blunt trauma: An acute injury, typically a direct injury to the soft tissues resulting in muscle hematoma.
2:Forceful contraction: The most common groin injury in athletes is muscle and tendon strain of the adductor muscle group. Change of direction and kicking have been described as the main actions resulting in adductor longus injury.
3:Microtrauma by repetitive injury: musculotendinous injuries to the groin are mainly a consequence of cumulative microtraumas (overuse trauma, repeated minor injuries) leading to chronic groin pain.
The main sign of the adductor muscle injury is intense pain in the groin area. Muscle strain injuries often arise from excessive stretching or stretching when the muscle is being activated. When there is a strain in the muscle, the damage is often localized near the muscle-tendon junction. The muscle is getting weaker and the risk of further injury rises.
Medical Management
Management is non-operative with rest, ice, compression, and gentle physical therapy or ROM. Injection at the adductor longus enthesis is helpful for patients refractory to conservative management. There is a clear efficacy of non-steroidal anti-inflammatory agent
Physiotherapy Management
The treatment of musculotendinous groin injuries is generally conservative. Surgical treatment in acute groin injuries is rarely indicated.[10]
In the treatment of muscle-tendon injuries, immobilization should be limited to as short a period as possible to avoid the harmful effects of immobilization including muscle atrophy and loss of function. Immediate rest after the injury should be used until a diagnosis is secured.
The primary goal of the treatment program is to minimize the effects of immobilization, regain full range of motion, and restore full muscle strength, endurance and coordination. Therefore, crutches, local cold application, and anti-inflammatory medication are recommended in the initial phase. Muscle exercises can usually be started early, but training should be performed within the limits of pain with careful isometric contractions against resistance.
After the initial phase, heat is usually valuable, especially when muscle training is started. In general, exercises are performed in a pain-free range of motion and increased pain should not occur after activity.
As rehabilitation progresses, mild pain can be allowed during exercise, but it should subside immediately after the cessation of training.
When full range of motion is accomplished, the injured muscle and tendon tolerates higher loads and the goal of rehabilitation should shift towards specific strength training exercises aiming for muscular recovery, increased endurance and a full range of motion
