Groin Pain and Strains: Causes, Treatment and Recovery

In short

Groin pain in an active adult is most often a groin strain: a pulled or torn muscle on the inside of the thigh, usually from sprinting, kicking or a sudden change of direction. It can also come from the hip joint, a hernia, the pubic bone area or the lower back. A mild strain often settles with sensible early care and a gradual return to activity. A physiotherapist can work out where your pain is coming from and guide your rehab, at home or by video.

Some groin pain is not a muscle problem at all. Sudden pain in a testicle, a new lump in the groin, or severe hip and groin pain after a fall in an older person all need a doctor before any physiotherapy. The section on warning signs further down explains where to go. The rest of this guide covers the usual causes, what to do in the first few days, and how groin strain treatment works.

Why does my groin hurt? The common causes

Your groin is where the tummy meets the top of the thigh, and a lot passes through that small space. There are the adductor muscles that pull your legs together, the hip flexors that lift your knee, the front of the hip joint, the pubic bones, the canal where inguinal hernias appear, and nerves coming down from the lower back. That is why groin pain can be hard to pin down, and why it is worth having it assessed if it lingers.

Adductor strain: a pulled inner thigh muscle

This is the classic sports groin injury. The adductors run from the pubic bone down the inside of the thigh, and they work hard when you kick, skate, sprint or change direction. A strain happens when the muscle is stretched or loaded beyond what it can cope with. People usually feel a sharp pain high on the inner thigh, then find it hurts to squeeze their knees together or swing the leg out to the side.

Hip flexor strain: groin pain when lifting the leg

If the pain sits at the front of the groin and catches when you lift your knee, climb stairs or swing your leg into the car, the hip flexors may be involved. The main one, iliopsoas, runs deep from the lower spine and pelvis to the top of the thigh bone. Strains here often follow sprinting or kicking, and the pain can feel deep, as though you cannot quite put a finger on it.

Groin tendon pain

Not every groin problem starts with a single moment. Tendon pain where the adductors attach near the pubic bone tends to build gradually, often in footballers and runners who have stepped up their training. It is typically stiff and sore at the start of activity, may ease as you warm up, then aches afterwards or the next morning. Tendons respond to carefully graded loading, which is a large part of what a physiotherapist does.

The hip joint

The hip joint sits deep in the groin, so hip problems are often felt there rather than on the side of the hip. In older adults, hip osteoarthritis commonly shows up as groin pain with stiffness, especially when putting on socks or getting out of a low chair. In younger, active people, problems with the shape of the joint or the cartilage rim around it can cause a deep, pinching pain in deep squats or after sitting for a long time.

Hernia, pubic pain, pregnancy and other causes

An inguinal hernia can cause a dragging ache and a lump in the groin that gets bigger when you cough or strain and smaller when you lie down. Pain over the pubic bone can come from the joint at the front of the pelvis. In pregnancy this is often part of pelvic girdle pain, which we cover in our guide to SPD and pelvic pain in pregnancy. The lower back can also refer pain into the groin and inner thigh.

There are medical causes too, including swollen glands from an infection, kidney stones, and problems with the testicles or, in women, the pelvic organs. A GP needs to look at these. A good physio will ask questions to screen for them, and if your symptoms do not fit a muscle or joint pattern, they will send you back to your doctor.

Symptoms of a torn groin or groin strain

A groin strain usually announces itself during activity. You might feel a sudden sharp pain high on the inner thigh, sometimes with a pulling or popping sensation, and have to stop. Afterwards the area is tender to touch and it hurts to bring your legs together against resistance. With a bigger tear, bruising can appear on the inner thigh a day or so later and slowly track down towards the knee.

The signs people most often describe after a strained groin muscle are listed below. You may have only a few of them, and a mild strain can feel like little more than tightness that you notice the next morning, or when you first try to jog again.

• sharp pain in the groin or inner thigh at the moment of injury
• tenderness when you press along the inner thigh
• pain squeezing your knees together, or lifting your leg forwards or out to the side
• a limp, or pain when walking quickly, climbing stairs or getting in and out of a car
• swelling or bruising, which is more likely with a larger tear
• weakness, or a sense that the leg will not do what you ask

Grades of groin strain

Muscle strains are often described in three grades. A grade 1 strain is a mild overstretch, with tightness and soreness but little loss of strength. A grade 2 strain is a partial tear, with more pain, a limp, weakness and often bruising. A grade 3 strain is a severe or complete tear, with intense pain, marked weakness and sometimes a dent you can feel. Anything that looks like a grade 3 groin tear should be seen by a doctor.

Treat the grade as a rough picture only. Two people with the same grade can recover quite differently, depending on where exactly the tear is, what they need the leg to do, and how the early stage is managed. When a groin muscle tear involves the tendon close to the bone, a medical opinion and sometimes a scan may be needed before rehab starts.

How to treat a groin strain in the first few days

For a fresh strain, NHS advice on sprains and strains is a sensible starting point. For the first couple of days, protect the area and stop the activity that caused it. Ice can help with pain and swelling: use an ice pack or frozen peas wrapped in a tea towel, never straight on the skin, for short spells. A compression bandage or snug shorts can feel supportive, and resting with the leg comfortably supported helps too.

In those first days, try to avoid heat such as hot baths and heat packs, alcohol and massage, as they can increase swelling. A pharmacist can advise on painkillers, such as paracetamol or an anti-inflammatory gel, and whether they suit you. The NHS guide to sprains and strains sets out this early care and when to get help.

What to do for a pulled groin muscle after that

Once the sharpest pain eases, gentle movement usually helps more than complete rest. Walk as normally as you comfortably can. Easy exercises include lying on your back and letting your knees drift slightly apart, or squeezing a pillow between your knees with light effort. Keep to mild discomfort at most, and do not stretch hard or push into pain. If a movement makes the pain sharper, or it is still sore the next day, ease off.

A few habits tend to slow people down: stretching a fresh strain hard, trying to run it off, and going back to five-a-side as soon as walking feels fine. Groin injuries often come back when people return before the muscle has regained its strength. A structured rehab plan builds that strength back before you return to sport.

When groin pain needs a GP or urgent help

Most groin strains can be managed without a doctor, but some symptoms need checking first. Use the list below to decide where to go; only a doctor can tell you what is causing the symptoms. If you are unsure, NHS 111 can advise you by phone or online. A physiotherapist who sees any of these signs during a visit will stop and point you to the right service.

• Sudden, severe pain in a testicle, or testicle pain with feeling or being sick or tummy pain: go to A&E or call 999 straight away.
• A lump, swelling or change in shape of a testicle: ask for an urgent GP appointment or contact NHS 111.
• A lump in the groin that gets bigger when you cough or strain, which may be a hernia: see your GP. The NHS page on hernias describes the usual signs.
• A hernia, or a groin lump, that becomes painful, especially with a bloated tummy, being sick or constipation: contact NHS 111 urgently.
• Severe hip or groin pain after a fall, especially in an older person who cannot stand or put weight on the leg, or whose leg looks shorter or sits at an odd angle: call 999, as this can be a broken hip.
• You heard a crack at the moment of injury, or the leg is numb, tingling or an odd colour: go to A&E. If you cannot put weight on it or walk more than a few steps, contact NHS 111.
• Back pain with numbness around your genitals or bottom, or new problems peeing or pooing: call 999 or go to A&E.
• Groin pain with a high temperature, or feeling hot and shivery: contact your GP or NHS 111.
• Pain that is getting worse, or not improving after a spell of sensible self-care: see your GP or a physiotherapist.

Call 999 for chest pain, sudden weakness or numbness, or signs of a stroke. This platform facilitates booking only. It does not provide medical advice. If an older relative has been treated in hospital after a fall, our guide to home physio after a fall explains what rehabilitation at home can look like.

How long does a groin strain take to heal?

It varies by person. There is no standard groin injury recovery time, and we will not put a number on it, because a mild overstretch in someone who walks the dog and a tendon-level tear in a footballer are very different injuries. What we can explain is what tends to shape groin strain recovery, whether you call it a groin pull, a strain or a tear, so you know what to watch and what to ask your physiotherapist.

• how much of the muscle or tendon is injured, and exactly where
• whether this is a first injury or the latest in a run of groin problems
• what you need the leg to do, from walking to work to sprinting and kicking
• how the early stage is managed, including not rushing back
• your general health, sleep and strength before the injury
• whether some of the pain is actually coming from the hip, back or pubic area

Physiotherapists judge progress by milestones. Can you walk, jog and climb stairs without pain? Can you squeeze your knees together hard without it hurting? Is the injured side about as strong as the other one? Can you sprint, turn and kick at full effort? Each milestone tells you that you are ready for the next step, and a missed one tells you to slow down. The NHS page linked above gives general guidance on how strains heal.

How a physiotherapist treats a groin strain

Groin strain treatment starts with a proper assessment. Your physiotherapist will ask how it happened, what makes it worse and whether you have any other symptoms. They will then check your hip movement, test the adductors and hip flexors, press along the tendon and pubic area, and look at your lower back. That helps separate a simple muscle strain from tendon pain, a hip joint problem or something that needs a GP, and they will explain what they find in plain language.

Groin strain therapy then usually moves through stages, although the plan is always built around you, your injury and what you want to get back to, whether that is a Sunday league match or a long day on a building site. A typical outline looks like this:

1. Settle the pain, with activity advice, early care and gentle movement that does not stir things up.
2. Restore movement, so the hip moves comfortably and you can walk without a limp.
3. Build strength, starting with squeezes against a ball or pillow, then side-lying inner thigh lifts and bridges, and later harder exercises such as the Copenhagen adductor plank.
4. Add speed and sport, such as jogging, side-stepping, changes of direction, kicking and drills for your sport.
5. Return to play, with training first and matches later, once strength and confidence are back.

Hands-on treatment such as soft tissue work may be used for comfort, but strengthening does most of the work in rehab after a groin muscle tear. Your physio will also look at what may have contributed, such as a sudden jump in training, weak hip muscles or stiff hips, and build that into the plan, with the aim of lowering the chance of it happening again. If you have had a hamstring strain before, our article on pulled hamstring recovery follows a similar approach.

UK Physio Tip: Use a pillow squeeze to track your progress. Lie on your back with your knees bent, put a firm pillow between your knees and squeeze slowly. Notice how hard you can press before it starts to hurt, and try again every few days. If you can squeeze a little harder each time, you are heading the right way. If it suddenly gets worse, ease back and tell your physio.

Physiotherapy for groin pain at home or online

A groin injury makes travel awkward, and driving is often the worst part, because lifting the leg in and out of the car is exactly the movement that hurts. With FlexAura, an HCPC-registered, DBS-checked physiotherapist comes to your home anywhere in England, Scotland and Wales. They can assess you, teach your exercises in the space you will use, and progress the plan at follow-up visits. Our sports injury physio at home page explains more about rehab for active people.

If you would rather start with advice, an online video consultation is £45 and available anywhere in the UK. A home visit is £110 for the first visit and £99 for follow-ups, and a 5-session home package is £450. Prices are the same everywhere, the physio's travel is included, you pay after the visit, and there are no cancellation fees. Our pricing page has the details.

You do not need a GP referral. We match a physiotherapist to your booking and confirm who is coming and when before the visit, and if nobody can come, you pay nothing. If you have private health insurance, check your policy before you book. If you hurt your groin at work, some of our physios are occupational health physiotherapists who can help with a return-to-work plan.

You can read more about physiotherapy at home before you decide. When you are ready, book a physiotherapist online, call 07782 610 633 or WhatsApp us, and tell us a little about the injury so we can match the right physio to you.