Athletic Groin Injury Causes and Risk Factors

Ice hockey, soccer, and football players have the highest risk for adductor strain (also called a groin strain or pulled groin muscle), which is the most common type of groin injury. Rapid starts and stops while running and jumping are the chief causes of this injury.

Causes of Groin Injury

Common causes of groin injury and pain include, but are not limited to:

• Repetitive stress. There are several bony structures in the hip, pelvis, groin, and upper leg that can be subject to overuse stress fractures. These bones include the femoral head, the femoral neck, and the pubic ramus bone, among others. Other common groin injuries such as osteitis pubis and snapping hip syndrome are typically associated with repetitive stress that occurs over a long period of time.

See Stress Fracture Causes and 3 Types of Snapping Hip Syndrome

• Short, intense training periods. Some types of injuries that are typically associated with long-term overuse, such as pelvic stress fractures and osteitis pubis, may also develop quickly as a result of an intense training over a brief period, such as preparing for an upcoming sports event or dance recital.
• Not resting following an acute groin injury, such as an adductor strain (groin pull). If an athlete “plays through the pain” rather than taking an appropriate break from the sport(s) that contributed to the groin problem, an acute groin injury can become chronic.

See Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours

In addition to ice hockey, soccer, and football, some other sports and activities that commonly contribute to groin pain and injury in athletes include:

• Distance running
• Track and field events, especially hurdling and high-jumping
• Gymnastics
• Basketball
• Ballet
• Rugby
• Triathlon
• Wrestling
• Figure skating

Other groin injury risk factors

There are a number of factors that can increase an athlete's risk of groin injury, including:

• Adolescent girls are at a higher risk of stress fractures in the groin area and elsewhere,¹Morelli M. Groin injuries in athletes. Am Fam Physician. 2001. Oct 15; 64 (8): 1405-1415. http://www.aafp.org/afp/2001/1015/p1405.html . Accessed December 5, 2014. though they can occur in both sexes and at many ages.
• Adolescent athletes of both sexes are at higher risk for avulsion fractures in the pelvis than adults.¹Morelli M. Groin injuries in athletes. Am Fam Physician. 2001. Oct 15; 64 (8): 1405-1415. http://www.aafp.org/afp/2001/1015/p1405.html . Accessed December 5, 2014.
• Military recruits undergoing basic training and athletes increasing the number and intensity of their training sessions frequently experience stress fractures.²Roos HP. Hip pain in sport. Sports Med Arthroscopy Rev. 1997; 5: 292-300. http://journals.lww.com/sportsmedarthro/Abstract/1997/10000/Hip_Pain_in_Sport_.7.aspx . Abstract accessed December 5, 2014.
• Sudden changes in athletic foot gear or playing surface can increase the risk of stress fractures.³Rolf C. Pelvis and groin stress fractures: a cause of groin pain in athletes. Sports Med Arthroscopy Rev. 1997; 5: 301-4. http://journals.lww.com/sportsmedarthro/Abstract/1997/10000/Pelvis_and_Groin_Stress_Fractures__A_Cause_of.8.aspx . Abstract accessed December 5, 2014.
• Overuse-related groin injuries’ gradual onset and relative low level of pain means that many athletes ignore symptoms until the injury becomes severe, which can complicate otherwise easy-to-treat injuries.
• Men are at greater risk of hernia, especially inguinal hernia.

While the above factors can increase athletes’ risk for sustaining a groin injury, people without any of the above can also develop groin injuries.