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Massage Therapy and Hip or Groin Pain?

Why do I have Groin or Hip pain?

Groin pain: Pain which is localized to the inguinal region or crease (The depression between the thigh and trunk.)
Common causes of Groin pain or discomfort:
The causes of groin pain are many, however commonly hip and groin pain are caused from the following:

  1. Osteoarthritis
  2. Congenital hip dysplasia
  3. Iliopectineal bursitis
  4. Labral tear, synovial pit
  5. Groin strain/Pull
  6. Pregnancy
  7. Hernia (inguinal), Athletic hernia
  8. Femoral neck fractures (seniors)
  9. Ankylosing Spondylitis
  10. Hip Flexor strain
  11. Hip dislocations
  12. Femoral nerve entrapment

The following information will discuss common signs, symptoms, and management of conditions listed 1-5. The discussion is meant to be in “lay terms” so that the general public is able to follow some basic information without having a medical or an anatomy background.
Tabers 14 edition page 610


Osteoarthritis (OA) or Degenerative joint disease

Hip pain or discomfort due to osteoarthritis usually starts with people who are in the forties or fifties and occasionally later in the sixties. Men and women are equally affected.

How do I know if my groin pain is generated from Osteoarthritis (OA)?

Signs and Symptoms:
Most people experience some form of morning hip stiffness that lasts for an hour or so after waking. The morning stiffness is somewhat relieved by walking or stretching or by taking a hot bath, however the hip or groin pain tends to return later in the day, particularly after long walks or prolonged sitting or driving. Pain may not be limited to the groin area. The pain can be experienced also in the buttocks/gluteals, low back, thigh or hamstring areas.
Limited range of motion (rom) is another common finding with hip OA, in other words the inability to turn the thigh inwards (internal rotation) and or backwards (extension) and sometimes bending the hip/knee towards the chest (flexion).
Imaging such as x-rays, ultrasound, MRI or Cat scans can be useful in the diagnosis of AO.

What can be done to manage this condition?

Pain or discomfort experience with OA can be managed with massage, joint mobilizations, stretching and appropriate exercise therapy. Weight management is often a relieving factor in pain management. Exercising in water or swimming pool helps relieve the stress on the weight bearing joints and can help to reduce pain.
Advanced OA of the hip usually results in having a hip replacement.

Hip Dysplasia

Abnormal development or malformation of the head and or socket of the hip joint. The hip socket may be too shallow or the head of the femur (hip bone) is not round or has a flattened appearance.

How do I know if my groin pain is generated from hip dysplasia?

Signs and Symptoms:
Hip dysplasia is a condition that is from birth. Hip dysplasia is usually diagnosed at birth by the attending physician by doing an examination and hip range of motion assessment (ROM). Occasionally it is discovered later when the baby is learning/attempting to crawl and is having difficulties as the hip may be dislocating. Imaging such as x-rays, ultrasound, MRI or Cat scans can be useful in the diagnosis.

Hip pain or discomfort from a dysplasia is usually a feeling of tight muscles in the front of the hip or in the groin area. Pain is often felt in the buttock/gluteals, low back, thigh or hamstrings area. The hip(s) may be sore after prolonged activity such as walking, running or standing. The hip(s) may to turned in (toes pointing inwards) and may appear to have limited outward rotation (toes pointing outwards)

What can be done to manage this condition?

Pain or discomfort experience with hip dysplasia can be managed with massage, joint mobilizations, stretching, and appropriate exercise therapy. Weight management is often a relieving factor in pain management.

Iliopectineal bursitis/iliopsoas bursitis

Swelling or inflammation of the bursa that lies beneath the hip flexor muscles. (in the crease where the thigh joins the body)
What is a bursa? Answer: A bursa is a cushion or pad like structure that is used to protect muscles and tendons from fractioning or rubbing against bones, ligaments and tendons.

How do I know if my groin pain is generated from iliopectineal/iliopsoas bursitis?

Signs and Symptoms:
If you feel a swelling or pressure in your inguinal crease area after activity such as hiking, running or sporting activities you may be experiencing a bursitis in the hip.  Bursa are sacs lined with membranes that produce fluid. Sometimes the membranes produce too much fluid with causes them to swell much like a joint that swells after an injury or irritation. The iliopectineal bursa is a specialized bursa that protects the hip flexors (iliopsoas muscle) from rubbing on the pelvis so if this muscle is overused in activities such as running, the bursa can swell causing pain in the hip crease area.

What can be done to manage this condition?

Before strenuous activity, warm up the hips with fast walking or a slow jog followed by stretching the hip flexors (iliopoas, quadriceps) and extensors (hamstrings).
Stop the activity if the hip(s) are getting sore. Stretch after the activity as you did in your warm-up. Apply cold or ice to reduce or prevent any swelling.

Labral tear/synovial pit

A labral tear is when the cartilage ring that surrounds the hip joint is torn or becomes detached from the surrounding bone. This may be associated with some of the surrounding membranes being trapped in the torn cartilage (synovial pit).
This injury may occur with a traumatic event such as a fall or collision or in sports.  This type of condition may also occur without any precipitating event or any mechanism of injury. This condition is usually associated with active people involved in sports which can damage the hips; examples are hockey, gymnastics, basketball and soccer.

How do I know if my groin pain is generated from a labral tear?

Signs and Symptoms:
Pain is often felt while weight bearing on the affected leg. The person may feel that the hip is weak or unstable. There is sometimes a clicking or catching sensation within the hip with certain leg movements like extension and rotations. Hip flexor spasms may be experienced in the groin area.
This condition affects the ability to continue to perform sporting activities and therefore can severely limiting.

What can be done to manage this condition?

It is important to get a proper diagnosis.
Imaging such as x-rays, ultrasound, MRI or Cat scans can be useful in the diagnosis.
Strengthening the muscles around the hip can help reduce the symptoms associated with a cartilage/labral tear. In some cases surgery may be recommended to repair or remove the damaged cartilage.

Groin strain/Pull

A groin strain or pull is when the muscles on the inside of the thigh as strained or torn.
This can occur close to or on the bone (pubis) to which the muscles attach. It can be a minor strain in which only a few of the muscle fibres are damaged or can be a major tear where a substantial amount of the muscle fibres have torn or pulled away from the pelvic bone (pubis). This condition is usually associated with active people involved in sports, examples are: hockey, gymnastics, basketball and soccer.

How do I know if I have a groin pull or Stain?

The onset of the symptoms is sudden with a groin pull. There is usually intense pain as the inner muscle of the thigh. Weight bearing on the affected leg is causes pain in the groin.

What can be done to manage this condition?

After the initial injury it is important to use the “PRICE” protocol.
P” is to Protect the area from further injury in other words stop the activity immediately.
R” is to Rest. Depending on the severity of the injury it may be necessary to allow enough time for the muscle(s) to heal, this may take up to 6-8 weeks or more.
I” is to Ice the area. Icing helps to control the swelling and reduce the pain.  Place a wet towel with crushed ice in it or cold pack application for 10 -15 minutes helps to reduce pain and control inflammation.
C” is to Compress. Use a tensor bandage to stabilize the groin muscles for a few days.
E” is to Elevate. Raising the legs helps to control swelling and bruising.

If you have any of the above conditions book an appointment with Mike Dixon RMT at www.dixonmassagetherapy.com

To make an appointment with our highly qualified massage therapists in Tsawwassen, please contact us today!