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Physical therapy for groin complaints.

Physio Vital stands for modern physical therapy. In our physical therapy practice, the focus is on orthopedic rehabilitation. This means that we treat injuries to tendons, muscles, bones and/or joints. Sometimes nerves are indirectly involved. We make the treatment plan as transparent as possible so you understand where you stand. Our approach consists of a combination of the latest scientific insights combined with years of expertise in the field of injury treatment. Within these frameworks, we offer an exclusive service and there is always room for personal preference. Our treatment is designed to give people back their autonomy over their bodies. Fysio Fitaal Tilburg consists of a team of experts with a passion for physiotherapy and always goes for a sustainable result.

  • About 33% of all cases involve an acute injury
  • The moment of injury is then obvious and often happens during explosive movements during sports
  • In 66% of cases, the symptoms gradually increase to a point where the sport can no longer be performed adequately

Groin pain is common in athletes. Especially in sports where there are many changes in speed and direction. Think sprinting, turning, slowing down and jumping. In this case, it is often a muscle injury. Therefore, this is the most common cause of groin pain in adults. The muscles in the groin are called the adductors and are responsible for the force in the hip inward. The adductors are very important during different types of sports such as: soccer, sprinting, rugby and field hockey. Besides the adductors, other muscles of the hip and muscles in the abdominal region can be the reason for the symptoms. In addition to muscle injuries, groin pain can also result from problems at the hip joint.

Gradations of a groin muscle injury

With a muscle injury, we use different degrees. Namely, it is possible that there is only muscle pain or a mild strain. But it is also possible that there is a muscle tear or even a complete tear. 


  • 1A Fatigue of the muscle which can result in muscle strain, usually due to overuse or exercising on a different surface.
  • 1B Muscle pain, generalized muscle pain of the adductors, usually caused by powerful moments of braking during sports.
  • 2A Muscle injury resulting from radiating pain from the low back 
  • 2B A local neuromuscular dysfunction of the muscle
  • 3A Small local muscle tear less than 1 muscle bundle 
  • 3B Medium-sized muscle tear, multiple muscle bundles involved in the injury 
  • 4A (Sub)total muscle tear, avulsion fracture 
  • 4B Muscle contusion due to severe collision with outside person or object
Cruciate ligament injury

Tendon pain in the groin

Groin pain can also be caused by a tendon injury. We call this a tendinopathy of the adductors. Previously, it was also called tendinitis. An acute tendonitis is called tendinitis. Itis a suffix in the medical world indicating which part is inflamed. Tendo is tendon in Latin. So inflammation of the tendon. The irritation is from overuse and not from any other condition in the body. So you also don't have a fever with this form of inflammation. Sometimes this is accompanied by an injury to the lower abdominal muscles. Often the symptoms begin with some stiffness before and after exercise. After that, the pain is often continuous during sports. Performance often decreases and eventually performing your sport is no longer possible. Sometimes there may be swelling. Scientific research indicates that after the inflammation phase, eccentric training is necessary to rebuild the quality of the tendon tissue. Eccentric training means that you deliver force while lengthening the muscle. In this way, the tendon is stimulated to produce stronger new fibers in the proper tensile load of the tendon. This allows the forces to be properly transferred back to the bone.

Risk factors for developing a groin injury

  • A previous injury to the groin region

  • Reduced strength of the adductors, proper rehabilitation is therefore crucial
  • Reduced hip mobility
  • Reduced control of the pelvis/low back
  • Top Sports
  • Fatigue
  • Moderate preparation for competition


Groin pain due to complaints in the hip joint

Possibly the groin pain is caused from a structure in the hip. So in this case, it is not a muscle in the hip that is sensitive. The capsule of the hip, the labrum or extra bone growth on the head or socket of the hip may be causing the pain. 

Femoro Acetabular Impingement(FAI)

FAI occur when there is extra bone growth at the head or at the socket of the hip joint. Extra bone growth on the head of the hip is called the CAM type. Extra bone growth on the acetabulum (socket) is called the PINCER type. There can also be both, this is the mixed type. In the long run, this can cause problems with the cartilage of the hip and/or the labrum.

How is a groin injury diagnosed

A muscle injury in the groin is often confirmed by pain with tightening, stretching and palpation of the injured structure. You may be able to see some fluid or damage on an ultrasound image, but in most cases, additional examination is not necessary for a muscle injury. In complaints caused from the hip, we often see a restriction of movement in that joint. Also, the symptoms have often been present for some time and have slowly gotten worse over time. Should the source of pain come from the hip joint, additional examination is often indicated. First, the physical tests must indicate a suspicion of a problem coming from the hip. 

Knee osteoarthritis

Physical tests for groin pain

Several tests can be performed when an injury in the groin region is suspected. Here we distinguish between muscle injuries and problems from the joint. 

Muscle strength testing hip

The adductors bring the leg inward. In a flexed and extended position of the knee, the hip can be muscle-tested inward. 

Stretch and palpation of the muscle group

With the knee in an extended and flexed position, the leg is brought outward. If there is recognizable pain, the test is positive. Palpation of the adductors may also give recognizable pain. 

Faber test

Faber stands for Flexion ABduction and External Rotation. When there is pain with the combination of these three movements in the hip, a statement can be made about possible complaints in the hip, low back or pelvis. Depending on where the symptoms occur.

Fadir test

Fadir stands for Flexion, ADuction and Internal Rotation. When there is pain with the combination of these three movements in the hip, a statement can be made about the involvement of the joint in relation to the symptoms experienced.

Kevin van Geel

The different stages in the treatment of a groin injury

Successful rehabilitation consists of several stages and steps. Good strength, stability and control is necessary to safely return to your sport. 

Adjusting the (training) load

In this phase, we focus primarily on symptom reduction. There is often pain and reduced mobility of the hip. Therefore, it is important to regain good control over your hip movements. This is achieved through exercises of the muscles and possibly supportive treatments. With muscle injuries, you may experience some discomfort with exercise. A pain score of 3 on a scale of 0-10 is acceptable. So is the response to exercises afterward. 

Strength and coordination phase

In this phase there is more of a build-up in strength. How quickly this is built up depends on the reaction to the given load. Because the risk of a new injury is greater after a previous injury, it is extremely important to make a lasting build-up in strength and coordination. This is often greatly underestimated and the risk of a new injury is greater than intended. 

Sport-specific phase

The final phase focuses particularly on maximum strength, jumping power and explosiveness. This is all necessary to quickly change direction within your sport. We also work towards a competitive condition so that you can continue to perform under fatigue. The quality of movement must remain good under these conditions.

Sports Resume

The timing of sports resumption remains a difficult decision. This is because there is a proven criteria for sports resumption. Wanting to start again too soon often leads to a new injury. In all cases, the athlete must be able to sprint again painlessly, maximize leg muscle tone and perform sport-specific skills such as shooting a ball. In addition, the movement pattern must be sufficiently improved to allow for a dosed build-up in training before resuming (competition) matches. 

Rehabilitation at Physio Fitaal

In certain phases it will probably be slower than you had thought beforehand. Our specialists will guide and motivate you as much as possible during this process. Fysio Fitaal works with specialists in the field of sports rehabilitation. Because of this combination of expertise, extensive facilities and passion for sports, you have come to the right place.

Team Physio Vital

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