Living with groin pain
Groin pain can be frustrating because it is a symptom, not one single diagnosis, and the “right” fix depends on what is actually being irritated. In active adults and athletes, groin and hip problems make up a meaningful share of sports injuries, especially in cutting and kicking sports, and they often return if the root cause is not addressed.¹
In older adults, hip osteoarthritis can show up as deep groin pain with stiffness, and most people can begin treatment without imaging.² The good news is that many common causes improve with guided, progressive exercise and smarter load management.¹
What are the symptoms of groin pain?
- Deep ache or sharp pain in the crease of the hip or inner thigh
- Pain with sprinting, cutting, kicking, skating, or quick direction changes
- Pain when squeezing the knees together or pushing the leg inward
- Pain with hip flexion activities like hill walking, sit-ups, or getting into a car
- Discomfort with coughing, sneezing, or straining, often more toward the groin canal or pubic area
- Clicking, catching, or a “C-shaped” deep pain in the front of the hip
- Stiffness, reduced hip movement, or trouble turning in bed, which is common with hip arthritis²
Did you know?
Many people assume groin pain always means a “sports hernia,” but expert consensus recommends classifying groin pain by the most likely irritated area because this approach better guides rehabilitation and next steps.¹
What causes groin pain?
Groin pain can come from muscles, tendons, the hip joint, the abdominal wall, or sometimes non-muscle causes. A widely used sports medicine framework groups groin pain by the structure most likely being irritated based on symptoms and exam findings, which helps guide the right rehabilitation plan.¹
Common musculoskeletal causes and risk factors include:
- Adductor-related pain, involving the inner-thigh muscles and tendons, often worse with cutting and kicking, and linked to lower adductor strength and prior groin injury¹
- Iliopsoas-related pain, involving the front hip flexor, often worse with hip flexion and stretching
- Inguinal-related pain, involving the groin canal region, often worse with coughing, sneezing, or abdominal bracing, even without a clear hernia¹
- Pubic-related pain, involving the pubic bone and nearby attachments, often worse with single-leg loading and direction changes
- Hip-related pain, coming from inside the hip joint, including femoroacetabular impingement syndrome, which requires symptoms plus exam findings and imaging, not hip shape alone³
- Hip osteoarthritis, more common with age, often causing deep groin pain with stiffness, and usually managed first with education and exercise²
Seek a doctor right away if you notice:
- Fever, severe illness, or a hot, very painful hip with trouble bearing weight
- New groin pain with night pain or strong pain when weight-bearing, especially if you are a runner, in the military, or have bone stress risk factors
- Pregnancy with severe pelvic or lower belly pain
- Sudden, severe testicular or scrotal pain, especially with swelling or nausea, which may be testicular torsion and is a time-sensitive emergency⁴
- A painful groin lump that is tender and will not go back in, especially with vomiting or fever
- Blood in the urine, severe flank pain, or symptoms suggesting a kidney stone or urinary infection
How is groin pain treated?
Most people improve with active care, which includes understanding the main driver, adjusting aggravating loads, and building strength and control over time. Surgery is usually reserved for specific problems, such as a true hernia, certain stress fractures, or persistent hip impingement symptoms after a high-quality rehabilitation trial.¹⁵
Typical groin injury treatment options
- Education and activity changes: Short-term reduction of the biggest triggers, like hard sprinting, cutting, or maximal kicking, followed by a gradual return with better pacing and load control.¹
- Exercise-based rehabilitation: Progressive strengthening and movement retraining matched to the likely pain category. In long-standing adductor-related groin pain, active training has outperformed passive treatment in clinical trials, and many athletes need at least 8 to 12 weeks of progressive rehabilitation before full return-to-sport testing.⁶
- Medications, such as NSAIDs: Sometimes used short term for pain flares, if safe for you. For suspected bone stress injuries, prolonged use is generally avoided.
- Injections, if needed: Sometimes considered for specific diagnoses, usually after a solid rehabilitation trial, since long-term benefit can be uncertain.
- Surgery, for persistent or severe cases: Hip arthroscopy may be considered for femoroacetabular impingement syndrome when symptoms, exam findings, and imaging fit and structured rehabilitation has not been enough. In a major trial, both surgery and physiotherapy improved outcomes, with surgery showing a modest average advantage in selected patients.⁵
Sword's approach
Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.
Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.
- Care that adapts to your progress in real time
- Licensed experts guiding every step
- Simple, non-invasive, evidence-based programs
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