How to diagnose and
treat groin pain

How do clinicians diagnose groin pain?

When you see a clinician for groin pain, the first step is usually a detailed conversation about your story, not just a quick look at a scan.¹ ¹⁰ ¹⁵ They will ask where you feel the pain, when it started, what sports or activities you do, and which movements or positions make it better or worse, such as sprinting, kicking, sit ups, or getting out of a chair.¹ ² ³ ¹⁵

They will also ask about your training load, recent changes in volume or intensity, previous groin or hip injuries, and any concerns about hernias, bone stress, or hip joint problems.¹ ⁵ ⁶ ¹⁰ ¹¹ ¹⁵ Questions about night pain, pain at rest, major limping, or sudden swelling help them screen for more serious causes such as femoral neck stress fracture or hernia complications.¹⁰ ¹¹ ¹² ¹⁴ ¹⁵

Clinicians often use the Doha agreement system to organise your symptoms into helpful groups such as adductor related, pubic related, inguinal related, hip related, or other causes like nerve or bone stress.¹ ¹⁵ This makes it easier to see whether your pain is mainly from the inner thigh muscles, the pubic bone, the abdominal wall and inguinal canal, the hip joint, or a mix of these.¹ ¹⁵

Next comes a focused physical examination. Your clinician will usually check the following:¹ ⁴ ⁵ ⁶ ⁷ ¹⁵

• Tenderness along the adductor muscles and their attachment on the pubic bone
• Pain when you squeeze your legs together in different positions
• Soreness directly over the pubic symphysis in the midline
• The inguinal area for tenderness, weakness, or a hernia bulge
• Hip range of motion and tests that load the hip joint
• Core and trunk control, single leg balance, and change of direction movements

In active people, your clinician may also use questionnaires like the Copenhagen Hip and Groin Outcome Score to measure symptoms and track progress over time.⁴

Not everyone with groin pain needs a scan right away. Many adductor related and pubic related problems can be diagnosed from the history and examination and respond well to exercise based care. Imaging is more likely to be recommended if:⁷ ¹⁰ ¹¹ ¹² ¹⁷

If imaging is needed, plain X rays are usually the first step. An MRI can show stress injuries and hip joint changes.⁷ ¹⁰ ¹¹ ¹² ¹⁷ Ultrasound can assess adductor tendons and inguinal structures.¹⁰ ¹³ ¹⁷

If your clinician is worried about a femoral neck stress fracture, urgent imaging and orthopaedic review are needed.¹⁰ ¹¹ ¹² If there are signs of an incarcerated hernia or testicular torsion, emergency surgical assessment is recommended.¹³ ¹⁴ Throughout this process, the goal is to match symptoms, exam findings, and imaging into a clear working diagnosis.¹ ⁷ ¹⁰ ¹⁵

Clinical insight

Modern guidelines encourage clinicians to use clear categories rather than vague labels like “groin strain.” This matters because many athletes have more than one problem at the same time. Clinicians also stay alert to serious bone stress injuries, because early MRI and protection reduce complications.¹ ¹⁰ ¹¹ ¹² ¹⁵

What are the treatment options for groin pain?

Groin pain treatment is usually stepwise. Most people start with education, load management, and targeted strengthening rather than injections or surgery. The aim is to rebuild strength and return safely to sport.¹ ⁵ ⁶ ⁷ ¹⁵

Education and load management

Treatment often begins with changes to training volume and intensity. This may include gradually reintroducing high demand drills. Your clinician will also help identify aggravating movements and how to modify them.¹ ⁵ ⁶ ⁷ ¹⁵

Exercise-based rehabilitation

Exercise-based rehab is the core of care.¹ ⁵ ⁶ ⁷ ¹⁵

Adductor related groin pain Active strengthening is more effective than passive treatments.⁵ Modern programs include progressive adductor loading with hip and trunk strengthening.⁵ ⁶ ¹⁵

Pubic related pain Rehab combines graded strengthening with a careful return to sprinting and kicking.¹⁵ ¹⁷

Inguinal related pain Conservative care focuses on core and adductor strength before surgery is considered.¹ ¹³ ¹⁵

Hip related groin pain Both surgery and conservative care can improve symptoms, with surgery helping some selected patients more in the short term.⁷ ⁸ ⁹

Medications

Short courses of pain relief or NSAIDs may help symptoms but are not a long term solution.¹ ⁵ ¹³ ¹⁵

Injections and other procedures

Injections or shockwave therapy may be used when rehab progress stalls.¹³ ¹⁷ ¹⁸

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
• Proven results for pain relief, movement, and satisfaction

How can I find pain relief for groin pain?

Many people can start with low risk steps. 

• Adjust training load gradually
• Use pain scales to guide activity
• Build hip and trunk strength
• Use short term pain relief if appropriate

Persistent or recurring groin pain should be assessed.¹ ² ⁵ ⁶ ¹⁵