Sports Therapy

Groin Pain? It could be coming from the hips…

On October 18, 2011
By Dr. Nekessa Remy | 2 Comments

Most of us assume that pain in the groin is the result injuries like a groin pull or perhaps a hernia. However 22% of athletes with groin pain suffer from what is know as a labral tear.

The labrum is a fibrocartilagionous structure that outlines the socket of the hip joint. It has many functions including shock absorption, joint lubrication, and pressure distribution and aiding in hip stability.

Labral tears are often the result of trauma (including repetitive strain injuries), capsular laxity/hip instability, degeneration and hip joint impingement. However 74% are not associated with any known specific event or cause, and these are generally insidious in onset, with the underlying cause thought to be repetitive micro trauma.

Athletic activities that involve repetitive pivoting motions and specific activities such as soccer, hockey, golf and ballet have been linked to labral abnormalities because they require frequent external rotation of the hip.  Some tears have also been attributed to running and sprinting.

90% of patients diagnosed with labral tears complain of anterior hip or groin pain. Other common symptoms include clicking, locking, catching, or giving way of the affected hip. The pain is often a constant dull pain with intermittent episodes of sharp pain that worsens with activity.  Walking, pivoting, prolonged sitting, and impact activities, such as running, often aggravate symptoms. 71% of patients also describe night pain as a common symptom.

For a proper diagnosis you should visit your chiropractor. The best method for diagnosing labral tears is with an MRA, Magnetic Resonance Arthrography that would require a referral from a family physician.

How to avoid a labral tear?

There is an associated postural dysfunction that is associated with developing labral tears, called lower crossed syndrome, which involves a pattern of muscular imbalance in the pelvis.

Lower crossed syndrome can develop from too much sitting and slouching with no low back support. The resultant posture is a pelvis that is rotated forward and a low back that is arched or extended too much.  This causes the lower back muscles or erector spinae to continually contract to hold the body’s weight upright while the constantly flexed position shortens the muscle length of the iliopsoas and rectus femoris muscles.  Through continued concentric contraction or in a shortened position, the muscles adapt and shorten in length leading to muscle tightness. However, since the body acts like a series of pulleys and levers, when one muscle gets shortened, it usually means that another muscle gets lengthened.  This phenomenon is known as reciprocal inhibition.

In the case of lower cross syndrome the muscles which are tight or short require stretching and the muscles that are lengthened or weak require strengthening.


Muscles requiring stretching include:

  • Iliopsoas
  • Rectus femoris
  • Erector spinae
  • Piriformis
  • Tensor fascia latae (TFL)
  • Leg adductors

Muscles requiring strengthening:

  • Abdominal group (transverse abdominus)
  • Gluteal group

To learn more about exercises geared towards reducing lower crossed syndrome or to book an appointment with Dr. Remy,  please send an email to

2 comments on Groin Pain? It could be coming from the hips…
Kaye Kabin
  • Apr 25 2013
Hi I have had groin pain in the left groin for about a year. I have been to a chiropractor who said the pelvis had been moved in a D&C and now I am at a physio who says it is from my L2 in my spine. My posture is poor. I don't feel any pain while sitting or lying and it can be from slight pain in both groins and hips to extreme pain causing limping in my left leg and groin and hip when moving. Any ideas to add to my pain killers and anti-inflammatories. thanks Kaye
Dr. Nekessa Remy
  • Apr 25 2013
Hello, I am not a licensed medical doctor, therefore I can not give advise on prescription medication. I do suggest you get x-rays taken of your pelvis just to rule out inflammation of your pelvis ; otitis pubis. Best of luck

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