A complex area of the body, the groin is made up of muscles, tendons, fasciae, ligaments, and nerves.
The structure and function of the hip and pelvis are interwoven with that of the groin.
These muscles play a crucial role in maintaining balance and stability in various athletic activities. We will also discuss the common injuries and trigger points associated with these muscles, as well as their relation to osteoarthritis of the hip.
What are Groin Trigger Points
Groin pain is common in men and women, but it’s often overlooked as an issue. Groin discomfort may not always be at the top of the list of things to investigate because there are so many other painful conditions that can arise in the body. But if you experience this kind of pain, you shouldn’t ignore it.
Groin pain can actually come from a variety of sources and trigger points are one of them. So, what are groin trigger points?
They are tender places in the groin muscles that feel like they are being pulled in various directions. They can be quite small and difficult to find, but once you have them, they have a powerful impact.
Usually, they generate tingling and shooting pains all over your body, letting you know exactly where they are and how bad they ache! They frequently happen when you sit or remain still for extended periods of time or perform any kind of hard lifting over time.
Common Injuries and Activities Associated with Hip Adductor Issues
Hip adductor injuries often occur during sports or activities that involve sudden outward leg movements. These include sports like soccer and rugby, where players may experience sudden jinking movements or forceful kicks.
Injuries to the adductor muscles can also happen during skiing or slipping on black ice. Prolonged sitting in a cross-legged position can exacerbate trigger points in the adductor muscles.
Trigger Points in the Hip Adductors
Trigger points in the adductor longus and brevis muscles are typically located high up in the groin area. These trigger points can cause pain in two main regions: the groin and the lower leg.
The pain from these trigger points can closely mimic that of osteoarthritis of the hip, as both share similar pain patterns. It is important to note that the trigger points in these muscles are relatively superficial, so deep pressure is not necessary for effective treatment.
The Relationship Between Hip Adductor Trigger Points and Osteoarthritis
Osteoarthritis of the hip can often activate trigger points in the hip adductors. The pain caused by these trigger points is very similar to the pain experienced from osteoarthritis.
The hip joint is actually located in the groin area, and the pain from both conditions is typically felt in this region. As a result, it can be difficult to distinguish between pain caused by hip adductor trigger points and osteoarthritis of the hip.
Groin muscle anatomy
The groin is made up of three muscle groups: The abductors, which are responsible for moving our leg away from our body, the adductors, which will pull the leg back into our body, and the hamstrings-the long muscles on either side of our pelvis.
Adductor muscles of the Hip
The adductors are a group of muscles located on the medial (inner) side of your thighs and 6 different muscles are included in this group: Adductor longus, adductor Magnus, adductor brevis, obturator externus, gracilis, and pectineus muscles-each of these muscles can cause a variety of pains. Let’s see the pain patterns and symptoms of these muscles at glance.
Adductor Magnus pain patterns
Trigger Points extend deeper into the pelvis and are located in the groin and inner thigh. These more severe aches are typically classified as internal pelvic pain. However, they can also apply to the pubic bone, vagina, or rectum. Patients have even occasionally mentioned bladder pain.
Pain patterns of the adductor longus and adductor brevis
There is localized sensitivity of pressure in the inner thigh due to trigger points in the adductor longus and brevis, but a pain in other locations is also possible.
- Shin pain
- Groin pain
The gracilis’s pain patterns
The medial side of the thigh may experience pain from gracilis trigger points. Most people who experience this muscle pain describe it as hot and stabbing.
Pectineus pain patterns
Similar to the short adductors, the pectineus refers to discomfort mostly deep into the groin and below the inguinal ligament. The hip joint itself may appear to be the source of the pain.
Abductor muscles of the Hip
Leg displacement away from the body’s midline is referred to as hip abduction. Hip abductor muscles are found on the lateral thigh and consist of the following muscles primarily:
- Gluteus medius
- Gluteus minimus
- Tensor fasciae latae
Let’s have a look at the first two muscles since they are common sources of pain.
Gluteus medius
The gluteus medius is the main muscle involved in hip joint abduction. It is situated beneath the iliac crest on the lateral edge of the upper buttock.
There are three main trigger point locations in the muscle that typically refer discomfort to the lower back, across the ilium, to the sacrum, and the lateral/posterior buttock.
Pain patterns: You may have pain when walking or sleeping on your side if the gluteus medius is overly tight or contains trigger points. Additionally, the piriformis, gluteus minimus, or gluteus maximus may develop secondary or “satellite” trigger points as a result of gluteus medius trigger points.
Gluteus minimus
The gluteus minimus, as the name suggests, is the smallest of the gluteal muscles and thus belongs to the buttock muscles. It, like all the other muscles on this site, can become overloaded, tense, and develop trigger points.
Pain Patterns: When the gluteus minimus is tense, it is sensitive to pressure and painful locally. That means that pushing into the muscle will cause pain right there. If the muscle contains trigger points, the pain may radiate to other areas. In this case, to the affected side’s leg. The pain zones differ depending on the location of the trigger points.
Hamstring muscles
The hamstrings, which can cause pain in your thighs, knees, and calves, are situated in the back of your thighs. These aches are frequently brought on by trigger points, shortened muscles, and tension.
Three muscles make up the hamstrings:
- Biceps femoris
- Semimembranosus
- Semitendinosus
The Importance of Treating the Hip Adductors
The hip adductors play a crucial role in maintaining balance and stability during various athletic activities.
As soccer players engage in kicking and rotational movements, the adductor muscles are heavily relied upon, making them susceptible to injury. This makes it essential for athletes to incorporate regular hip adductor treatment into their routines.
Proper Positioning for Adductor Treatment
To effectively target the hip adductors, it’s important to position the leg correctly. Begin by placing the leg into a slight hip flexion, bending the knee upwards, and then bringing the leg up into mild abduction.
This position allows you to access the adductor muscles, including the adductor longus, more effectively.
A Broad Approach to Adductor Longus Massage
When treating the adductor longus, it’s crucial to use a broad approach to avoid causing discomfort or muscle guarding. One effective technique involves using an L-shaped hand position to brace and support the muscle.
By doing so, you can pick up and manipulate the tissue without digging too deeply into the muscle.
Addressing Trigger Points in the Adductor Longus
While it’s important to locate and work on trigger points in the adductor longus, the primary focus should be on achieving a comprehensive, broad approach to the muscle.
This will help address the muscle’s load-bearing capacity and improve its overall function during activities like kicking, turning, and agility movements.
Final take away: Groin trigger points
Trigger points in the groin are frequent but rarely discussed. This is largely due to the fact that talking about them can be awkward. However, don’t let that deter you from continuing to read because the material is crucial to your rehabilitation and overall wellbeing.
MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.