Now accepting new patients. Schedule a visit.

Groin Pain in Athletes: Hip Joint, Adductor Strain, or Sports Hernia?

Princeton Sports and Family Medicine, P.C. Blog Groin Pain in Athletes: Hip Joint, Adductor Strain, or Sports Hernia?

Groin pain in athletes can be difficult to sort out.

A soccer player feels pain when cutting. A hockey player has pain with skating strides. A runner feels deep groin discomfort that worsens with impact. A lacrosse player feels pain with sprinting and change of direction. A lifter feels a pinch in the front of the hip during squats. Another athlete has pain that lingers despite rest and keeps returning as soon as practice intensity increases.

The word “groin” can refer to several different structures.

Pain may come from the adductor muscles, hip joint, labrum, hip flexor, abdominal wall, pubic region, lower back, pelvis, or bone. It may be a classic groin strain. It may be hip impingement. It may be a labral problem. It may be athletic pubalgia, often called a sports hernia. In some runners and endurance athletes, it may even be a stress injury.

For athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County, the goal is not to guess. The goal is to identify the source of pain, understand the sport demands, and build a safe return-to-play plan.

Quick Takeaways

Why Groin Pain Is So Confusing

The groin is a crossroads.

The hip joint, pelvis, abdominal wall, adductors, hip flexors, nerves, tendons, and pubic bone all meet in the same region. Many sports require explosive motion through that area.

That means different injuries can feel similar.

An athlete may point to the same general area for several possible problems:

The first step is to stop using “groin pull” as a catch-all diagnosis.

A true groin strain is common, but not every groin pain is a strain.

What Is an Adductor Strain?

An adductor strain is an injury to the muscles on the inner thigh. These muscles help bring the leg toward the midline and help control the pelvis and hip during athletic movement.

Adductor strains are common in sports that involve:

Athletes in soccer, hockey, lacrosse, football, basketball, tennis, rugby, field hockey, and court sports may be affected.

A mild adductor strain may feel like soreness or tightness in the inner thigh. A more significant strain may cause sharp pain, bruising, weakness, limping, or difficulty returning to sport.

What Does an Adductor Strain Feel Like?

Adductor strain often causes pain in the inner thigh or groin.

Symptoms may include:

Some athletes feel a sudden pull or pop. Others notice soreness that builds over time.

If symptoms improve with rest but return as soon as sprinting or cutting resumes, the adductor may not yet have enough strength or load tolerance for sport.

Why Groin Strains Keep Coming Back

Recurrent groin strains are common when athletes return too quickly.

Pain-free walking does not mean the athlete is ready for full-speed cutting, sprinting, or kicking. The adductor muscles may feel fine during daily activity but fail when exposed to game-level demands.

Groin strains often recur because of:

A good return plan should be criteria-based, not calendar-based.

When Groin Pain Comes From the Hip Joint

Groin pain can also come from inside the hip joint.

Hip joint-related pain often feels deeper than a simple muscle strain. Athletes may describe it as a deep ache, pinch, catching sensation, or pain that is difficult to touch from the outside.

Possible hip joint causes include:

Hip joint pain may worsen with:

If groin pain feels deep, mechanical, or associated with clicking, catching, locking, or pinching, the hip joint should be considered.

Hip Labrum Pain

The labrum is a ring of cartilage around the hip socket. It helps with stability and load distribution.

Labral irritation or tearing may cause:

Labral findings on imaging do not always explain symptoms. Some people have labral changes without pain.

That is why the history, exam, mechanics, and sport demands all matter. The question is not just whether a labral tear exists. The question is whether it is the pain generator and what can be done to restore function.

Hip Impingement and FAI

Hip impingement, or femoroacetabular impingement, often causes front-of-hip or groin pain.

Athletes may feel a pinching sensation with deep hip flexion, rotation, squatting, skating, cutting, or sitting. Runners may notice symptoms with hills or faster running. Lifters may feel it during deep squats or lunges.

FAI and labral symptoms often overlap.

Athletes with hip impingement may need:

Many athletes improve without surgery, but the plan must match the demands of the sport.

What Is Athletic Pubalgia or “Sports Hernia”?

Athletic pubalgia is often called sports hernia, though it is not the same as a typical visible hernia.

It usually involves pain around the lower abdomen, groin, pubic region, or adductor-abdominal connection. It may occur in athletes who perform repeated sprinting, cutting, kicking, twisting, or explosive core movements.

Symptoms may include:

Athletic pubalgia can be frustrating because rest may help temporarily, but pain often returns when intensity increases.

Because symptoms overlap with adductor strain, hip labrum, FAI, and abdominal conditions, evaluation is important.

Is Sports Hernia a Real Hernia?

The term “sports hernia” can be confusing.

A traditional hernia often involves tissue protruding through a weakness in the abdominal wall and may create a visible or palpable bulge. Athletic pubalgia typically refers to pain from deeper soft-tissue injury or overload around the lower abdominal and pelvic region, often without a classic bulge.

That distinction matters.

If there is a visible bulge, severe abdominal pain, testicular pain, nausea, vomiting, fever, or bowel symptoms, the athlete should be evaluated for non-sports causes as well.

Not every groin pain belongs in sports medicine alone. Some symptoms require primary care, urgent care, or surgical evaluation.

Could It Be a Stress Injury?

Yes.

Stress injuries are important to consider, especially in runners and endurance athletes with deep groin pain.

A femoral neck stress injury can present as groin pain, hip pain, or thigh pain. This can be serious if missed.

Warning signs include:

If a stress injury is suspected, the athlete should stop impact activity and be evaluated. Imaging may be needed.

Pushing through deep groin pain with impact is not worth the risk.

Could It Be Coming From the Back or Nerves?

Groin pain can sometimes be referred from the low back, pelvis, or nerves.

Clues that referral may be involved include:

Hip, adductor, and back problems can also coexist.

A careful exam can help determine whether the pain is coming from the adductor, hip joint, lumbar spine, pelvis, or a combination.

Non-Sports Causes That Should Not Be Missed

Not all groin pain is musculoskeletal.

Athletes should seek medical evaluation if groin pain is associated with:

These symptoms may need evaluation beyond a sports injury visit.

It is important not to treat every groin symptom as a pulled muscle.

How Clinicians Sort Out Groin Pain

A good evaluation starts with the story.

Important questions include:

The physical exam may include hip motion, strength testing, adductor testing, abdominal/core loading, single-leg control, gait, and sport-specific movement patterns.

Do You Need Imaging?

Not always.

Many adductor strains and groin strains can be diagnosed clinically. Imaging may be considered when symptoms are severe, persistent, recurrent, unclear, or concerning for another diagnosis.

Imaging may be useful if there is concern for:

X-rays, MRI, ultrasound, or other tests may be considered depending on the suspected diagnosis.

The best imaging decision is based on whether the result will change the plan.

Should You Keep Playing?

It depends on the symptoms and diagnosis.

Athletes may be able to continue modified activity if:

Athletes should stop and be evaluated if:

Playing through groin pain can make recovery longer, especially if the athlete compensates or the diagnosis is not a simple strain.

Treatment for Adductor Strain

Treatment for adductor strain usually includes relative rest early, followed by progressive loading.

A plan may include:

The athlete should not jump from pain-free walking directly to full practice.

Sprinting, kicking, skating, and cutting come later.

Treatment for Hip Joint or Labral Pain

Hip joint-related groin pain often requires a slightly different plan.

Treatment may include:

The goal is to improve tolerance to the positions and loads that matter.

Not all labral or FAI-related pain requires surgery. Many athletes can improve with a non-operative plan, especially when strength, mobility, and load management are addressed.

Treatment for Athletic Pubalgia

Athletic pubalgia often requires careful progression because symptoms can return with high-speed and rotational activity.

Treatment may include:

This condition can be more persistent than a simple muscle strain.

The athlete often needs a coordinated plan that addresses the adductor, abdominal wall, hip joint, and sport demands together.

Return to Sport: Pain-Free Is Not Enough

Pain-free daily activity does not mean the athlete is ready for competition.

Return to sport should consider:

Groin injuries often recur when athletes return before high-speed and change-of-direction capacity is restored.

A good return-to-sport plan should progress from controlled movement to game-level intensity.

Common Mistakes With Groin Pain

Common mistakes include:

Groin pain should be respected because the diagnosis can vary widely.

A specific diagnosis leads to a better plan.

Groin Pain in Athletes Near Princeton, NJ

Athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County often seek care because groin pain keeps returning when sport intensity increases.

They may be asking:

Those questions deserve a sport-specific evaluation.

How PSFM Can Help

At Princeton Sports and Family Medicine, groin pain is evaluated with a “rule-in/rule-out” approach that considers the adductor, hip joint, labrum, hip impingement, abdominal wall, pelvis, low back, and bone stress injury.

Sports Medicine Services can help evaluate acute groin pain, recurrent adductor strain, hip joint symptoms, suspected athletic pubalgia, stress injury concerns, and return-to-sport decisions.

Physical Therapy can help restore adductor strength, hip strength, trunk control, single-leg stability, sprint tolerance, cutting mechanics, and sport-specific progression.

For runners and field athletes, the Run Stride & Performance Evaluation can help connect symptoms to running mechanics, hip control, impact loading, cadence, stride, and training patterns.

For condition-specific education, PSFM provides pages on Groin Strain, Adductor Strain, Hip Pain, Hip Labrum Tear, Hip Impingement and FAI, Stress Fracture, and Return to Sport.

PSFM Wellness can support fitness, recovery, and healthy training habits. Fuse Sports Performance can help athletes build strength, durability, speed, and performance capacity after symptoms are controlled.

The goal is not simply to get the athlete out of pain. The goal is to restore the ability to sprint, cut, kick, skate, lift, and compete with confidence.

Related Pages

FAQs

What causes groin pain in athletes?

Groin pain in athletes can come from adductor strain, hip flexor strain, hip labrum irritation, hip impingement, athletic pubalgia, stress injury, low back referral, or non-sports medical causes.

How do I know if groin pain is an adductor strain?

Adductor strain often causes inner thigh or groin pain with sprinting, cutting, kicking, skating, or squeezing the legs together. A clinical exam can help confirm the diagnosis.

What is the difference between a groin strain and sports hernia?

A groin strain involves muscle injury, commonly the adductors. Athletic pubalgia, often called sports hernia, involves deeper abdominal or pelvic soft tissues and usually causes more persistent lower abdominal or groin pain.

Can hip labrum pain feel like groin pain?

Yes. Hip labrum irritation or tear often causes deep groin or front-of-hip pain, sometimes with clicking, catching, pinching, or pain with squatting, sitting, pivoting, or hip rotation.

When is groin pain in a runner concerning?

Groin pain is concerning if it is deep, worsens with impact, causes limping, hurts with walking, occurs at night, or is associated with a history of stress fracture or low energy availability.

Should I keep playing with groin pain?

You may be able to modify activity if pain is mild and does not worsen, but stop and get evaluated if pain causes limping, worsens during play, affects walking, or returns immediately with sport.

Do I need imaging for groin pain?

Not always. Imaging may be considered if symptoms are severe, persistent, recurrent, traumatic, unclear, or concerning for stress injury, labrum injury, tendon tear, or athletic pubalgia.

Where can I get groin pain evaluated near Princeton, NJ?

Princeton Sports and Family Medicine evaluates groin pain, adductor strains, hip joint symptoms, labral concerns, sports hernia patterns, and return-to-sport questions in Lawrenceville for athletes in Princeton and surrounding Mercer County communities.

The Bottom Line

Groin pain in athletes is not always a simple groin pull.

It may come from the adductor muscles, hip joint, labrum, hip impingement, athletic pubalgia, stress injury, low back referral, or non-sports medical causes. The location, triggers, sport demands, and red flags all matter.

If groin pain is limiting sprinting, cutting, kicking, skating, running, lifting, or competition, request an appointment with Princeton Sports and Family Medicine.

This content is educational only and is not a substitute for individualized medical advice. If you have severe pain, rapidly worsening symptoms, inability to bear weight, limping, deep groin pain with walking, night pain, testicular pain, abdominal pain, visible bulge, fever, vomiting, urinary symptoms, new weakness, numbness, tingling, major trauma, significant swelling, chest pain, fainting, or other concerning symptoms, seek medical evaluation.

Author
Peter Wenger, MD Peter C. Wenger, MD, is an orthopedic and non-operative sports injury specialist at Princeton Sports and Family Medicine, P.C., in Lawrenceville, New Jersey. He is board certified in both family medicine and sports medicine. Dr. Wenger brings a unique approach to sports medicine care with his comprehensive understanding of family medicine, sports medicine, and surgery. As a multisport athlete himself, he understands a patient’s desire to safely return to their sport.

You Might Also Enjoy...