Although knee injuries, IT band syndrome, plantar fasciitis, and shin splints might be more common running injuries, groin pain from running is also a pesky injury that can sideline you from training for quite a while if not properly diagnosed and managed.
Groin pain from running can be difficult to diagnose and many runners with groin pain simply assume they have a pulled muscle. However, there are several potential causes of groin pain from running and the key to treating the injury is to properly identify the problem.
In this guide, we will look at the various causes of groin pain from running, risk factors for groin pain running, and what to do if your groin hurts after running.
We will cover:
- Why Does My Groin Hurt When I Run?
- The Anatomy Of The Groin
- Groin Pain From Running? Here Are 8 Possible Causes
- Risk Factors For Groin Pain In Runners
- Preventing and Treating Groin Pain From Running
Let’s get started!
Why Does My Groin Hurt When I Run?
Before we go into the specific causes of groin pain from running, it’s helpful to touch upon the key structures in the groin. Diagnosing groin injuries in runners is notoriously difficult, primarily due to the complexity of the anatomical structures in the groin area.
The groin can be considered a “busy” area from an anatomical perspective because it has a lot of bones, ligaments, muscles, tendons, and nerves attaching to or passing through the area. This means the list of potential culprits of your groin pain when you run is long.
The Anatomy of the Groin
The groin is the area in the front of your hips and pelvis between your stomach and thigh. Essentially, the groin is located where your torso ends and your legs begin both in the front and inside of your legs.
There are five primary muscles in the groin, called the adductor group, that work together to move your leg. The muscles in the groin include the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.
The pubic symphysis is a bony union of the two sides of your pelvis at the front portion of the bottom of your pelvis. It serves as the attachment point for the adductor muscles as well as the rectus abdominis muscle that forms your abs.
The pubic symphysis also plays a key role in balancing and stabilizing your pelvis when you walk and run.
Groin Pain From Running? Here Are 8 Possible Causes
Some runners with groin injuries experience groin pain while running and/or groin pain after running. The nature of your injury can provide clues as to the root cause. Here are the most common causes of groin pain in runners:
#1: Pulled Groin
A pulled groin or groin strain is the most common cause of groin pain from running and refers generally to a strain in the muscles or tendons of the groin.
Research shows that the majority of groin injuries in runners are adductor injuries. An adductor strain causes pain and tenderness near the pubic symphysis, with pain exacerbating upon resisted adduction of the legs.
You can test for an adductor injury by placing an inflatable ball between your legs and trying to press them together as hard as possible to squeeze the ball. If this elicits pain, there’s a good chance your adductors are involved in the injury.
The iliopsoas is the other major muscle that may be injured in a classic groin strain. You will feel pain with resisted hip flexion and some pain to the outside of the pubic symphysis. You can test for this groin injury by trying to lift your leg up towards your chest while simultaneously pressing against it with your hand.
Using either a partner or a solid structure to provide resistance, you can also test for iliopsoas pain by lying down and attempting to lift your leg against resistance with your knee slightly bent. If this provokes pain, your injury is likely rooted in the iliopsoas.
#2: Adductor Tendinopathy
Adductor tendinopathy is also one of the most common causes of groin pain from running. It differs from a groin strain in that it is more of a chronic, inflammatory injury and is usually in the tendons of the muscle not the muscle fibers themselves.
Adductor tendinopathy is often due to pelvic instability, a sudden increase in mileage or intensity, or extensive downhill running. The pain usually develops during a run, but may appear after a hard workout, and will progress over the next several runs.
#3: Hip Joint Impingement
Hip joint impingement, referred to as femoroacetabular impingement, is actually a hip issue, but the pain is often referred to in the groin. Many runners with hip joint impingement feel groin pain running and possibly afterward as well.
Hip joint impingement is due to inflammation that occurs in the ball-and-socket joint of the hip from excessive internal rotation of your hips when you run, which results in a painful pinching of the nerves or ligaments in the hip joint. The pain usually develops gradually over several weeks.
#4: Osteitis Pubis
Osteitis pubis is an overuse injury and a fairly common cause of groin pain in runners. This injury develops slowly over time and is caused by a lack of core strength and instability in the pelvis and hips, which causes excessive movement and strain on the tendons and connective tissue attached to the pubic symphysis.
#5: Hip Arthritis
Hip arthritis is a degenerative condition that refers to a thinning of the cartilage between the bones of the hip joint. It can cause rubbing and crepitus in the joint, and pain can be referred to the groin.
#6: Hip Stress Fracture
A stress fracture of the femoral neck or hip is an overuse injury that can cause referred pain to the groin when running.
#7: Pubic Stress Fracture
You can also get a stress fracture at or near the pubic symphysis. This injury usually causes dull groin pain after running, and the pain may be present at the start of a run as well.
A hernia is a hole in the abdominal wall in which contents of the abdominal cavity may protrude, forming a visible or palpable lump. Pain is exacerbated when coughing or sneezing and depending on the location of the hernia, it is also likely that you will experience groin pain while running.
Risk Factors for Groin Pain In Runners
There are several training errors and risk factors for groin injuries from running to consider, including the following:
- Sudden increases in volume or intensity
- Not warming up prior to a workout
- Osteoporosis and/or inadequate caloric and nutrient intake
- Excessive downhill running
- Weak hips and glutes
- Tight hips
- Sudden twisting or turning
- Overtraining or insufficient rest and recovery
Preventing and Treating Groin Pain From Running
Determining the cause of your groin pain from running is the key to fixing the problem and getting back to pain-free mileage.
Treating groin injuries usually involves some amount of rest from running, with the potential for low-impact cross-training so long as it is pain-free. Depending on the diagnosis, ice, heat, and physical therapy might be recommended. Surgery is sometimes implicated, depending on the type and severity of the injury.
In terms of returning to running and preventing groin pain, runners should implement the following practices:
It’s crucial to warm up before jumping into your workout. Warming up increases circulation to your tissues, which increases your range of motion and prevents strains. Do 5-10 minutes of brisk walking or easy jogging followed by dynamic stretches before heading out for your full workout.
Be Mindful of Volume Increases
Overtraining and sudden increases in mileage and intensity put you at a greater risk for groin injuries from running. Heed the 10% rule, meaning you should only increase your mileage by a maximum of 10% from one week to the next. For example, if you are currently running 30 miles a week, run no more than 33 miles next week.
It’s also important to pay attention to jumps in intensity. Groin strains often follow hard workouts, so ensure you give your body ample recovery between hard efforts.
Limit Downhills and Trails
Both downhills and trails put excessive strain on the adductors and pubic symphysis due to the increased demand to stabilize the pelvis. If you’re prone to groin injuries, consider running on flatter, smoother terrain.
Examine Your Diet
To promote healthy bones and recovery from workouts, make sure you are getting enough calcium, vitamin D, protein, and total calories through your diet. Consider speaking with your doctor or sports nutritionist if you have concerns.
Strengthen Your Core and Hips
There is evidence to suggest that strength training can yield a clinically-relevant reduction in groin injury risk in athletes.
A weak core leads to instability of the pelvis, which puts extra strain on the adductors and pubic symphysis. A well-rounded strength training program for runners should strengthen the entire core, including the iliopsoas, and also target the hip internal and external rotators and adductors and abductors.
Tight hip flexors, adductors, and hamstrings increase your risk of groin injuries. Ensure you are stretching frequently, especially after running.
Taking good care of your body should always be your number one priority, and following these helpful tips will assist you in avoiding groin pain from running.