Groin and Hip Pain

I have had groin/hip pain--about a year ago in my left, and right now in my right. It is very annoying, and can be devastating to a runner...it can take you off the roads altogether. I was able to run some during last year's groin crisis, but have been out nearly three week's with this year's groin crisis. I have run only twice, and feel like a broken down old man when I do so. The pain tells me that it is simply not good to run right now. Very depressing with a marathon coming up in about seven weeks.

I have been to both PT and massage therapy. PT is okay, and massage seems to help a bit. Judging by your comments, if I were you I would have a massage therapist work on my psoas muscle. If it is the psoas, then massage can really help, and probably get you running normally again soon. I wish you all the best, as this problem has been a real downer for me.

I agree with outsiderunner regarding the psoas muscle. I went through some bad groin pain back in 2013. Went to a chiro who does ART and she could feel the psoas was strained. Was fine for over a year then it came back due to overtraining in 2014. After another 2-month layoff I am back to running although my psoas gets a bit sore if I push too much.

you should check out piriformis syndrome - very very common in runners and often very easily treated with self massage (sitting on a baseball or lacrosse ball)

your problems sound like they could be piriformis related

I have had pyriformis issues on that side, with deep pain in my right buttocks. Besides, I could always run through pyriformis pain with no problem, mainly because there wasn't any damage being done (it was just a pain tolerance issue). This pain isn't pyriformis pain though.

With the groin, I know how touchy they can be. And I've never had a groin problem before. A tight hip on that side, yes, but nothing that ever said "stop running".

I don't run fast enough to get hurt. I run far all the time, and generally any aches and pains just warm up as I get a few miles into it and they end up being fine. My fear is running on this sore groin/adductor and making it worse, since a groin injury can linger and keep you from running.

Thanks for all of your responses as well.

The pinching on extension or full flexion is likely indicative of a psoas issue (tendinitis, bursitis, strain).

That sounds an awful lot like a labral tear. Might want to talk to a hip orthopedist who is knowledgeable about labral tear / FAI if it doesn't go away.

Yes, I was hoping it wasn't that, but certainly a possibility.

I can do almost everything pain free, clams, front leg raises, side leg raises, scorpions, fire hydrants, squatting into the catcher's position, crunches, planks, even a forward lunge. Today I can pull both knees up to my chest, the affected one only feels a slight bit of pain (like a 3 out of 10) but it gets better every day (I can pull my knee up and touch my nose). It sometimes gets aggravated when sitting.

Anyway, I will continue to do some dymanic warm up activity and very light stretching, take off the rest of the week and try to jog for a mile on Saturday afternoon.

You'd think after 30 marathons I'd learn when to take an extra day to rest.

Something that aggravates this hip pain is when I stand with feet shoulder-length apart, put my hands on my hips, push my hips forward, and lean my head back. That causes some pain in that groin area, sometimes it radiates down the leg and other times not.

Thirty marathons. Wow. God bless you. All the best to you.

I hope to be running again soon.

I had an issue in my lower abdomen/groin and into my hip that lasted about a year. At first I thought it might be a hernia but physio ruled this out, I then thought it was some kind of psoas issue. Over time and after doing Pilates I realised that my buttocks were not firing at all, after some practice I could get the unaffected side to work but not the other one. I kept trying to do this and I did lots of planking which improved the issue, no stretch or release worked, it made the pan worse. I then went to see another physio who filmed me running on an ipad. Up to this point I'd always assumed I was a neutral runner, the film showed that I was neutral on landing but on pushing off I pronated, leading to my knee and hip to come across my body, he thought this was my problem. I had been wearing Adidas Boost (very very soft). I changed to a firm shoe with some medial support (asics gt2000), that was about 8 weeks ago, the improvement was very quick and I am now about 90% pain free. At times the pain was so bad I thought i'd have to stop running altogether but this has cured the issue.

Interesting comments. I have thought of going back to my GT-2000s, but they tend to pinch the outside (lateral) part of my foot. If it's not one thing, it's another...

Buttocks not firing at all. This is scary stuff. I think I am in the same boat, and such is why I am concerned about being a distance runner. If the body is malfunctioning in such an obvious manner, I am afraid to think of the awful injury that could be the consequence of this.

Thanks buttocks. That is interesting, I should try something like that to see if I can avoid re-injuring myself once I get better. Also, I never thought I'd type thanks buttocks.

If I press my thumb into where the sartoris muscle meets the crease, I get some pain, and same if I press my thumb into the fat part of the groin. I can't tell if they're related or two separate issues. I'm otherwise fairly pain free (except when running, as described earlier).

I'm trying to figure it out as well. I hurt myself about a week ago after coming back and doing an hour long treadmill run four days after a 50K (dumb). I took a day off, and then did an 8 mile tempo run (no crazy pain, but felt a burn in the "crease" of my right leg). I took two more days off and tried out the treadmill again, within 10 minutes I felt the burn again (less bad, but there). I'm taking the rest of the week off and it acts up this weekend, I'm seeing a doctor. It would be great if he videod me. Also, I recently switched to Glycerins (love them) after years in Triumphs (loved them until they dropped the heel), but that is going from one soft shoe to another. But it's worth examining.

Hi Niceguy, sorry about your injury. I don't have any advice but just wanted to say I seem to be experiencing something extremely similar (see my thread a ways down the board on groin pain possibly caused by biking). Reading the groin pain threads on this site have really freaked me out and I'm desperately hoping I don't have a stress frx or labral tear. Going for an MRI next week and will check back with you.

Alright, I hate to also be the bearer of bad news, but it's best to throw it out there so that you don't miss it and deal with the injury longer, like I did lol I had the same symptoms for over a year until it royally blew up and left me unable to walk normally, let alone run. I'll give you a few things to try that bothered me when other things were totally fine. Lie on your side (the same side as the "bad" hip) and do a leg raise with the affected leg (so as to use the adductor to lift it towards the ceiling) opposite of a normal side raise. That killed me. Also, if you have a friend that can assist get in the same position (this will be done on both sides) and do a normal side raise and hold it, now have your friend apply pressure and you resist it. See how that feels. I've extensively researched everything that involves the hip, nerves, the back, etc. The issues associated with what can be mistaken as a groin strain are compression of the obtorator nerve via inflammation of the psoas or surrounding structures. I too would have days, weeks, and sometimes months of relief with slight "pressure" deep in the groin. I truly hope this isn't the issue you're having, but if it is I'd meet with an ortho to get an MRI. You'll need an arthrogram which is a dye injection to ever even see a tear, but you'll figure out whatever the problem is via MRI. Obviously this is pretty much if things get unbearable and you've exhausted all other resources.

Some things to keep an eye on: If you feel shooting pain into your lower back on one side (check out hip spine syndrome)

Shooting or dull pain up buttcrack region

Numbness in genital region,

weakness, clicking, or giving out during activity

Pain, numbness, weakness in the front of the thigh/IT band area that stops at the knee

The reason I was able to have periods of relief was due to the fact that there are limited nerves in the hip joint capsule itself, thus limited pain receptors. So, when the inflammatory response would be triggered it would take time for the mediators to get out of the capsule.....the problem with the hip is that it is a close neighbor to a heavily innervated area that will pick up those mediators and cause pain all over.

I spent a year of running on it and it never got better, and I wish I knew what I know now haha After seeing multiple doctors I wasn't able to get any answers, so I saw an ortho that specialized in this type of thing by recommendation by a sports massage therapist. There are only 4 doctors that do hip arthroscopy in my state, so you may have difficulty finding someone that could diagnose it if that's your problem...so be weary of who you work with. MRI's can be expensive and you need a specific one to see a tear, or you'll miss it and waste money.

Good luck, I hope it's just a strain

Thanks HipHop and gazellerunner. Thanks for all of that information, it's really helpful. I tried your reverse adductor test and I didn't have pain. I can do side leg raises but will try with resistance, maybe using a theraband or something at the gym later. What was your final diagnosis?

It's a weird issue. My groin was painful to the touch last week (almost like I aggravated a lymph node) but now it's fine. Also, I just absentmindedly sprinted up the stairs because my phone was ringing, but it turned out to be fine. Yet, I walked my dog for 30 minutes and the groin fired up just a little bit, like something was present in there.

I guess I'll spend the next few days not running and looking up good hip and groin doctors. All of your personal experiences are really interesting though. I mean without you all I'd probably just walk into a doctor's office, listen to their diagnosis, and take their word for it. Now I know to look for a orthopedic hip specialist, and to ask for an arthrogram.

Could be a stress fracture. I had similar symptoms misdiagnosed as adductor strain. MRI told the truth. Healed up fine once I stopped running and cross trained fiendishly for a couple months.

We struggled for a little while to figure it out. It would be painful to the touch, and really tight and overall painful. The pain was unique in the respect that it was very deep inside the leg, which is sort of hard to imagine unless you felt it. Heat would help, stretching did a little bit as well. I did exercises and ART for about 2 weeks to get me through some limited running and workouts for our conference/regional meet and it would only bandaid the problem. I had a definite tear on the front side and very very significant bruising on the back side of the labrum as well. I have probably had a tear for a long period of time, but only a little over a year of complications associated with it. Much like the shoulder, you can have tears in the CT surrounding the joint and be without any symptoms or complications. Several studies have looked at potential causes of spontaneous pain associated with benign labral tears and they sort of point to hip/glut/core instability. Many people will go into an anterior tilt of the hips causing an exaggerated lumbar curve, thus changing the joint angle in the hips. By balancing this you can counteract that tilt and return things to normal. In my case I suspect the tear to have caused some problems, but the bruising is what truly sidelined me at the end. This was due to the back side of the labrum taking a lot more friction and catching than normal and it became inflamed as it had never been subjected to that load under normal joint conditions. I had surgery last week to repair the tear and reshape the femur/acetabulum/capsule, therapy was an option but at my age and fitness level it would've been a waste of time due to me already exploring those options previous to the "final solution"

I don't have pain doing any of the things HipHop mentioned above. Just had the MRI and apparently the Dr ordered the arthrogram kind w/contrast. I've got the images on CD but can't see the Dr to get the verdict until Wednesday. I tried looking at them and comparing them to images on the web, but it's really hard to tell. I definitely didn't notice anything really out of the ordinary like misshapen (pistol) femur heads or large tears or anything that looked like a fracture line. Hoping the news is not too bad. In the meantime, I'm still not running and the groin still feels tight but not really painful. For what it's worth, strength stuff and elliptical seem to make it feel better, as opposed to resting it completely.