Undiagnosed groin pain--pelvic free fluid?

If you're in or near the Philadelphia area make an appointment with the Vincera Institute.

Would definitely need more details on this one, is it tender to palpate the tendon, pubic region or abdominal area? Is it painful to squeeze the legs together, deep squat, or perform a resisted sit-up? Does sneezing hurt? I'm guessing there is no palpable bulge around the inguinal region? Sounds like insidious onset after a prolonged period of no running, would be interested to know how much running you did in your first session back?

Apologies for all the questions, but this info would add to the picture. Take a look at the Doha agreement for classifying groin pain, this may assist you.

Note: this is not medical advice, I'm merely someone that has suffered from groin injuries

injuredboi wrote:

Would definitely need more details on this one, is it tender to palpate the tendon, pubic region or abdominal area? Is it painful to squeeze the legs together, deep squat, or perform a resisted sit-up? Does sneezing hurt? I'm guessing there is no palpable bulge around the inguinal region? Sounds like insidious onset after a prolonged period of no running, would be interested to know how much running you did in your first session back?

Apologies for all the questions, but this info would add to the picture. Take a look at the Doha agreement for classifying groin pain, this may assist you.

Note: this is not medical advice, I'm merely someone that has suffered from groin injuries

There are not many areas that are tender to the touch, although my inners thighs were VERY sensitive the day after my test run, which was only a mile after 4 weeks of no running. I'm closing in on 6 weeks now.

Squeezing my legs together is incredibly painful. One of the things I have been doing in PT are "ball squeezes" with my knees and a small inflatable ball to address the pain there. I can perform a squat okay, but I cannot do a single situp (forget resistance) from the lower abdominal pain. I also get a lot of pain if I rotate my hips inward. And yes, both sneezing and coughing hurt. It is so frustrating as my foot is definitely healing, but I cannot test it out as I cannot run more than a step or two from the groin pain.

Pain with groin squeezes would suggest injury to contractile tissue i.e Tendon/Muscle of the adductors. Same with the resisted sit-up with regard to abdominals i.e. Obliques and rectus abdom. These muscles exist together as an anterior sling around the pelvis, which effectively cross brace it. Hence an injury to the left adductor could effectively disrupt the right obliques and vice versa as the cross brace mechanism is compromised. Loss of this stability may then result in overload to the pubic rami bones, resulting in edema. The hip pain may warrant imaging to rule out FAI morphology as well, which typically presents as insidious hip and groin pain.

These types of injuries were previously known as Sports hernias, gilmores groin, osteitis pubis etc. Nowadays the doha agreement provides classification i.e Adductor related, Inguinal related, hip related and pubic bone related pain, for diagnostic simplicity. It is possible to have a combination of these as well given the close anatomical relationship between structures.

As you can see it is quite complex, so I'd recommend visiting a physiotherapist or sports physician with a good understanding of the sporting hip and groin for a diagnosis. Many clinicians simply are not up to date with the presentation and management of chronic groin pain.

In my case I had inguinal and adductor related pain on both sides that stopped me from running. Sneezing and sit up pain were both present and did not improve with rehab. Ended up having the area surgically reconstructed, which ultimately solved the issue.

Note: I'm not a medical professional, but have experienced groin injuries.

Radiologist overinterpretation could be cause of free fluid.