Groin pain rarely comes from a single place. The groin is an anatomical crossroads: the hip joint, the adductor muscles, the abdominal wall, nerves and blood vessels all meet within a few centimetres. That is why the same pain can mean a simple muscle strain, a hip joint problem or an inguinal hernia — and the difference matters enormously for what you should do next.
This guide, written by the physiotherapists at Medicine Park, helps you understand where the pain may be coming from, which signs need a doctor straight away, and what physiotherapy can realistically do.
What exactly is the groin?
The groin is the crease between your abdomen and your thigh. Packed into that small area are the adductor tendons (the muscles on the inside of the thigh), the iliopsoas muscle, the inguinal canal through which a hernia can appear, and several sensitive nerve branches. The hip joint sits directly underneath and very often “lends” its pain to the groin. To pinpoint your symptom more precisely, use our pain map.
The common causes, in short
1. Muscle and tendon causes — the ones we see most in clinic
An adductor strain is the classic sports injury: a sudden change of direction, a kick, a slip — and pain appears on the inner thigh, close to the groin crease. Adductor tendinopathy develops with repeated overload, while athletic groin pain (pubalgia) — common in football players and runners — builds up gradually and flares with sprinting, cutting movements or striking a ball. Irritation of the iliopsoas muscle belongs here too, typically felt when lifting the knee or taking long strides.
2. Joint causes — the hip
The hip is the great impersonator of groin pain. Femoroacetabular impingement causes groin pain when squatting, sitting for long periods or rotating the leg. Hip osteoarthritis usually appears after 45–50, with morning stiffness and pain on the first steps. Labral tears can produce a sharp, deep pain, sometimes with a catching or clicking sensation.
3. Other causes — not muscular or articular
An inguinal hernia often feels like a bulge that appears with effort, coughing or lifting and settles when you lie down. Nerve irritation in the area (the ilioinguinal nerve, for example) causes burning or tingling towards the thigh or genitals. Swollen lymph nodes, pain referred from the lumbar spine, and — in women — pregnancy or certain gynaecological conditions can also cause groin pain. In men, pain originating from the testicle always takes priority for medical assessment.
Red flags — when to go straight to a doctor
Most groin pain is mechanical and benign. Go straight to a doctor or the emergency department if any of the following appears:
- A groin bulge that no longer goes back in, becomes painful and hard, with nausea or vomiting — this may be an incarcerated hernia, a surgical emergency.
- Sudden, intense testicular pain — needs emergency assessment within hours.
- A fall followed by inability to put weight on the leg, especially in older people — a hip fracture must be ruled out.
- Fever, chills, unexplained weight loss, or pain that wakes you at night and has no link to movement.
- Numbness in the genital area or urinary problems appearing together with the pain.
None of these signs is treated with physiotherapy — our role is to recognise them at assessment and refer you immediately to the right specialist.
How we find the cause: the assessment
At the first session we reconstruct the story of your pain: when it started, which movements trigger it, what eases it. Then comes clinical testing — palpation, resistance tests for the adductors and iliopsoas, joint tests for the hip and mobility checks for the lumbar spine. The goal is to separate the true source of the pain from the areas that merely feel it. If the clinical picture suggests a hernia, a urological issue or advanced joint disease, we refer you to the right doctor — sometimes with a recommendation for imaging — before starting any rehabilitation programme.
What physiotherapy can do — and what it cannot
For muscle, tendon and joint-related causes, physiotherapy is the first-line treatment supported by current guidelines: a progressive strengthening programme for the adductors and deep abdominal muscles, restoring hip mobility, correcting movement patterns and a graded return to sport. At Medicine Park the plan is built individually during kinetotherapy sessions, and for athletes we follow sports injury rehabilitation protocols with clear progression criteria. If the pain comes from the adductors or the pubic bone, see our treatment pages for groin pain and osteitis pubis.
What physiotherapy cannot do: it does not repair an inguinal hernia (that is solved surgically), and it does not treat infections or urological or gynaecological conditions. That honesty is part of the treatment — it saves you time, money and worry. The full list of therapies and prices is on our prices page.
What you can do at home, starting today
- Relative rest, not total rest — avoid the movements that trigger sharp pain (sprinting, cutting, kicking), but keep walking and doing whatever does not hurt.
- In the first days after a strain, a cold compress for 10–15 minutes can settle the area.
- Gentle adductor isometrics — squeeze a pillow between your knees for 10–15 seconds, pain-free; this is the first reloading step used in athletes’ rehabilitation too.
- Stop re-testing the pain — checking “does it still hurt?” keeps the irritation going.
- Track your progress — if the pain has not eased after 7–10 days, or returns every time you resume activity, book an assessment.
Frequently asked questions
Does groin pain go away on its own?
Mild strains can settle within one to two weeks with relative rest. Pain that lasts beyond 2–3 weeks, returns every time you resume sport, or gets gradually worse usually has a cause that needs to be assessed and treated specifically — otherwise it tends to become chronic.
How do I know if it is a hernia or a muscle strain?
As a rough guide: a hernia is often associated with a visible or palpable bulge that grows with coughing or effort and settles when lying down; a strain hurts when the muscle contracts or stretches, without a localised bulge. A reliable distinction, however, can only be made at an examination — and when in doubt, medical assessment comes first.
Can I keep playing sport with groin pain?
It depends on the cause and the intensity. The practical rule used in rehabilitation: pain up to 3/10 that settles by the next day usually allows adapted activity; pain that increases during exercise or persists into the next day calls for reduced load and an assessment. Playing through pain with pubalgia or tendinopathy significantly prolongs recovery.
How many physiotherapy sessions will I need?
There is no universal number. A simple strain may need a few sessions plus a home exercise programme; long-standing pubalgia or tendinopathy typically requires a 6–12 week programme with graded progression. After the assessment you receive a plan with clear goals and timelines, which we adjust to your actual response.