Possible Causes of Groin Pain After Running

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Struggling with groin pain after running? There’s no way to avoid using the muscles in your groin when you’re running. So if you’re feeling pain in the area, it’s in your best interest to diagnose it and treat it as soon as possible.

The tricky thing with groin pain after running is that it can be from a problem with the groin itself, or it can be referred pain from a hip injury. If you continue to run through the pain, you may do more harm than good!

In this article, we’ll look at possible causes of groin pain after running, how to treat it, and some things you can do to prevent it from happening again in the future.

What Exactly Is The Groin?

The groin consists of three muscle groups in the front of the hips and pelvis and running into the inner thigh—the lower abdominals, the iliopsoas, and the adductors.

Injuries to the groin often happen to the adductors. They’re a group of four muscles—adductor longus, adductor brevis, adductor magnus, gracilis—which help you to move your leg.

These muscles attach to the pelvis at the pubis symphisis, which is a joint at the bottom of the pelvis where the left and right sides meet. This joint absorbs shock, which also makes it prone to groin pain.

The iliopsoas—a group of three muscles, iliacus, psoas major, psoas minor—is also commonly affected in groin injuries.

Who Is At Risk of Groin Pain After Running?

Trail Runners

Trail runners are at an increased risk for groin pain due to the uneven terrain they have to navigate, especially if the trail has elevation changes.

Rough terrain can be jarring to the pelvis, but if it’s hilly, then even more so. Running downhill can increase your chance of developing groin pain.

Runners With Weak Hips, Core, & Glutes

If you have weak core strength, hip muscle, and glutes, you may be more likely to develop pain in the ground after running.

This is because a lot of strain is placed upon these areas when running. If the core is weak, it fails to stabilize the pelvis adequately, leaving you open to pain.

On the other hand, if the hips and glutes are weak, they naturally become more susceptible to injury, either from overuse or jarring.

Those With Poor Form

Overstriding is a common mistake the runners make with their form. The truth is, longer strides don’t make you faster—increasing your cadence and taking shorter strides can help you perform better.

If you feel that overstriding may be a reality for you, take a video of yourself running. You should be able to spot it easily—your foot will land on the ground far in front of your pelves. It should be leaning close to right underneath the body with good form.

From there, you can either train to improve your form or enlist a running coach’s help.

Runners Who Overtrain

Running too hard or not giving your muscles enough time to recover in between exercises can lead to overtraining, which makes you more prone to injury.

Make sure you don’t do intense workouts back-to-back. Allow enough time for your muscles to rest and recover before leaping into a new workout.

Also, be careful how quickly you increase your time or distance. Moving ahead too quickly can also lead to overtired, overworked muscles, and if the hips are a weak point, they could easily become injured.

People With Tight Hips

If you have naturally tight hips, you may be more susceptible to groin pain after running, as the tension on the hip flexors makes your range of motion difficult.

Not only is this frustrating, but it can cause a significant amount of pain if you’re running with overly tight hips, as the pelvis gets pulled out of alignment by the tight hips.

Women Who’ve Had a Baby

Groin pain in women may result from pelvic floor weakness after childbirth. You may need to do pelvic floor exercises to strengthen the whole area and reduce the chances of developing groin pain.

Possible Causes of Groin Pain After Running

Now that you know the risk factors, let’s look at the physical causes behind groin pain after running.

1. Groin Strain

The most common cause of groin pain after running is a strain in the muscles or tendons of the groin area.

This usually affects either the iliopsoas or the adductors, although research indicates that the adductors are most commonly injured.

Symptoms

The symptoms of a groin strain differ depending on whether the iliopsoas or the adductors are affected.

If you have an adductor strain, you will have pain near the pubis symphysis—the bottom middle of your pelvis. The pain will be worse on resisted adduction—bringing your legs together.

Hold an inflatable ball between your thighs or knees to test for an adductor strain. If you feel pain when squeezing the ball, your adductors are injured.

If your iliopsoas is injured, you will feel some pain on the outside of the pubic symphysis. The best way to test for this is to lift your leg upwards to your chest while simultaneously pushing it down with your hand. If you have pain, it’s most likely your iliopsoas.

Other symptoms may include:

  • Lower abdominal pain radiating into the thigh
  • Pain in the inner thigh
  • Testicular pain
  • Pain in the perineum
  • Worse pain when coughing or sneezing

2. Adductor/Iliopsoas Tendinopathy

If groin pain after running becomes chronic, it could be adductor or iliopsoas tendinopathy.

This is when the tendons become inflamed, which can be caused by overuse due to instability of the pelvis, too much downhill running, or a sudden increase in intensity.

Symptoms

The pain will develop during a run and ease when you stop running. It will increase over the next several runs and only eases up with significant rest.

The pain appears in the same places as a groin strain and can develop gradually or suddenly. There may also be stiffness and a decreased range of motion in the area.

In some cases, you may also feel swelling or a lump.

3. Hip Joint Inflammation

This happens when nerves or ligaments are pinched due to excessive hip joint rotation in the socket—known as hip impingement.

Although this happens in the hip, the pain often refers to the groin. However, it will most likely occur along with pain in the affected hip.

Symptoms

You may find that pain develops over several weeks, and you feel it when running and after your run as well.

The pain increases when you bend at the waist, and you may also feel pain in the hip, stiffness, and a reduced range of motion in the hip.

4. Osteitis Pubis

Osteitis pubis is an overuse injury. It results in chronic inflammation of the pubic symphysis and the surrounding tissues, eventually leading to cartilage degeneration if not treated.

This is often caused by a weak core, which results in unstable hips and pelvis. This causes strain on the pubic symphysis joint as the tendons and ligaments work overtime to stabilize the pelvis.

Symptoms

The pain of osteitis pubis develops gradually. You may feel it either in the anterior—front—of the groin or the medial—side. In some cases, you may feel it in both places. You may also feel pain in your lower abdominal muscles.

The pain gets worse when stretching the adductors, the movement of standing up from a seated position, or movements that involve rapid hip flexion like kicking a ball or dancing.

5. Hernia

A hernia occurs when there’s a gap or tears in the wall of the abdominal muscles. This results in some of the soft tissue protruding through the hole, which causes pain and inflammation.

You can get a hernia in the abdomen or in the groin—known as an inguinal hernia. Both types can cause pain in the groin area. You should not attempt to treat a hernia at home but get it seen by a doctor.

Symptoms

An aching pain may be felt in both the abdomen and the groin, with the location depending on where the hernia is.

The pain worsens when you cough, sneeze or tighten your abdominal muscles. It will also worsen with any kind of activity that puts strain on the area. Running may cause it to worsen due to the jarring with every step.

There may also be a feeling of pressure in the area or a burning sensation. Men may feel a tugging sensation in the testicles.

Often, there will be a noticeable bulge at the site of the hernia, although this is more common in abdominal hernias.

A hernia should be treated with surgery to prevent it from getting worse. If you experience any of the following symptoms, you should see your doctor as soon as possible:

  • Nausea
  • Vomiting
  • Bloating
  • Rapid heartbeat
  • Fever
  • Escalating pain
  • A growing bulge
  • Difficulty having a bowel movement

These are signs of a medical emergency, and you will need surgery as soon as possible to repair it.

6. Stress Fractures

Stress fractures in the hip or pelvis are not common injuries. However, pelvic stress fractures do sometimes occur in long-distance runners. Hip fractures can cause referred pain to the groin.

A stress fracture is when there’s a fine crack in the bone, and it isn’t broken all the way through. This is a less serious kind of fracture and will most likely not require surgery.

However, you will need to rest and visit a physiotherapist, and you may want to take over-the-counter pain meds to manage the pain. For hip fractures, your physiotherapist may ask that you use crutches to prevent them from potentially getting worse.

Symptoms

You may find that you have a dull, aching pain in the groin, hip, or lower back that gets worse when you move your legs or when you take a step. There could also be numbness or a tingling sensation in either the groin or the hip.

It may be difficult to pinpoint the location of the pain in both hip and pelvic stress fractures. With a hip stress fracture, you may be unable to bear weight on the affected side.

For both hip and pelvic stress fractures, the pain will worsen while you’re doing an activity and ease while resting.

Treating Groin Pain

Most groin pain can easily be treated the same way. Most of it doesn’t require a doctor, but you may want to see a physiotherapist to ensure everything is okay before getting back into running.

You may want to consult a healthcare practitioner if your pain is debilitating, prevents you from exercising, lingers for a long time after running, or occurs while resting. They will be able to make sure there isn’t an underlying reason that requires medical treatment.

Rest

Resting your body is one of the best ways to help groin pain heal on its own. Pain can signify pushing your body too hard, too far, or too fast. So a rest from activity for at least a few days is highly recommended for treating groin pain.

Take a few days off from any activity involving the movement that causes the pain. You can do other forms of cross-training that may not aggravate it, like swimming or jumping rope.

Return to Running Slowly

If you’ve rested for a few days and you’re keen to get back into running, we advise getting back into it at a less intense level than you left.

Starting slowly is the best way to gauge whether or not your pain has actually healed or if it’s still lingering. If you jump back into running at the same intensity, you risk reinjuring yourself.

Stretch & Strengthen the Hips

A lot of groin pain can be attributed to weak muscles and tight tendons in the hips. You can reduce the chance of groin pain by strengthening your hips muscles and stretching regularly to loosen the hips.

Incorporating glute bridges, hip thrusts, and other glute-activation exercises into your strength or resistance training can help to build muscle. More muscle stabilizes the joints, ligaments, and tendons.

Doing pelvic floor exercises can also help to strengthen the muscles in the groin area and possibly prevent pain when running.

See a Doctor or Physical Therapist

If you struggle to ease the pain, you can visit a physiotherapist. They will assess your injury and possible reasons behind it, as well as grading your injury if it’s a groin strain.

Based on your grade—1, 2, or 3—your physiotherapist will give you a treatment plan, prevention tips, and possibly a plan to get you back to running.

They will also be able to tell you if there’s a high likelihood of an underlying problem that a doctor should handle.

Groin Injury Prevention Tips

Once your groin pain has gone away and you can start running again, you should take precautions to prevent it from returning. Here are some things you can easily do to reduce the chance of getting groin pain after running again.

Warm Up Adequately

Make sure not to exclude your hips and glutes from the warm-up. Stretching can loosen up tight ligaments and tendons, while some running drills can get the blood flowing and prime you for movement. Don’t forget to cool down as well before your hips start to stiffen up.

Strengthen the Core, Hips, and Glutes

Strengthening these areas can stop the same thing from happening in the future. As mentioned above, you should incorporate hip, core, and glute strengthening exercises into your resistance training so that the muscle can better support the activity.

If you have a weak core, the pelvis becomes less stable. An unstable pelvis puts extra strain on the area’s adductors and tendons. Your training program should include all the core muscles, as well as the hip flexors and iliopsoas.

Change the Terrain

Running on downhills can place excess stress on the muscles of the groin. It’s also jarring, as it’s harder to control your speed and be careful about your footfall.

As a result, your adductors and pubic symphysis take on extra strain as they work to stabilize the pelvis.

However, you can reduce the chances of developing groin pain simply by running on more flat terrain. The pelvis isn’t as affected in these cases.

Stretch

Your chances of developing groin pain are higher if you have tight hip flexors, hamstrings, or adductors.

Both your warm-up and your cool-down routines should include stretching of these areas. Warm-up stretching will get the blood flowing through the muscles and ease up any pre-run stiffness. Cool-down stretching will help the body to remove waste products like lactic acid.

Don’t Sit for Long Periods

If your job entails sitting behind a desk for long periods of time, it’s easy for your hip flexors and other muscles to become stiff and tight.

You can avoid this by going for frequent walks to stretch your legs and get the blood flowing. Instead of phoning your colleague down the hall, take a walk to speak to them. Try to walk during your lunch hour, or take the stairs instead of the elevator.

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AUTHOR

Ben is an avid road and trail runner, and has completed multiple marathons and ultras. A former running store owner, he now shares his knowledge and experience writing these articles.