Hip and groin pain

We start with your story: where the pain sits, what brings it on, and how it began. A groin pull usually has one moment, such as a ski split or a skating push. A pinch or a worn joint creeps in over a season.

Then we examine the hip: how far it moves, and whether squatting low or turning it inward brings on the pinch. We test the muscles around it, including the inner thigh (the adductors) and the muscles at the front (the hip flexors), against the other leg.

Groin pain does not always come from the hip: the lower back and the joints of the pelvis can send pain there, so we test them too. We also watch how you squat, land and stand on one leg.

Anything that needs a closer look goes to a doctor or nurse practitioner, who can order a scan.

Treatment follows the assessment, and most of it is exercise. It often includes:

• Load management: which movements and loads the hip can take now, and which to trim. For a pinch, that may mean shallower squats and less sitting low; for a pull, a break from sprinting and cutting.
• Hands-on treatment: joint and soft-tissue mobilization and manipulation for pain and stiffness in the hip, back and pelvis. See manual therapy.
• Strength around the hip and trunk: inner thigh, buttock muscles (the glutes), hip flexors and trunk, loaded in stages so the joint carries less.
• Movement patterns: how you squat, land and push off, and how your pelvis moves on the bike or on skis.

For a worn joint (osteoarthritis), the plan has the same shape: keep it moving, build the muscles around it, and pace what it does in a day.

The later stages move into strength and conditioning, built around what your sport or job asks of the hip.

You go back when the hip passes testing, not on a date. For a groin pull, that means the inner thigh matches the other side and takes a hard push, a cut and a wide stride without pain. For a pinch, it means squatting, landing and twisting as deep as your sport needs, with the hip no more than a little worse after.

We train for what your sport asks of the hip. On skis, that is a deep tuck and the split a caught edge can force. On the bike, it is hours bent low, then a hard push off the pedals. On the trail, it is the uphill stride and the braking on descents. Sports physiotherapy covers technique analysis and the return to sport.

If you have surgery, such as a keyhole operation (arthroscopy) or a hip replacement, rehab follows your surgeon's protocol. Their timing then counts alongside our testing.

Book an assessment if hip or groin pain stops you skiing, biking or running, if the hip catches or locks, or if it is slowly stiffening. Come in too if a groin pull keeps coming back: the earlier it is assessed, the sooner the plan for work, study and sport starts.

Go to the emergency department right away, or call 911, if any of these happen:

• you cannot put weight on the leg after a fall
• the leg looks shorter or turned outward
• a hot, swollen hip, or a fever with the pain
• new numbness or weakness in the leg
• groin pain with a lump that will not go back in