If you have groin pain when exercising or when your hips are in certain positions such as getting into and out of a car, it may be that the bony shape of your hips is causing abnormal pressure on the surrounding soft tissues.
What was previously passed off as a groin strain has in recent years been commonly found to be caused by femoro-acetabular impingement (FAI).
There are two main types of FAI, occurring either in isolation or together. A “cam” lesion is where the femoral head (ball) is more elliptical than spherical. A “pincer” lesion is cause by either a deep or misdirected acetabulum (socket). The resulting mismatch of articular surface shapes can lead to trapping of the acetabular labrum, causing it to tear and become painful. The labrum normally acts as a “wind screen wiper” keeping the articular surfaces well lubricated. Loss of this lubrication is thought to play an important role in the onset of arthritis.
Diagnosis of FAI is largely by clinical examination and plain x-rays, but often requires an MRI scan to confirm or plan any operative intervention.
Treatment can involve non operative measures such as physiotherapy, simple analgesia or hip injections. Operative intervention aims to restore the normal anatomy of the hip in order to prevent soft tissue damage and hence pain. Debridement of the femoral head-neck junction or acetabular margin, or labral restoration surgery can usually be achieved through a small “bikini” incision.
If you are concerned that your groin strain is not settling and that you may have femoro-acetabular impingement, I would be happy to discuss your individual treatment requirements in one of my clinics.