The Dangers of Groin Injury In Women’s Football
By Chinwendu Blessing Ekwem
Football (soccer) is played by more than 300 million people globally. It is the most popular sport in the world, and participation in this dynamic sport continues to grow. Football (soccer) brings joy, health, recreation, and entertainment to billions, but as a high-impact contact sport, it is associated with significant
Groin injuries are among the three most common and time-consuming injuries in football, accounting 2-14% of all injuries in females, with an incidence of 0.1-0.6 injuries per 1000 hours of play in females.
Groin injuries have historically been challenging to diagnose and treat. A wide range of diagnoses have been described, with an equally long list of different treatment options. In an effort to help clarify the diagnostic terminology used to describe groin injuries in football players, the World Conference on Groin Pain in Athletes was held in 2014.
Groin Injuries Among Female Athletes:
Groin injuries are common in female athletes participating in sports that involve running, sprinting, kicking, jumping, sudden changes of direction and rapid acceleration, such as football, basketball, hockey and athletics.
A groin injury refers to pain or damage involving the muscles, tendons, joints or other structures around the inner thigh, hip and pelvic region. The most commonly affected muscle group is the hip adductors, particularly the adductor longus.
The adductor muscles perform important functions:
- Bring the legs towards the midline.
- Stabilise the pelvis during movement.
- Control leg movements during running and kicking.
- Support balance and coordination.
Common types of groin injuries in female athletes
- Adductor related:
Injury to the inner thigh muscles. Common during sprinting, kicking and sudden changes of direction. - Psoas related:
The iliopsoas muscle is a flexor and external rotator of the hip. It is the most powerful flexor of the hip joint. As a result, it is a very important muscle for the kicking action. The muscle is most frequently injured acutely during kicking. - Inguinal related:
the pain also has an abdominal element located in the area of the inguinal canal and/or the region of the rectus abdominis muscle at the pubic bone.
3.Public related:
many athletes with chronic groin pain were diagnosed as having “osteitis pubis”
Osteitis pubis is an inflammatory or stress-related condition affecting the Several factors may contribute to groin injuries: the athletes have localised tenderness in the region of the pubic symphysis.
Other conditions:
There are a variety of other conditions that can cause groin symptoms in football players, and athletes in general.
- Disorders of the hip joint
- Young adolescent athlete, it is essential that one consider a slipped capital femoral epiphysis (SCFE) as a potential cause of pain.
- In young men, testicular cancer is relatively common and should not be missed. One should consider performing a testicular exam as part of a comprehensive assessment if the cause of pain is not immediately clear.
Factors that causes groin injury:
A. Muscular factors:
- Weak hip adductor muscles.
- Poor core stability.
- Muscle strength imbalance.
- Previous groin injury.
B. Training factors: - Sudden increase in training intensity.
- Excessive match exposure.
- Inadequate recovery.
- Repetitive sprinting and kicking.
C. Female-specific considerations: - Individual differences in pelvic and hip biomechanics.
- Menstrual health and associated symptoms.
- Low energy availability and inadequate nutrition.
- Low bone mineral density and risk of bone stress injuries.
Clinical signs and symptoms:
A female athlete may present with:
- Pain around the inner thigh or groin.
- Tenderness over the adductor muscles.
- Pain when squeezing the legs together.
- Difficulty sprinting or accelerating.
- Pain during kicking.
- Reduced hip mobility.
- Weakness during hip adduction.
- Discomfort when changing direction. Important clinical test:
- Adductor squeeze test: Assesses pain during resisted hip adduction.
- Resisted adduction test: Evaluates adductor muscle strength and symptoms.
- FABER test: Helps assess hip and surrounding pelvic structures.
These tests must be interpreted alongside the patient’s history and other examination findings.
Immediate management:
Groin pain can be difficult to treat. It is important to ask the player to reduce his or her training volumes, and in many cases stop playing football completely for a period. Selective strengthening exercises of the hip, groin and abdominal muscles are all-important.
For an acute suspected groin muscle injury:
- Stop the activity causing pain.
- Protect the injured area.
- Apply ice if it provides pain relief.
- Assess pain and weight-bearing ability.
- Arrange appropriate clinical assessment.
- Avoid aggressive stretching during the acute painful phase.
- Severe pain, inability to bear weight or suspected bone injury requires urgent assessment.
Prevention of groin injuries:
Prevention should be integrated into the athlete’s regular conditioning programme.
Recommended strategies:
- Copenhagen adduction strengthening.
- Core stability exercises.
- Hip mobility and strengthening.
- FIFA 11+ injury-prevention warm-up programme.
- Gradual increase in training workload.
*Adequate nutrition and recovery. - Early management of previous injuries.
Return-to-play considerations
An athlete should not return to competitive football simply because the pain has reduced.
Before returning, assess:
- Pain-free functional movement.
- Adequate adductor strength.
- Full or near-full hip range of motion.
- Ability to sprint and accelerate.
- Ability to kick and change direction.
- Successful completion of full team training.
- No significant recurrence of symptoms.
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Other differential diagnoses include: - Endometriosis.
- Ovarian cysts or ovarian torsion.
- Pelvic inflammatory conditions.
- Urinary tract disorders.
- Femoral neck stress fractures.
- Inguinal or femoral hernias.
- Persistent or unexplained groin pain warrants appropriate medical evaluation.
Conclusion:
One important area that sports medicals should not overlook is the relationship between groin pain, pelvic health and bone health. For example, an athlete with persistent groin pain may have a femoral neck stress injury associated with low energy availability or reduced bone mineral density.
Groin injury management in female athletes requires a holistic approach that combines sports medicine, musculoskeletal assessment, rehabilitation, injury prevention and attention to female athlete health.
Reported: Chinwendu Blessing EKWEM
