The Guru tells Steve that groin issues can be tricky

December 10, 2015

Hi, I have a chronic groin strain that I can’t shake off for maybe 2 years. It’s very close to pubic bone.

I am fit healthy active 45 year old with ideal weight. Nhs have tried strengthening exercises, private physio tried cortisone injection. Recently had an MRI scan and I think I will now be referred for a guided injection.

Keep getting conflicting advise. Is 2 cortisone injections too much? Nothing seems to work.

Not sure if I should rest it or gently exercise it? What would you advise.

Thanks in advance

December 10, 2015

Hi Steve

Tricky thing about recalcitrant groin issues is that you need to see the right person to do the right thing, not just a person doing a thing.

There is a variety of differing treatments interventions – some invasive (jabs) some in the middle (bisphosphonates) and some therapeutic (rehab) BUT if you don’t know why you’ve got it and why it’s not going away it’s pretty pointless repeating the same intervention (being jabbed under guidance or not) and expecting a different outcome.

Most groins fail because they cannot deal with the load that need to go through them. If you do too much they break down and if you don’t do enough they won’t repair. It’s a bit like Goldilocks and the 3 Bears – you need to do not too much, not too little but just the right amount. It’s all to do with load management, and this will be 2016, 2017 and 2018 new buzz word!

If you cannot control the shear forces around one side of your pelvis when you take weight on that side, then the groin will break down. You need to get control when your walking, jogging, hopping and change of direction. It’s not just about getting stronger. It’s about getting the rest of your body moving better (to take excessive load off of your groin) to allow you to retrain your muscles to accept load. Then you get stronger!

My advise would be to see somebody who knows about groins (I can prompt you in the right direction). They take time. You’ll need to have bits treated you didn’t know needed treating (thoracic spines) and you don’t really want anyone poking anything (fingers, metal things) anywhere near your groin. You’ve got a diagnosis, but you haven’t got a cause of symptoms. You need this before you can start to get better.

2 jabs are not too much, but I’m not sure it’s going to help without the right rehab….in fact do the right rehab and don’t bother with the jab. Don’t give up!

The Guru

Guru Responded

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