Groin & Hip Injuries

Is it a groin strain or something else? Adductor, hip flexor, hernia or hip joint

Groin pain most often comes from an adductor (inner thigh) muscle strain, but it can also arise from the hip flexors, from a hernia, or from the hip joint itself. An adductor strain usually follows a specific movement and hurts when you squeeze your legs together or stretch the inner thigh. Hip flexor pain is felt more to the front and hurts on lifting the knee. Hip joint problems tend to cause deep pain, stiffness and reduced movement. A hernia may show as a lump or pain that worsens on coughing or straining, and needs a doctor. Because the treatments differ completely, an accurate diagnosis matters, and some causes are not muscular at all.

Groin pain is one of the trickiest complaints to pin down, because several very different problems all produce pain in roughly the same place. People assume any groin pain is a pulled muscle, rest it, and are puzzled when it does not settle, or when it turns out to be coming from the hip joint or, occasionally, a hernia that needs a doctor rather than a physiotherapist. Telling these apart is the first and most important step, because the right treatment depends entirely on the right diagnosis.

This guide explains the main causes of groin pain, how they tend to differ in where and when they hurt, and, crucially, the signs that mean you should see a doctor rather than manage it yourself. It is written to help you understand the possibilities, not to replace an in-person assessment.

Why groin pain is so easy to misread

Several structures overlap in the groin region: the adductor muscles of the inner thigh, the hip flexors at the front, the hip joint deep inside, and the abdominal wall and inguinal area. A problem in any of them can produce pain in a similar spot, which is why self-diagnosis so often goes wrong. The key to telling them apart is not just where it hurts, but what brings the pain on and what eases it.

The main causes and how they differ

Adductor (inner thigh) strain

The most common cause. It usually comes on with a specific movement, a sprint, a change of direction, a kick, and hurts along the inner thigh or where those muscles attach at the pubic bone. It is typically painful when you squeeze your knees together against resistance, or when you stretch the inner thigh. This is the classic groin strain.

Hip flexor strain

The hip flexors run at the front of the hip and lift the thigh. Strain here is felt more to the front of the groin and hip, and is aggravated by lifting the knee, sprinting or kicking. It is a different muscle group from the adductors, though the two can occur together.

Hip joint problems

Pain coming from the hip joint itself, from the cartilage, the labrum, or in older adults osteoarthritis, tends to feel deep in the groin, and often comes with stiffness, reduced range of movement, or a catching or grinding sensation. It usually behaves differently from a muscle strain, being more about joint movement than a specific muscle action. Hip osteoarthritis in particular is a distinct issue, more common with age, and we cover it separately in our guide to hip osteoarthritis.

Hernia and non-muscular causes

An inguinal hernia, or a sports hernia, can cause groin pain that is easy to mistake for a muscle problem. Signs that point this way include a visible lump or bulge, or pain that worsens on coughing, sneezing or straining. This is not a physiotherapy problem in the first instance; it needs a doctor. Other, less common causes are not musculoskeletal at all, which is why certain symptoms should always be checked medically.

How the cause changes the treatment

Getting the diagnosis right matters because the treatments diverge completely. An adductor strain is rehabilitated with a progressive loading programme. Hip joint issues need a different approach focused on the joint. A hernia may need surgical assessment. Treating a hip joint problem or a hernia as if it were a simple muscle strain wastes time and can make things worse. A chartered physiotherapist can assess the groin, identify the likely source, and either treat it or refer you on if it is something that needs a doctor.

Getting an accurate assessment

If groin pain is not settling, or you are unsure what is causing it, an in-person assessment is the sensible next step. A chartered physiotherapist tests the different structures, movement by movement, to work out where the pain is coming from, and knows when a symptom means a referral to a doctor. Somerton Physiotherapy runs a sports injury clinic in Dublin assessing and treating hip, groin and related injuries. See our guidance on who to see for a sports injury, and call (01) 9069566 to arrange an assessment.

Frequently asked questions

• How do I know if my groin pain is a muscle strain or something else?

  An adductor strain usually follows a specific movement and hurts when you squeeze your legs together or stretch the inner thigh. Hip flexor pain is felt at the front and hurts lifting the knee. Deep pain with stiffness suggests the hip joint. A lump, or pain that worsens on coughing or straining, may be a hernia and needs a doctor. An in-person assessment is the reliable way to tell.
• Can groin pain come from the hip joint?

  Yes. Pain from the hip joint itself, including the labrum, cartilage or, in older adults, osteoarthritis, is often felt deep in the groin and tends to come with stiffness, reduced movement or a catching sensation. It behaves differently from a muscle strain and needs a different approach, which is why an accurate diagnosis matters.
• When is groin pain a hernia?

  A hernia is more likely if there is a visible lump or bulge in the groin, or pain that worsens on coughing, sneezing or straining. A sports hernia can also cause groin pain that mimics a muscle problem. These need medical assessment rather than physiotherapy in the first instance, so see a doctor if you notice these signs.
• Should I rest a groin strain or get it assessed?

  Short-term relative rest is reasonable, but if the pain is severe, you cannot bear weight, it is not settling, or you have any of the warning signs such as a lump or testicular pain, get it assessed rather than waiting. A chartered physiotherapist can confirm the cause and set the right rehabilitation, or refer you on if needed.

For independent health information, see the HSE on muscle and joint injuries.

Reviewed by a Chartered Physiotherapist
Reviewed by a Chartered Physiotherapist (MISCP, CORU registered) at Somerton Physiotherapy on 20 September 2026. This article is general information, not a diagnosis or a treatment plan. Every injury is different and should be assessed in person by a chartered physiotherapist or doctor.