RSM-REM-007
Written by Hironori Ikeda, MSc Sports Medicine
RSM International Academy · Chiang Mai, Thailand
What Should You Assess When Groin Pain Appears During Kicking, Cutting or Sprinting?
The athlete often reveals the problem through the movement itself: shortening the stride, avoiding a hard kick, turning the pelvis away from one side or grabbing the groin after a cut. The painful phase of the movement helps define the examination, but groin pain is not one diagnosis. Adductor-related, iliopsoas-related, inguinal-related, pubic-related and hip-related presentations can overlap, and more than one contributor may be present.
I first reproduce the painful sporting task safely, then use adductor loading and a hip screen to decide whether the local tissue finding actually matches the athlete’s problem. Compare adductor squeeze or resisted adduction, hip ROM and symptom location; broaden the differential when coughing, abdominal load, clicking, locking, neurological change or a non-muscular pattern changes the picture.
In this article, you will learn how to assess groin pain in sport, identify what matters to the therapist, choose between adductor-focused treatment, a broader hip / pubic strategy or referral, and re-test the same kick, cut or change-of-direction task.
In This Article
- What Should You Assess When Groin Pain Appears During Kicking, Cutting or Sprinting?
- In This Article
- 1. Clinical Problem & Differential: Groin Pain in Sport
- 2. Muscle / Joint / Nerve Comparison: Adductors & Iliopsoas + Hip
- 3. Differential Assessment: Adductor-Related Groin Pain + Hip Screen
- 4. Treatment Scope & Symptom Re-Test: Adductor-Related Groin Pain
- 5. Re-Test: Controlled kick or direction change at matched intensity
- Related RSM Clinical Blogs
- Study Remedial Massage at RSM
1. Clinical Problem & Differential: Groin Pain in Sport
Clarify gradual versus sudden onset, kicking, cutting, sprinting, coughing, abdominal load, clicking, locking and training change. Severe trauma, inability to bear weight, suspected fracture, testicular or abdominal emergency symptoms, fever, unexplained swelling, night pain or progressive neurological loss requires urgent medical assessment.
The location of groin pain is often imprecise. I ask whether the complaint is at the proximal inner thigh, pubic region, inguinal region or deeper hip, and whether the support leg or moving leg is involved. This matters before a squeeze test: a painful adductor contraction may be relevant without explaining pain during coughing, catching or an entirely different sporting phase.
2. Muscle / Joint / Nerve Comparison: Adductors & Iliopsoas + Hip
Adductor longus, brevis and magnus, gracilis, iliopsoas and rectus femoris may contribute, but tenderness alone cannot classify groin pain. Compare the pubic region, inguinal canal, abdominal wall and hip joint. Screen obturator, femoral or lumbar neural involvement only when symptom distribution or weakness suggests it.
Adductor longus, brevis and magnus contribute to hip adduction, with additional actions that vary by region and hip position; iliopsoas primarily contributes to hip flexion. A painful squeeze and pain during resisted hip flexion therefore load different combinations. The Doha categories use symptom location and examination together. An athlete can fit more than one category, so a positive adductor finding does not erase a hip, pubic or inguinal question.
Anatomy note: Adductor longus also participates in hip flexion: EMG research found preferential recruitment from an extended hip, showing why an adductor's role depends on the starting position.
3. Differential Assessment: Adductor-Related Groin Pain + Hip Screen
- Establish the comparable kick, cut or direction-change task.
- Palpate the adductor origin and assess pain with resisted adduction.
- Use a standardized adductor squeeze position and record pain and force.
- Compare hip internal/external rotation and flexion.
- Use FADIR/FABER as supporting hip findings, not standalone diagnoses.
- Examine iliopsoas-, inguinal-, pubic- or abdominal-related patterns when indicated.
- Re-test the identical sporting task at a safe intensity.
The Doha definition of adductor-related groin pain requires both adductor tenderness and resisted adduction that reproduces the athlete’s familiar pain in the adductor region. Pain felt only in the inguinal region during a squeeze does not meet that definition. Multiple clinical entities may coexist, and agreement between examiners is imperfect.
During palpation and resisted testing, I alter hip flexion and rotation to place different adductor fibres under load rather than treating the medial thigh as one structure. I then compare that finding with the phase of kicking, cutting or deceleration that produces the familiar pain; the sport movement decides whether the local finding is clinically useful.
4. Treatment Scope & Symptom Re-Test: Adductor-Related Groin Pain
Treatment may address symptom-relevant adductor, iliopsoas, rectus femoris and adjacent tissues within a graded loading plan. It cannot resolve every hip, inguinal or pubic disorder through soft-tissue work. I compare the support-leg and kicking-leg demands before choosing a region. Any adductor contact uses consent, draping and an identified accessible muscle belly; a deep groin sensation is not a reason to pursue the iliopsoas or press into the femoral triangle. Repeat the same kick or cut at the same controlled intensity, recording pain, range and confidence. Persistent loss of function, catching/locking, suspected hernia, stress injury or systemic signs requires referral.
I support the thigh at a tolerable hip angle and use an identified accessible adductor belly for any local contact. A short longitudinal stroke and a small transverse comparison are separate inputs, with consent and draping maintained throughout. These terms describe stroke travel, not pressure direction. Pressure into an accessible muscle belly and an oblique load across it are different from sliding the hand or moving the supported thigh; compare these variables separately, without directing force proximally into the femoral triangle. Newly provoked sharp, electric or spreading pain, tingling or numbness means stop contact and reassess. If the familiar pain appears only with the field task and local findings do not agree, I do not pursue deeper groin structures to manufacture a treatment target.
5. Re-Test: Controlled kick or direction change at matched intensity
Repeat a controlled kick, step or direction-change task at the original safe intensity. Keep support-leg position and the moving-leg demand distinct, recording which phase produces the familiar pain.
If local tenderness changes but the task does not, reconsider the load or clinical category. Progression to harder cutting or kicking needs an appropriate plan; unexplained pubic, inguinal or hip symptoms should not be managed by expanding the massage area.
Related RSM Clinical Blogs
Browse all Remedial Massage clinical guides
▷ Pain Under the Sit Bone: Hamstring Tendon or Nerve? — Remedial Massage · Broaden the differential assessment.
▷ Inner Thigh Tightness in Athletes: Adductor Load & Deceleration — Sports Massage · Connect the findings with the sport task and training exposure.
▷ Groin Pain When Kicking: Hip Rotation, Pelvis & Kicking Mechanics — Sports Massage · Connect the findings with the sport task and training exposure.
Study Remedial Massage at RSM
In practical training, learn to use groin-pain categories to choose a safe muscle comparison and identify when the sporting task needs further assessment. Work through the task, anatomical landmarks and hand-position choices with a clear reason for the next assessment.
▷ Remedial Massage — course details and entry requirements
About the Author
Hironori Ikeda, MSc Sports Medicine
Founder and lead instructor of RSM International Academy, Chiang Mai, Thailand. His teaching connects functional anatomy, clinical palpation, movement assessment and sports medicine manual therapy.