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Pulled Groin or Hernia? Why the Confusion

by Jaydee Vykoukal, PT, DPT February 14, 2021 0 Comments


Groin strains are more common in the younger population when people are active and playing sports. However, if you’re past your high school and college days, the closer you get to 65 years old, the more likely it is that pain in your groin is caused by a hernia. These two conditions can be easily confused yet have slightly different treatment options and risks associated with them. Today, we will dive into how to differentiate between a pulled groin or hernia. 

Why the confusion?

A pulled groin or hernia can be easily confused because they essentially affect the same area. Plus, chronic groin pulls can lead to tissue damage that causes a hernia in the long term. Thus, some of the general symptoms like groin pain and stiffness are similar with either issue.

In fact, they’re so similar that a pulled groin in athletes is sometimes called a “sports hernia.” However, a sports hernia is a bit of a misnomer since there is no actual hernia. A true groin hernia is known as an inguinal hernia.

Pulled Groin vs. Hernia - What’s the Difference?

The two most common factors that differentiate between a pulled groin and inguinal or sports hernia; 1. Age and 2. Lump or Bulge (while common, there are always exceptions).


If you are greater than 50 year of age, there is a high chance that your groin pain is the result of a hernia

Presence of a lump or bulge

If you notice a lump near your pubic bone that is more prominent with standing, coughing, or lifting then there’s a pretty good chance it’s a hernia.

If there is no lump and you are younger it is most likely a groin muscle strain.

Groin Pulls

A groin pull refers to straining the muscles that attach to the inner pelvis; most often the inner thigh muscles referred to as the adductors and commonly associated with physical activity, sports, running, or jumping. Groin pull symptoms are straightforward and easy to diagnose without any x-rays or special imaging.

What Does a Groin Pull Feel Like?

A groin strain is often described as a sudden sharp pain in the inner thigh- most often near the pelvic bone. Common symptoms from this injury include:

  • A popping or snapping sensation in the inner thigh at the time of injury
  • Tenderness to palpation along the inner thigh
  • Pain when lifting the leg or moving the leg inward
  • Loss of leg strength and range of motion
  • Swelling or bruising with more severe strains

Diagnosing a Pulled Groin Injury

Groin Strain Treatment

Once you’ve been diagnosed with a grain strain, exact treatment will vary depending on the severity of injury and your general health. Treatment options include:

Guide to Treating a Groin Strain

  • Rest
  • Ice with compression
  • Nonsteroidal anti-inflammatories (NSAIDs)
  • Activity modification
  • Strengthening the hip and core muscles 
  • Stretching 
  • Physical therapy

Groin Injury Stretches

Physical Therapy Exercises


An inguinal hernia refers to an opening in the abdominal wall; including the belly button, upper abs, or inner groin (most common). When contents from within the abdomen, such as fatty tissue or a small section of the intestine, poke through; this is what is classified as an inguinal hernia. This condition is very common in the older population, especially men. It is most often caused by aging (wear and tear), genetics, family history, and coughing.

Symptoms of a Hernia

An inguinal hernia can come with a range of symptoms. Most often, an inguinal hernia is benign. However, it can turn into a medical emergency if it results in loss of circulation to the bulging tissue. Signs and symptoms include:

  • A bulge near the pelvic bone/groin area that is more obvious with strain, sneezing, coughing, or standing
  • Pain that is burning or aching in nature near the bulge
  • Discomfort with lifting, bending, sneezing, or coughing
  • Pressure in the lower abdomen or pelvis
  • Weakness in the groin or abdominal muscles

More severe signs to watch out for that require immediate medical attention include:

  • Nausea
  • Fever
  • Sudden severe pain
  • Discoloration of the bulge (red or purple)
  • Inability to have a bowel movement or pass gas

Inguinal Hernia Treatment

If a hernia is small and not bothersome, the most common treatment is consistent close monitoring. While the abdominal hole will not heal on its own, it can often stay manageable without surgery. Sometimes an abdominal brace or core strengthening is recommended to support a hernia as well. If symptoms are affecting your quality of life, getting worse, or are at a high risk for tissue strangulation, surgery will be necessary to close the abdominal wall hole.

When to Consult a Doctor

If you are experiencing groin pain and notice a bulge in your pelvic region, get in touch with your doctor for a physical examination, proper diagnosis, and specific recommendations to prevent aggravation. They will also be able to closely monitor the progress of the hernia to prevent any unnecessary complications.

What to Expect from your Physical

Often, a physical examination from your doctor will help them quickly assess if you have an inguinal hernia. They will palpate the pelvic region and ask you to cough or strain to determine the severity. Diagnostic tests, like an MRI, CT scan, or abdominal ultrasound, are not common but can be ordered to rule out other issues or assess any suspected underlying problems.

Getting the Right Diagnosis

Whether you have a groin injury or inguinal hernia, you can expect to recover quickly and manage symptoms with the right awareness and treatment. Understanding some of the key differences between these injuries can help you get back on track with your life quickly. As always, consult your doctor to address any questions or concerns you have. Always seek medical care immediately if your symptoms suddenly become severe.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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