What is a soft groin?

The inguinal region is located at the transition from the lateral abdominal area to the thighs, i.e. at the connection line between the upper iliac crest and the pubic bone.

The soft groin is also known as the athlete's groin and includes several symptoms of different causes.

In general, it is long-lasting pain after loading in the groin area due to a weak connective tissue, hence the name soft groin.

Further general information on this topic can be found on our website Strip.

Causes of a soft groin

A soft bar or athlete bar occurs primarily in team sports, primarily football.

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Sometimes a soft groin is also referred to as an adductor strain, whereby the adductors are a muscle group of the inner thigh muscles.

These adductors arise in the area of ​​the groin and can therefore lead to pain in the groin when pulled.
Strictly speaking, an adductor strain is not a soft groin.

However, since the soft groin and the athlete's groin are used as a synonym, and adductor strains can easily occur in athletes, the pain in the groin region that this causes is often included in the athlete's groin.

Actually, however, a soft groin is a connective tissue weakness.

Nevertheless, an adductor strain can be the cause of a soft groin.
At least an adductor strain can ensure that connective tissue is damaged by the strain, which favors a soft groin.

However, the structure of the inguinal canal, which is located in the groin area, is decisive. In men, this channel contains the spermatic cord (Funiculus spermaticus).

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Blood vessels are also found in the inguinal canal in both sexes (Arteries and veins), Lymph vessels and various nerves, such as the genital branch of the genitofemoral nerve. All these structures are secured by the inguinal canal so that they cannot be constricted.

You can find out more about the topic here: Inflammation of the inguinal canal

However, if the connective tissue weakness mentioned above occurs, the canal may be damaged not stable remains. The reason for this is the limitation of the inguinal canal.

Of the ground of the inguinal canal is formed by a band that Inguinal ligament.

The Front wall is formed by the aponeurosis of a Abdominal muscle (External oblique muscle).

The Back wall is from a fascia that Transversal fascia educated.

The top, roof the inguinal canal, on the other hand, is only separated from the overlying connective tissue Abdominal muscles Cut.

If there is a weakness of the connective tissue here, it can be a too much pressure acts from the abdominal area on the groin and the inguinal canal.

The name soft bar comes from the "give way“Connective tissue that is no longer able to compensate for the pressure that occurs in the abdomen when kicking football, for example.
If the shot comes to one sudden strong muscle contraction in the abdomen and thus to increased pressure on the inguinal canal, a soft groin can arise.

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The problem is that the muscle-free tissue now presses on the inguinal canal and constricts it. The nerves and vessels contained therein are narrowed and it comes to severe pain.
So the cause of the severe pain in the soft groin is one Pressure load on the nerves (Ilioinguinal, iliohypogastric, and genitofemoral nerves) of the inguinal canal.

How is a soft groin diagnosed?

In order to be able to make the diagnosis of a soft groin, the doctor uses various aids.

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First of all, the conversation with the patient and the anamnesis are very important in order to find out whether the patient has overworked or improperly exercised.

By feeling the groin area (Palpation) the doctor can at most determine that it is not an inguinal hernia, as it is usually palpable.
The doctor can rarely recognize a soft groin and assess the severity just by palpation.

To get the exact diagnosis "soft groinHowever, sonography is the main option. The doctor can recognize the displaced connective tissue and assess the narrowing of the inguinal canal.

Soft groin symptoms

The symptoms of a soft groin are manifested as severe pain in the groin area and can radiate into the thigh or the abdominal region.

In contrast to the inguinal hernia, the soft groin is not a complete breakthrough of the abdominal wall, but only a protrusion of connective tissue, which occurs mainly when under stress.

It is therefore understandable that not only is it difficult to diagnose, but that the pain also occurs mainly during or after severe stress. Above all, jerky leg movements or insufficient warm-up training can quickly lead to the characteristic pain of a soft groin.

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It is also important that various nerves run in the inguinal canal, which can be narrowed by a soft groin. On the one hand, the ilioinguinal nerve supplies parts of the abdominal muscles (Musculus transversus abdominis et Musculus obliqus internus abdominis) and can therefore lead to pain there, and on the other hand, it sensitively cares for the front part of the testicle in men.

In women, the nerve supplies the labia with sensitivity.

Therefore, if this nerve is constricted, pain or sensitivity disorders in the area of ​​the testicle (scrotum) or the labia (Labia major) come.

Another nerve that runs through the inguinal canal and can be narrowed is the iliohypogastric nerve. This also partially supplies the lower abdominal muscles and ensures the sensation in the groin area.

If the nerve is narrowed by the soft groin, severe pain occurs in the groin area.

The last nerve that runs through the inguinal canal is the genitofemoral nerve. This nerve has a small branch called the genital ramus.
In men, this small branch supplies the cremaster muscle, i.e. the muscle that lies around the testicles.
In addition, the nerve branch provides the sensitive sensation in the area of ​​the testicle.

If this nerve constricts, it can lead to pain in the groin, leg and lower abdomen as well as severe pain and abnormal sensations in the testicle area.

It is characteristic of the soft groin that the symptoms, i.e. the pain and the discomfort, are felt almost exclusively under heavy stress. After a short time they disappear as soon as the patient relaxes.

However, since the cause cannot be treated by simply waiting, the symptoms reappear every time after exercise, for example after football training. It is therefore important to consult a doctor even if the symptoms subside in order to avoid an inguinal hernia and to find a suitable therapy.

Pain

Pain is the main symptom of the soft groin and is therefore the most important distinguishing feature for the doctor. Unfortunately, the pain associated with an athlete's hernia is often uncharacteristic, especially at the beginning: it can occur in the lower abdomen, on the hips, in the area of ​​the groin itself or on the thigh. The pain is typically transmitted to the thigh and / or the genital area. Often times, things like coughing, sneezing, sit-ups, or lifting heavy weights make the pain worse. The reason for this is the increasing pressure in the abdomen, which is transferred to the inguinal canal and there intensifies the compression of the affected nerve.

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Soft groin therapy

First of all, one tries to find a conservative therapy, that is, not to perform an operation.

Rather, attempts are made to relax the groin area with physiotherapeutic measures or targeted muscle training.

Secondary complaints, such as an adductor strain, should also be treated in order to permanently improve the symptoms of the soft groin. It is also important to point out to the patient that the training that has taken place so far needs to be changed slightly. An extensive warm-up program with correctly performed stretching exercises should be created. Cooling compresses are also recommended to relieve the pain.

However, if the pain gets worse, you can also resort to drug therapy to make the pain in the soft groin bearable. In the past, cortisone preparations were often injected. Today we know that this therapy of the soft groin should be avoided as it only improves the symptoms in the short term, but worsens them in the long term. Some patients have also had great success with acupuncture.

In advanced cases, however, usually only an operation will help. A distinction is made between the laparoscopic surgical technique and the open surgical technique. In the laparoscopic surgical technique, an image of the groin area is created using an optical instrument, the laparoscope, by inserting the laparoscope under the abdominal wall, similar to a video camera. This is a minimally invasive surgical technique in which only extremely small scars can be seen later.

With the open surgical technique, on the other hand, the entire inguinal canal is opened in order to have a large-area overview.
This technique is particularly useful because it causes further injuries (for example on the muscle) can be recognized and treated if necessary. At the same time, however, a larger scar arises, which is not necessarily annoying in the groin area.

If possible, one also likes to operate on these complaints without an additional mesh, since young people in particular are affected by the soft groin and a foreign body insert during an operation always brings risks with it.

During the operation, attempts are made to locate and eliminate the cause of the pain, as well as to stabilize and strengthen the posterior wall of the inguinal canal. The attending surgeon will provide detailed information on the operation before the operation. Then the point in time should be presented and discussed all the advantages and disadvantages of the various techniques. If you decide to have an operation, you should not wait too long, as otherwise the pain that is already there could be chronically imprinted on the so-called pain memory and may not subside even after the operation. Furthermore, long-standing pain often results in a relieving posture, which can lead to serious consequential damage, which in the worst case also has to be treated surgically again.

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In some cases, nerves are also removed during the operation in the inguinal canal in order to completely eliminate the pain. However, this technique is much discussed. Although there is an improvement immediately after the operation and the patient can quickly take up the normal amount of exercise again, a relapse often occurs after months, i.e. a return of the old symptoms.

It is therefore more important to stabilize the slack connective tissue and thus prevent pain in the soft groin and prevent it permanently.
This stabilization as therapy for the soft groin takes place with the help of a plastic net that is stapled in the area of ​​the weak point and thus prevents the weak point from breaking in again.
This gives you long-term therapy and a very good chance of complete recovery.

Taping a soft bar

If the term “soft groin” refers to an adductor problem, a temporary treatment with the help of tape may be an option. However, the taping itself should always be carried out by adequately trained specialists. If the soft groin is a “real” athlete's hernia, unfortunately nothing can be done with a tape bandage. Since the problem of the athlete's hernia lies in the inner abdominal wall and is not a muscular one, there is no need to attempt to stabilize it from the outside. Due to the fact that connective tissue weakness leads to the symptoms, there is no way to treat a soft groin externally.

Read more about this under: Tape bandage

Exercises for a soft groin

Since the symptoms of a soft groin are mainly aggravated by the chronic strain and strain on the hips and the resulting muscular imbalance, at least a partial improvement can be achieved through targeted strengthening of the abdominal muscles. However, the problem cannot be completely eliminated through exercises, since the posterior wall of the inguinal canal is usually affected and, as a sinewy connective tissue structure, cannot be trained like a muscle. Strong abdominal muscles can reduce the discomfort. The oblique abdominal muscles are particularly important for this. Exercises with your own body weight, which not only focus on the stomach in isolation, but also strengthen the entire core, are particularly suitable for exercising this.

It is highly recommended, for example, to hold the plank - i.e. the forearm support - as long as possible, but at least 3x 1 minute. The entire body remains in one line, the stomach is tight, the bottom completely flat. Then you can turn up to the side and hold the side support as long as possible. Then of course there is a change of page. If these exercises get too boring in the long run, you can always lower your hips in the side support towards the floor and push them up. The body stays in line and the tension in the stomach is maintained. Or you try to alternately pull one knee to the elbow on the same side from the straight forearm support. There are no limits to the variety of training available.

Read more about the topic here: Abs Workout - The Best Exercises

Frequency distribution

A soft groin occurs mostly in men and is extremely rare in women.

However, it does not arise out of nowhere but is always caused by incorrect or excessive strain on the leg and abdominal muscles.

A soft groin can easily develop, especially in soccer, where slides, shooting movements and extreme postures are common.

Circa 7% of footballers suffer from a soft groin at least once in their football career, even in professional footballers 10-15%.

Ice hockey players are also often affected by a soft groin. Here every fourth player suffers from the pain of a soft groin.

Soft groin in women

The clinical picture of a soft groin is rather unusual in women, but of course not impossible. Since these are traditionally male patients, it is precisely for this reason that special attention should be paid to women with corresponding symptoms: their symptoms are easily overlooked or misinterpreted as another clinical picture! It is even known that soft groins occur much more frequently in people with a genetically caused weakness of the connective tissue than in other people. In turn, these victims are more often than not women. Even - and especially - as a woman, one should insist on an ultrasound examination for clarification in the case of the typical symptoms of a soft groin.

Soft groin during pregnancy

Pregnancy is always an extreme change and at the same time an extreme burden for the mother-to-be. As the child grows, there is maximum expansion of the abdominal wall. In order for this to be possible at all, the connective tissue automatically becomes softer during pregnancy. This in turn favors the development of a soft groin during pregnancy. So if you know that there is a family-related risk or have already dealt with it yourself, you should pay particular attention to the symptoms of a soft groin during pregnancy. In contrast to other cases, however, it is advisable for pregnant women to wait before a possible operation. The risk for mother and child under anesthesia should be avoided if possible and the problem may become superfluous after the end of pregnancy and normalization of the abdominal-pelvic area.

Which doctor should I see?

Of course, every doctor should generally recognize a soft groin, but unfortunately this is often not the case in practice. If you are afraid of a groin injury, it is best to consult an experienced surgeon, a sports doctor or an orthopedic surgeon, who in the best case can also do an ultrasound examination himself to clarify the problem. Another alternative can be the presentation in the outpatient clinic in the hospital, which is, however, rather reluctantly seen by the doctors there. Initially, some patients also come to their gynecologist or urologist for clarification - especially if the pain radiating to the genital area is the leading symptom, a gynecologist or urological examination should also be carried out. In most cases, however, this proceeds without any noticeable result and the patient is referred to others.

prophylaxis

Unfortunately, there is no proper prophylaxis to avoid a soft groin.

However, it is important when training on one sufficient warm-up and warm-up program to pay attention and the stretching always to be carried out correctly.

You should also pay attention to to use all muscle parts equally.
Footballers in particular often shift the main focus of their training to that Leg muscles.
However, well-trained people are also important Belly- and Back muscles, as these are a good prophylaxis for a soft groin.

forecast

After the therapy, the athlete should be able to resume the old training after about 6 weeks.

What is important, however, is the load to increase slowly and first with light weight training and physical therapy to start to spare the bar a bit.

If you do not take any therapy, the pain disappears after every workout, but keeps coming back and a painful one emerges Inguinal hernia is becoming more and more likely.

Without therapy, the prognosis is therefore many times worse.
With treatment and surgery, approx 95% of all sick people fully operational again after 6 weeks and can pursue their sport as before.

Duration of healing

Without surgery, a soft groin can take a long time to heal. Chronic courses are then not uncommon, and the further healing process is often difficult to assess. Many sufferers bother with this problem for months or even years. With surgical therapy, the chances of success are extremely good. As a rule, the person affected is allowed to do light sport again after about 2 weeks and is soon fully resilient. As soon as the surgical wound has healed well, nothing stands in the way of normal everyday life and normal training. When exactly this time has come varies slightly from patient to patient. The attending physician will determine the individual time on the basis of regular follow-up checks.


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