The simple actions of kicking a ball or running laps around a track can cause an inguinal ligament to become stressed and possibly tear. A strain can range from mild to severe, and characteristic inguinal ligament strain symptoms include discomfort, pain, and sometimes a popping sensation in the pelvic region.
Most cases can be treated with specific stretching exercises and physical therapy. Learn the risks and what can be done for inguinal ligament pain in the comfort of your own home.
What Does Inguinal Ligament Mean?
The inguinal ligament is found in the abdominal wall, in the lower region of the abdomen and groin area. It is a group of tissue fibers banded together, running through the pelvis and stretching from the external oblique to the front of iliac spine.
It is primarily responsible for supporting the blood vessels, nerves, veins, and arteries that travel through the pelvic region. The inguinal ligament also helps support the external oblique muscle, the tissues of the groin, and keeps the intestines in their proper location. This important ligament gives us the ability to move our hip bones and joints.
What Is an Inguinal Ligament Strain?
Based on the position and the role it plays in our body, the inguinal ligament is susceptible to trauma. A strain can happen with overuse or working the ligament in a repetitive motion over time. This stress on the inguinal ligament usually presents as pain in the groin region and can be divided into three type of strains.
Grade I
Grade I indicates the inguinal ligament strain is mild enough not to affect movement of the region, but does offer slight pain and discomfort of the groin region.
Grade II
This is referred to as a moderate range of strain, with a deal of difficulty in performing activities that may place pressure on the thighs. This can include running and jumping. A grade II inguinal ligament strain may offer pain along with swelling and bruising of the skin.
Grade III
When an inguinal ligament strain is diagnosed at this level, there is usually no possible movement of the lower extremities. There also may be muscle spasms. On the pain scale, this type can leave one in excruciating pain.
Inguinal Ligament Strain Causes
An inguinal ligament strain can be caused by varying factors that see the fibers of the ligament pulled and stretched beyond their capacity.
1. Sports Hernia
This medical condition happens when tissue in the inguinal canal becomes damaged from repetitive movement or twisting. The actions of kicking, sprinting, and turning can create an environment of strain that eventually leads to tears, and possibly force the muscle to work itself away from the ligament. Despite the name, there is no actual herniation that occurs. This can present severe pain in the region, and is common in athletes in football, tennis, rugby, soccer, and hockey. A sports hernia is also referred to as a groin disruption or Gilmore’s Groin.
2. Pregnancy
An inguinal ligament strain can also be caused by the pressure applied during the changes of a pregnancy. The abdominal walls are stretched, and the ligament is at risk for tearing during childbirth. If the woman has had multiple pregnancies, the ligament can become weak.
What Is the Treatment for Inguinal Ligament Pain?
Inguinal ligament strain treatment highly depends on the underlying cause and the severity of any damage to the ligament. The first 48 hours following a strain are crucial for successful treatment and proper healing. An ice compress on the groin region may target pain and inflammation.
Any pain associated with a hernia affecting the inguinal ligament usually requires a surgery. It may be a procedure to graft the ligament with an artificial material for support.
A grade I strain will require regular exercises such as walking to gently work the ligament to promote flexibility.
Grade II strains treatment combines the use of heating compresses with leg exercises such as straight leg, hip rotation, abduction, and adduction movements.
For grade III treatment, the tears may need to be repaired with surgery.
Physical Therapy for Inguinal Ligament Strain
In addition to the above inguinal ligament exercise treatments for the strain, physical therapy is highly recommended.
Level 1
Using a stationary cycle, station the seat at the lowest position and resistance level. Avoid overdoing it. Groin stretches should also be performed five times each day with holds lasting 30 seconds.
Level 2
The next level steps up the groin stretches to strengthen the ligament. Perform straight-leg raises by pulling the leg toward midline and then, away from the body. New exercises are introduced such as hip internal and external rotation and hip flexion. These are to be done every other day.
Level 3
After one week of therapy, continue the stretches and exercises with increasing the repetitions each time. Also at this time, begin to reintroduce activities enjoyed before the strain.
Inguinal Ligament Stretches
Groin stretches are part of most treatment plans for an inguinal ligament strain. We have the top-used stretch exercises for the best results and a quick and safe recovery.
1. Supine Active Frog Stretch
Follow this exercise for internal and external hip movements. On the floor, lie on the back with knees bent and feet pulled toward the buttocks. With arms out to the side, move legs outward until the bottom of the feet touch, keeping the knees bent. Take a deep breath and return the legs to starting position. Repeat 10 to 12 times for two sets of repetitions.
2. Hip Flexor with Shoulder Flexion
Stretch the hip flexor while targeting the inguinal ligaments with this exercise. Stand with feet pointing in front and the right foot slightly behind the body. Clasp hands with palms facing the body and reach over the head. Clench the right buttock, and hold the position for five to six deep breaths. Repeat with the left leg behind body and left buttock clenched.
3. Overhead Lunges
Strengthen hips and legs with this stretch. Stand with the right foot in front of the body, and lunge down as if to touch the floor with the left knee. Reach the arm over the head and exhale before returning to starting position. Repeat on the other leg, with three sets of eight repetitions on each side.
4. Step-Ups
This exercise takes the lunge stretch to a higher level in more ways than one. Using an object two to three feet tall, such as a stool, place the left foot on the top while pushing off with right foot. Extend the right leg behind you, and hold for two seconds. Repeat on the other side with three sets of eight repetitions on each side.
Inguinal ligament pain can be quite bothersome as it can affect mobility of the hips, thighs, and legs. Performing repetitive movements with sports, or even the natural stretching of the ligament during pregnancy, can cause a serious strain to occur. Depending on the severity or type of the strain, there are specific stretching exercises to help strengthen the ligament. In more serious cases, surgery may be required to repair the inguinal ligament.
Sources:
“Inguinal Ligament Pain: Causes, Symptoms, Treatment,” ePain Assist; https://www.epainassist.com/joint-pain/hip-pain/inguinal-ligament-pain, last accessed April 28, 2017.
“Inguinal Ligament,” Healthy Life Med, May 30, 2015; http://healthylifemed.com/inguinal-ligament/, last accessed April 28, 2017.
Rockwell, R., “Physical Therapy for Inguinal Ligament Strain,” Live Strong, July 15, 2011; http://www.livestrong.com/article/493485-physical-therapy-for-inguinal-ligament-strain/, last accessed April 28, 2017.
Ng, N., “Workouts For The Inguinal Ligaments,” Live Strong, June 10, 2011; http://www.livestrong.com/article/468048-workouts-for-the-inguinal-ligaments/, last accessed April 28, 2017.