Groin pain occurring specifically when lifting the leg (hip flexion) points directly to structures at the front of the hip joint and groin crease. This movement recruits powerful muscles and connective tissues responsible for pulling the thigh upward toward the torso. Since the hip is a deep ball-and-socket joint, pain originating here can be difficult to pinpoint, often feeling like a deep ache or sharp stab. Discomfort can range from a simple muscle pull to a long-term structural issue within the joint itself.
Soft Tissue Injuries
The most frequent causes of groin pain associated with active leg lifting are injuries to the muscle-tendon units, particularly the hip flexors and adductors. The primary muscles responsible for hip flexion are the iliopsoas group (psoas major and iliacus). These muscles merge into a single tendon that attaches deep within the upper thigh bone, and when strained or inflamed, they register pain precisely during the action of lifting the knee.
An acute iliopsoas strain represents a sudden tear of the muscle fibers, often felt as sharp pain during activities like sprinting or quickly bringing the knee to the chest. Conversely, iliopsoas tendinopathy describes a gradual overuse injury of the tendon, presenting as a chronic, dull ache that worsens with repetitive hip flexion. Inflammation of the nearby iliopsoas bursa, a fluid-filled sac cushioning the tendon, can also mimic these symptoms by causing deep, aching pain when the tendon slides over the joint.
The adductor muscles, located on the inner thigh, also play a secondary role in hip flexion and are highly susceptible to strain. These muscles connect the pelvis to the femur and are responsible for pulling the legs together. Pain from an adductor strain is felt in the inner thigh or groin and is aggravated by lifting the leg or attempting to squeeze the knees together. Distinguishing between a sudden strain (acute tear) and a tendinopathy (chronic issue) is important for treatment planning.
Hip Joint Structural Problems
When groin pain persists and is accompanied by mechanical symptoms like catching or clicking, the origin may be structural issues within the hip joint itself. A common structural cause is a tear in the labrum, a ring of fibrocartilage that lines the rim of the hip socket (acetabulum). The labrum acts like a seal to stabilize the joint, and a tear can cause deep groin pain, especially when the hip is moved into high flexion, such as when lifting the leg.
These labral tears are often associated with Femoroacetabular Impingement (FAI), a condition where extra bone develops on either the ball (femoral head) or the socket (acetabulum). This abnormal bone shape causes the femur and acetabulum to collide prematurely during movement (impingement). When the leg is lifted, this bony contact pinches the soft tissues, including the labrum, leading to pain and progressive damage.
The two main types of FAI, cam and pincer, both restrict the smooth motion of the joint, making deep hip flexion painful. In cam impingement, the femoral head is abnormally shaped, while in pincer impingement, the rim of the hip socket extends too far. Repetitive microtrauma from this abnormal contact causes the characteristic pain deep in the groin.
Non-Orthopedic Contributors
Pain felt in the groin when lifting the leg is not always caused by a problem with a muscle or the hip joint structure; sometimes, it is related to surrounding tissue or nerve compression. Inguinal hernias are a significant non-orthopedic contributor, where tissue pushes through a weak spot in the abdominal wall near the groin. The act of lifting the leg can increase abdominal pressure, which pushes the protruding tissue further, leading to discomfort.
Hernia pain is frequently described as a dull ache or a sensation of heaviness in the groin, and it may worsen with activities that involve straining, such as coughing, bending, or lifting. A key differentiating factor is the presence of a palpable bulge or lump in the groin that may disappear when lying down.
Movement-related groin pain can also stem from nerve entrapment, where a nerve that runs through the area, such as the ilioinguinal or genitofemoral nerve, becomes compressed or irritated. Nerve-related pain often presents as a sharp, burning, or electrical shock sensation that may radiate into the inner thigh or genital area. These non-musculoskeletal conditions require different medical approaches than purely orthopedic issues.
When to Consult a Professional
While mild groin discomfort may resolve with simple self-care, specific symptoms warrant an evaluation by a healthcare professional. Initial self-management typically involves short-term rest, applying ice to the painful area, and using over-the-counter pain relievers to manage inflammation. If the pain is severe, if it does not begin to improve after a few days of rest, or if it significantly limits your ability to walk or perform daily activities, you should seek medical advice.
Immediate medical attention is necessary for certain red flag symptoms. These include groin pain accompanied by a fever, sudden and intense testicular pain, or pain that radiates into the abdomen, chest, or back. Additionally, any visible or palpable lump in the groin area that is painful, tender, or cannot be pushed back in should be examined promptly to rule out a complicated hernia.
The diagnostic process usually begins with a physical examination to test muscle strength and hip range of motion, which helps isolate the source of the pain. Diagnostic imaging may follow, often starting with X-rays to assess the bone structure for conditions like FAI or arthritis. To visualize soft tissues such as muscles, tendons, and the labrum, a healthcare provider may order an MRI scan, providing a comprehensive view of the underlying cause.