The sudden, sharp pain that appears in the inner thigh or hip crease when performing a squat can be a deeply frustrating experience. This discomfort, often generalized as “groin pain,” signals that the demanding mechanics of the squat are placing strain on sensitive structures in the hip and pelvis. Understanding the source of this pain requires looking closely at the specific anatomy engaged during the movement. This article explores the structures involved, the most common injuries that cause this pain, and the technique modifications that can help resolve the issue.
Understanding the Anatomy of Groin Engagement During Squatting
The groin region is defined by the adductor muscle group, comprising five muscles: the adductor longus, magnus, and brevis, gracilis, and pectineus. These muscles originate on the pelvis and insert along the femur, stabilizing the hip and knee joints during lower-body movements. While their primary function is hip adduction (drawing the legs inward), they also assist with hip flexion and extension when standing up from the bottom of a squat.
The squat requires deep hip flexion, intensely loading the adductor muscles. During the descent, they work eccentrically to control hip and knee opening. On the ascent, they contract concentrically to extend the hip and stabilize the pelvis against the load.
The movement also involves the hip flexor muscles, notably the iliopsoas, which runs from the spine and pelvis to the femur. The iliopsoas is heavily recruited to stabilize the core and pelvis throughout the squat. Weak, tight, or overstressed muscles can result in pain localized to the groin.
Common Musculoskeletal Causes of Groin Pain
The pain felt during a squat can stem from a muscular, soft tissue, or joint-related issue.
Adductor Strain (Pulled Groin)
The most frequent cause is an Adductor Strain, often referred to as a “pulled groin.” This involves a tear or overstretching of the adductor muscles, most commonly the adductor longus, and typically presents as a sharp, sudden pain during the squat or a specific movement like lunging. A strain is usually accompanied by tenderness near the pubic bone, and the pain intensifies with resisted leg adduction. The severity can range from a mild first-degree strain to a complete third-degree rupture resulting in bruising and significant loss of function.
Hip Impingement and Labral Tears
Another common cause is Hip Labral Tears or Femoroacetabular Impingement (FAI), which involves the hip joint itself. FAI occurs when abnormal bony formations on the femur or hip socket create friction, causing the bones to contact prematurely during deep hip flexion. The resulting pain is typically described as a deep, pinching sensation in the front of the hip or groin, sometimes following a “C-shape” around the hip joint, known as the C-sign. This mechanical block can eventually lead to a tear in the labrum, the ring of cartilage surrounding the hip socket. Pain that does not resolve with rest or that includes clicking, catching, or locking sensations in the hip joint often indicates FAI or a labral issue.
Sports Hernia (Athletic Pubalgia)
A soft tissue injury known as a Sports Hernia, or athletic pubalgia, can mimic a strain but is a more complex issue involving the soft tissues of the lower abdominal wall. A sports hernia involves a strain or tear in the tendons or muscles where they attach to the pubic bone. This condition is differentiated from a typical adductor strain by the presence of pain that often radiates to the lower abdomen and is worsened by activities that increase intra-abdominal pressure, such as sit-ups, coughing, or sneezing. Unlike an inguinal hernia, a sports hernia does not usually cause a visible bulge. The deep groin and lower abdominal pain associated with athletic pubalgia may temporarily decrease with rest but returns immediately upon resuming physical activity.
Biomechanical Triggers and Form Adjustments
Improper squat technique often triggers pain by placing undue stress on the groin. Excessive depth is a common issue, forcing the hip into a range of motion that exceeds available mobility, particularly for individuals with FAI. Limiting the depth of the squat, so the hip stops just before the onset of the pinching pain, can often prevent impingement symptoms.
Stance width and toe-out degree influence how the groin muscles are loaded. A wider stance with slightly outward-pointed toes can reduce hip impingement and allow for more effective posterior hip activation. However, an excessively wide stance may overstretch the adductors, increasing strain risk.
Knee valgus, where the knees collapse inward during the ascent, is another significant trigger. This inward movement stresses the adductor muscles as they attempt to stabilize the knee and hip joints. Actively pushing the knees out, ensuring they track over the feet, distributes the load more evenly and reduces inner thigh strain.
Underlying mobility restrictions, such as tight hip flexors, can force compensatory movements during the squat. Shortened hip flexors can pull the pelvis into an anterior tilt, altering the hip joint’s starting position and limiting available range of motion. Incorporating dynamic mobility drills into a warm-up routine can help prepare the hip for the demands of the squat and reduce tightness.
When to Seek Professional Guidance and Initial Management Strategies
When to Seek Professional Guidance
While mild, temporary soreness after a workout is a normal sign of muscle fatigue, certain symptoms indicate a need for professional evaluation. Pain accompanied by mechanical symptoms, such as catching, clicking, or locking within the hip joint, suggests a possible structural issue like a labral tear or FAI. If the pain is sharp, severe, or causes an immediate loss of function, medical guidance is necessary. Pain that does not improve after several days of rest, or pain triggered by non-squatting activities like coughing, sneezing, or sit-ups, warrants a consultation. Persistent discomfort or pain that radiates down the leg or is felt deep in the lower abdomen may indicate a more serious condition, such as a sports hernia, requiring specialized treatment.
Initial Management Strategies
Initial self-management focuses on immediate safety and reducing aggravation. This involves avoiding the specific movements and depths that reproduce the groin pain. Dynamic warm-ups, including light, pain-free range-of-motion exercises, should be prioritized to increase blood flow to the area before any activity. While complete rest is often the first step for acute strains, prolonged inactivity can be detrimental, so a graded, pain-free return to activity is recommended. Focusing on exercises that strengthen the hip adductors and abductors to address muscle imbalances can help stabilize the hip joint.