Be Your Best: R.I.C.E. is good initial treatment when dealing with groin injuries, Dr. Sokalsky says

(Dr. Brian Sokalsky, DO, is at the helm of Jersey Shore Sports Medicine in Ocean City and is a board certified family physician with special training in sports medicine. Once per month, Glory Days Magazine publisher Dave O’Sullivan talks with Dr. Sokalsky about various sports injuries, treatments and prevention methods.) In a previous edition of Glory Days Magazine, a reader named Linda asked for Dr. Sokalsky’s advice on how her daughter could treat a hip flexor injury. In keeping with that theme, we decided to ask Dr. Sokalsky about groin injuries, which are common in sports such as football and basketball when a lot of lateral movement at a fast pace is required. If a pulled groin sounds like something that is painful, it’s probably because it is. The groin basically connects the abdomen and the thigh muscles and therefore is a very important part of lateral movement, particularly in a sport such as a basketball. “The hip flexors are in the front of the hip, where as the groin is a little bit deeper. The groin muscles are the hip abductor muscles. When you bring your legs out to the side, they are the muscles that bring your legs back to the middle. They run up the inside part of the thigh and attach right onto the pelvic bone. It’s a very strong muscle, similar to a hamstring,” Sokalsky said. “You tend to pull it when you’re not properly warmed up or if you have some type of underlying muscle imbalance. With the hamstring, you tend to pull it when you’re doing start-and-stop motions going either forward or backward. The groin is the same way, just in lateral movement. We see it a lot in basketball, or any sport with rapid directional change, such as soccer, football and lacrosse.” Generally, groin injuries are referred to as pulls. Sokalsky said with such a large muscle, it’s fairly difficult to fully tear the muscle from where it attaches to bone. Brian Sokalsky is a doctor specializing in sports medicine. His office is located in Ocean City. To contact Dr. Sokalsky, call 609-545-8553 “A pull and a strain are basically the same thing. A pull is kind of the layman’s term for a strain. When you start talking a tear vs. pull, when we talk about strains we grade them 1, 2, or 3. A strain would be a 1, a partial tear would be a 2 and a full tear would be a grade 3,” Sokalsky said. “Just like any other muscle, you can pull, partially tear or completely tear your groin muscle. It’s pretty rare to tear the groin, it’s usually a grade 1 strain. If you see bruising, that’s your clue that it’s a lot more than just a strain.” The problem with a pulled groin, Sokalsky said, is that it’s not always easy for an athlete to devote enough time to rest so that the injury heals fully. By rushing back to the field or court, athletes put themselves at risk of having this type of injury linger throughout the course of an entire season. “If it’s just a little tweak, an athlete can come back pretty quickly. But if it gets to the point where an athlete is missing games, it’s usually a more severe injury. These are big muscles, so you really have to rest them until the healing is done then you have to fix any underlying causes that might have led to the initial injury. That might mean fixing any strength imbalances or flexibility imbalances. A lot of times the athlete tries to rush back and hasn’t fully healed, and they just keep re-injuring it,” Sokalsky said. “The groin is very similar to the hamstring. These kinds of injuries can linger all season because an athlete just doesn’t have time to fully rehab it.” So, you’ve pulled your groin. Now what do you do? “The first thing after the injury is R.I.C.E., or rest, ice, compression, elevation. That’s just to get the initial inflammation to calm down,” Sokalsky said. “Once the pain starts easing, then you can do some gentle stretching. As things improve, you can start going back to your strengthening exercises.” Perhaps the most difficult thing about coming back from a hamstring or groin injury for any athlete is getting over the mental hurdle. When you injure a large muscle such as a hamstring or groin, getting over the fear of injuring it again can be just as difficult as actually rehabbing the injury. “The athlete really does have to rebuild the confidence in their legs. It also depends on the severity of the injury. If it’s painful even with just walking, they are going to develop a limp, so they have to re-learn to walk or run normally without any compensation,” Sokalsky said. “So there are physical hurdles that they have to get over, but there are also mental hurdles. The body remembers what movements hurt, so they have to regain the confidence in their legs that they can do the movements they are used to without any pain.” [adsense]