Common Causes of Bilateral Groin Pain

Stuart Hinds explains the common causes of bilateral groin pain

Bilateral Groin Pain

Groin pain is typically caused by a muscle, tendon or ligament strain, particularly in athletes who play sports such as hockey, soccer and football.

Groin pain can start immediately following an injury or trauma, or it may develop gradually over a period of weeks or even months.

Because of this slow onset of pain, the condition is often ignored for a period of time, during which the underlying cause may be worsening. 

Although not as common, groin pain can also be caused by a hernia, fracture, bone or even by kidney stones (see "common causes" below).

Note that even though testicle pain and groin pain are different, there are some testicle conditions that cause pain which refers to the area of the groin.

Altered Movement Patterns and/or Holding Patterns

When dealing with groin symptoms in athletes or runners, especially bilateral pain, it's common to focus on the Gluteus Medius, the hip flexors, and hip adductor muscles, all of which may develop trigger points as a result of poor technique, over-use, or overexertion.

Hip flexors that are overactive and short at the anterior hip joint portion can also commonly be responsible for groin symptoms.

Note: whilst trigger points in the abdominal oblique muscles may be associated with groin pain, this is typically experienced as unilateral not bilateral.

Other Common Causes

Groin pain may be coming from other parts of the body (radiating or referred pain) and can be caused by numerous factors, including: 

• Infections, which may cause a lump, bumps, or swelling in the groin area. Glands (lymph nodes) in the groin may become enlarged when there is an infection in the surrounding part of the body or in the legs or feet. Where the infection is minor, the swelling may disappear on its own after a few days.
• A kidney stone passing through the ureter.
• Spasm, infection, inflammation, or decreased blood flow (ischemia) in the large intestine.
• A urinary tract infection.
• Female pelvic problems, such as pelvic inflammatory disease (PID), ovarian cyst, or ectopic pregnancy.
• Male genital problems, such as a skin infection of the scrotum, a prostate infection, or torsion of a testicle.
• A hip fracture/stress fracture
• Hip Arthritis, which may cause groin pain and stiffness.
• Some common back conditions. Spine issues around the area of the lower ribs can cause groin pain due to a pinching of the nerves that travel through the groin area. These conditions could include a herniated disc or a lumbar narrowing (stenosis).

Trigger Points

As stated above, the most common culprits are trigger points in the hip flexors and adductors, the gluteus medius, and abdominal obliques (less likely in the case of bilateral groin pain).

Trigger points in these muscles may become active as a result of an injury (muscle, tendon or ligament strain) and may last for quite some time after the original injury is healed. 

Failure to treat these trigger points effectively can often be the reason for such an extended recovery period required by athletes after suffering a groin injury.

In some cases, these trigger points will have played their part in leading to the cause of the original injury.

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About the author

Stuart Hinds is one of Australia’s leading soft tissue therapists, with over 27 years of experience as a practitioner, working with elite sports athletes, supporting Olympic teams, educating and mentoring others as well as running a highly successful clinic in Geelong.

Stuart has a strong following of practitioners across Australia and globally who tap into his expertise as a soft-tissue specialist. He delivers a range of highly sought after seminars across Australia, supported by online videos, webinars and one-on-one mentoring to help support his colleagues to build successful businesses.

In 2016, Stuart was awarded a lifetime membership to Massage & Myotherapy Australia for his significant support and contribution to the industry.

This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.