GROIN STRAIN |
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DESCRIPTIONA groin strain is injury to the muscles or tendons in the area of the groin where the abdomen meets the thigh. Muscles, tendons, and bones comprise units. These units stabilize the pelvis and allow its motion. A strain occurs at a unit's weakest part. This injury occurs mainly in older adolescents and adults; it rarely affects younger children. Appropriate health care includes doctor's diagnosis; self-care; physical therapy (moderate or severe strain); surgery (severe strain).
SIGNS & SYMPTOMS
Pain in the child's groin with motion or stretching the leg at the hip joint.
Muscle spasm in the abdomen or thigh.
Swelling in the child's groin.
Loss of strength (moderate or severe strain).
Crepitation ("crackling") feeling and sound when the child's injured area is pressed with fingers.
Calcification of a muscle or its tendon (visible with X-ray).
CAUSES
Prolonged overuse of muscle-tendon units in the groin.
A single violent injury, or force applied to a groin muscle-tendon unit.
RISK FACTORS
Contact sports; sports that require quick starts, such as the beginning of a race; any cardiovascular medical problem that results in decreased circulation; medical history of any bleeding disorder; obesity; poor nutrition; previous groin injury; poor muscle conditioning.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should participate in a strengthening and conditioning program appropriate for each sport. Warming up before each practice or competition is important.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor;
X-rays of the child's injured hip, thigh, and pelvis to rule out possible fractures.
POSSIBLE COMPLICATIONSProlonged healing time if activity is resumed too soon; proneness to repeated injury; an unstable or arthritic hip following repeated injury; inflammation at the attachment to the child's bone (periostitis); prolonged disability (sometimes).
PROBABLE OUTCOME
If this is a first-time injury, proper care and sufficient healing time before your child resumes activity should prevent permanent disability. Average times are: mild strain--2 to 10 days; moderate strain--10 days to 6 weeks; severe strain -- 6 to 10 weeks. If this is a repeat injury, the complications listed above are more likely to occur.
TREATMENT
FIRST AIDUse instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. Raise the foot of the bed on blocks. See Appendix 39 for details.
HOME CARE
Use ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
After the first 24 hours, apply heat instead of ice, if it feels better to the child. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Support the injured groin area with an elasticized bandage between treatments.
Begin rehabilitation exercises for the child, as prescribed by your doctor.
MEDICATION
For minor discomfort, use aspirin, acetaminophen, or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger pain relievers; injection of a long-acting local anesthetic to reduce pain; injection of a corticosteroid, such as triamcinolone, to reduce inflammation.
ACTIVITY
For a moderate or severe strain, the child should walk with crutches for at least 72 hours. See Appendix 37 (Safe Use of Crutches).
The child can resume normal activities gradually.
DIET & FLUIDS
Your child should eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk, and eggs. Increase the child's fiber and fluid intake to prevent constipation that may result from decreased activity.
OK TO GO TO SCHOOL?Yes, when condition and well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a groin strain.
Pain or swelling worsens despite treatment.
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