Pain guide · Hip pain

Groin pain: a strain, a hernia, the hip joint, the testicles and the other causes to know

Groin pain is common in active people, and most of it comes from the muscles and tendons around the hip and pelvis: the inner thigh, the hip flexors, the lower tummy wall or the pubic bone. From mid-life the hip joint itself is a frequent cause, and a hernia, the testicles, a kidney stone and, in women, the pelvic organs can all be felt in the groin.

This guide starts with the signs that need help, in the National Health Service's (NHS) words, from a 999 call or accident and emergency (A&E) to NHS 111 or a general practitioner (GP): sudden testicle pain, a painful hernia, severe pain low in the tummy and a child with a limp. It then maps the causes by the exact spot, explains when a scan or test helps, and gives a three-stage plan built on the strengthening programmes that helped and prevented groin pain in trials, ending with running, kicking and turning.

3-stage exercise plan When to get help 39 sourcesUpdated 24 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.
Go to A&E or call 999 for sudden, severe pain in a testicle, testicle pain with feeling or being sick or tummy pain, or testicle pain that has lasted more than an hour or continues at rest. It can be a twisted testicle (testicular torsion), which needs treating straight away. For a lump, swelling or a change in a testicle's size or shape, ask for an urgent GP appointment or get help from NHS 111.
Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of the thigh, in the groin) and very bad tummy pain, you feel sick or are being sick, you cannot fart or poo, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused. It may be strangulated, which is an emergency. Don't drive yourself.
Call 999 or go to A&E: you have pelvic pain (pain low in your tummy) and it's severe, getting worse or hurts when you move or touch the area, or you feel faint, dizzy or lightheaded or pass out, have pain in the tip of your shoulder, have difficulty breathing, have heavy bleeding from your vagina, or suddenly feel confused. Don't drive yourself.
Get help from NHS 111 if you have a hernia (a lump in the groin or tummy) and pain in or around it, a bloated tummy, you feel sick or are being sick, your vomit looks like coffee grounds, you're constipated, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused.
Same day (urgent GP appointment or NHS 111): severe pain that usually starts in the side of your tummy or your lower back, may spread to the area at the top of your inner thigh (groin), your testicles or the area around the opening of your vagina, and may come and go, or this pain with a high temperature or feeling hot, cold or shivery. It can be a kidney stone.
Get help from NHS 111: you have pelvic pain and you find it difficult to pee or poo, there's blood in your pee or poo, you have unusual discharge, fluid or bleeding from your vagina, pain when peeing or need to pee more than usual, a very high temperature or feel hot, cold or shivery, vomiting and diarrhoea or feel sick, or you are or may be pregnant. If you're 20 weeks pregnant or more, contact your midwife or maternity unit.
Contact your GP or call NHS 111 straight away: you might be pregnant, even without a positive pregnancy test, and you have a combination of tummy pain low down on one side, vaginal bleeding or a brown watery discharge, pain in the tip of your shoulder, or discomfort when peeing or pooing. It can be an ectopic pregnancy.
Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.
Groin or pubic pain with a high temperature, or feeling hot, cold, shivery or generally unwell; severe pain that started suddenly; or you can't move the leg or put weight on it: ask for an urgent GP appointment or get help from NHS 111. An infected pubic joint can look like osteitis pubis and needs treating quickly, usually in hospital. It's more likely after pelvic, bladder or incontinence surgery, with a weakened immune system, or if you inject drugs.
Same day, and stop running now: groin or front-of-hip pain in a runner, sometimes felt in the thigh or knee, that builds with running, hurts with every step or at night, or hurts when the hip is turned to the end of its range. Keep weight off the leg, using crutches if you have them, and get an urgent GP appointment or help from NHS 111 the same day: a stress fracture of the hip (femoral neck) needs urgent imaging.
Ask for an urgent GP appointment or get help from NHS 111 the same day if your child gets sudden pain in their hip, thigh or knee (hip problems can sometimes be felt in the thigh or knee), or is limping or cannot put any weight on 1 leg. This applies to teenagers too, and in some children knee pain is the only sign.
Same day: a teenager with sudden pain at the front or top of the hip bone after a sprint, kick or jump, often with a pop. A piece of growth plate can pull off the pelvis (an avulsion fracture), and it needs an X-ray the same day.
Tingling or loss of feeling in the hip or leg after an injury.
Call 999 or go to A&E if you have sciatica on both sides, weakness or numbness in both legs that's severe or getting worse, or numbness around or under your genitals, or around your bottom (anus); if you find it hard to start peeing, cannot pee or cannot control when you pee; or if you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. These could be symptoms of a serious back problem that needs to be treated in hospital as soon as possible.

See a doctor or physiotherapist if

Hip pain that stops normal activities or disturbs sleep, keeps getting worse, or has not improved after 2 weeks of looking after it at home.
A lump in the groin, or groin pain with coughing or straining (a possible hernia).
A lump in the groin, upper thigh or tummy, especially one that appears when you cough or strain and goes when you lie down: see a GP, as it may be a true hernia. A femoral hernia (a small lump at the top of the thigh, mainly in women over 50) needs treating in hospital.
Tender lumps in the groin that are getting bigger or haven't gone down within a week, feel hard or don't move when you press them, or come with night sweats, a very high temperature or no other sign of infection: see a GP. They may be swollen glands.
Pain or swelling around the testicles, or a hip that is hot, swollen or tender, especially if you can't recall an injury: contact your GP.
Groin pain with blood in your pee, pain when you pee, or no clear link to sport: see a GP, as it's unlikely to be a sports injury.
Pelvic or groin pain that comes and goes or doesn't go away, with bloating, losing weight without trying, feeling full quickly, or constipation or diarrhoea that doesn't go away: see a GP.
Painful catching or locking deep in the groin, or a hip that gives way: get it assessed.
Stiffness lasting more than 30 minutes after waking.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.
Hip or groin pain that hasn't settled after 6 weeks, especially with a normal X-ray, or new hip pain if you take high-dose steroids, drink heavily, or have sickle cell disease or lupus: ask your GP about an MRI (magnetic resonance imaging) scan and a hip specialist. It can be avascular necrosis, which an X-ray can miss early on.
Pain in one spot on the pubic bone, or low back or buttock pain on one side, brought on by running in a distance runner, especially if your periods have stopped or become irregular, you've lost weight or you've had a stress fracture before: stop running and see a GP. It can be a stress fracture of the pelvis or the sacrum, and a magnetic resonance imaging (MRI) scan is the usual test.
A stress fracture from ordinary activity, more than one stress fracture, periods that have stopped or become irregular, or worries that you're eating too little for your training: see a GP about bone health and energy intake.
Burning, tingling or numbness in the groin or inner thigh, especially after a hernia repair, or inner thigh pain that comes on with exercise and spreads down the inside of the thigh: see a GP or sports physician. A nerve may be irritated or trapped (our suggestion).
Pain or numbness in the groin that lasts more than 3 months after a hernia repair: see your GP or your surgical team. The NHS lists it as a possible complication.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The inner thigh close to the groin, worse squeezing the knees together, kicking, sprinting and changing direction

Usually adductor-related groin pain, often called a groin strain: the commonest cause in athletes.

Read: Groin strain →A sudden, sharp pain in the inner thigh during a sprint, kick or change of direction

An acute adductor strain.

Read: Groin strain →The front of the hip and groin when lifting the knee, kicking or running uphill

Iliopsoas-related groin pain, from the hip flexors.

Read: Hip flexor pain →Just above the groin crease, worse sprinting, with sit-ups, coughing or sneezing, with no lump

Inguinal-related groin pain, often called a sports hernia, though it isn't a true hernia.

Read: Sports hernia →Right on the pubic bone at the front, often both sides, in a kicking or turning sport

Pubic-related groin pain (osteitis pubis).

Read: Osteitis pubis →

A lump in the groin that comes and goes, bigger when you cough or sneeze, smaller when you lie down

An inguinal hernia: see a GP. Our exercise with a hernia guide covers staying active, and the warning signs say when it's urgent.

A small, grape-sized lump at the top of the thigh in the groin crease, mostly in women over 50

A possible femoral hernia, which needs treating in hospital: see a GP, and see the warning signs.

Several small, tender lumps in the groin with an infection nearby or a cold

Usually swollen glands, which go down within 1 to 2 weeks. See a GP if they last longer than a week, feel hard or don't move.

A deep groin pinch with deep bending, sitting low or getting out of a car, in a younger active adult

Possibly hip impingement.

Read: Hip impingement (FAI) →Deep groin pain with clicking, catching or locking

Possibly a labral tear.

Read: Hip labral tear →A deep ache in the groin and the front of the thigh from mid-life, stiff to get going, socks and car seats hard

Possibly hip arthritis, especially with morning stiffness of 30 minutes or less.

Read: Hip arthritis →Groin or front-of-hip pain in a runner or walker that builds with every step, then at rest or at night

A possible stress fracture of the hip: stop and get it checked the same day.

Read: Stress fracture →One spot on the lower pubic bone in a distance runner

A possible stress fracture of the pubic bone.

Read: Groin pain when running →Groin, hip or pubic pain after a fall in later life, making walking very hard

A possible broken pelvis or hip, even if the hip X-ray was normal.

Read: Broken pelvis →A teenager with sudden pain at the front of the hip bone after a sprint or kick, often with a pop

A possible avulsion fracture, where a piece of growth plate pulls off: it needs an X-ray the same day.

Read: Hip pointer →A young child, usually 3 to 8, suddenly limping, often after a cold

Often irritable hip, but a limp needs an urgent GP appointment.

Read: Irritable hip →A child aged about 4 to 10 with a limp, or groin, thigh or knee pain

Possibly Perthes disease.

Read: Perthes disease →A child or teenager aged about 10 to 16 with groin, thigh or knee pain and a limp, the foot turned out

Possibly a slipped upper femoral epiphysis, which needs checking the same day.

Read: SUFE (slipped hip growth plate) →Inner thigh pain that comes on with exercise, starts near the tendon and spreads down the inside of the thigh

Rarely, a trapped obturator nerve: see a sports physician if it doesn't settle with a groin strain plan.

Read: Groin strain →

Burning, tingling or numbness in the groin or inner thigh, especially after a hernia repair

An irritated nerve in the groin: see a GP or your surgical team.

Groin pain with low back pain on the same side, low at the back by the dimple

The sacroiliac joint, which some people feel in the groin.

Read: SI joint pain →Groin pain with back pain, or pins and needles, burning or numbness down the leg

It may come from the back.

Read: Back pain →A burning, numb patch on the outer thigh

Meralgia paresthetica, a squeezed skin nerve.

Read: Meralgia paresthetica →

Sudden, severe pain in a testicle, or testicle pain with feeling sick or tummy pain

A possible twisted testicle: go to A&E or call 999.

A dull ache in the scrotum, a lump, swelling or a change in a testicle

An infection, a cyst, swollen veins, a hernia or, rarely, cancer: ask for an urgent GP appointment.

Severe pain in the side or lower back that comes in waves and spreads to the groin, a testicle or the vagina

A possible kidney stone: get help the same day.

Read: Lower back pain on one side →

Pain low on one side of the tummy with a missed period, bleeding or pain in the tip of the shoulder

A possible ectopic pregnancy: see the warning signs.

Pelvic pain with periods or sex, or sudden severe pain low in the tummy

Endometriosis, or an ovarian cyst (a twisted or burst cyst is urgent). Our exercise with endometriosis guide covers the long-term plan.

Over the pubic bone, sometimes spreading to the thighs, in pregnancy or after giving birth

Pelvic girdle pain.

Read: Pelvic girdle pain (SPD) →Groin pain mostly when you run

Our groin pain when running guide.

Read: Groin pain when running →Groin pain mostly when you cycle

Our hip pain when cycling guide.

Read: Hip pain when cycling →Groin pain mostly when you walk

Our hip pain when walking guide.

Read: Hip pain when walking →Groin pain mostly when you sit

Our hip pain when sitting guide.

Read: Hip pain when sitting →

Understand it

Where it hurts is a clue, not a diagnosisStrong evidence

The groin is where the inner thigh muscles, the hip flexors, the lower tummy wall, the pubic bone and the hip joint all meet, and the testicles, kidneys and pelvic organs can be felt there too. An international agreement on athletes' groin pain, made in Doha, sorts the common sports causes by the spot and the tests that bring the pain on, keeps the hip joint in mind every time, and lists the other conditions not to miss.

So this guide says a spot points to a cause rather than proving it, and an examination decides. NHS inform says hip problems can be felt in the buttock, groin, back, thigh or knee, and new problems should begin to settle within 6 weeks.

Sources 1, 2, 3, 4

In active people: the muscles and tendonsEmerging evidence

The Doha agreement names four muscle and tendon causes. Adductor-related pain is tender on the inner thigh tendon and hurts when you squeeze the knees together against resistance; iliopsoas-related pain is tender deep at the front of the hip and hurts lifting the knee; inguinal-related pain is tender over the groin canal just above the crease, with no hernia you can feel, and is worse with coughing, sneezing or a resisted sit-up; and pubic-related pain is tender on the pubic bone itself.

Adductor-related pain was the main finding in 58% of 207 athletes in one clinic and 61% of 100 in another, and a third to almost half had more than one cause. Half of 695 sub-elite footballers had hip or groin pain during a season. A 2025 family-medicine review estimates that 2% to 20% of athletes get groin pain, depending on the sport and the level, and says how often it happens in everyone else is unknown. Nearly all of this research is in men.

Sources 1, 5, 6, 7, 3

The hip jointEmerging evidence

A deep groin pain, a pinch with deep bending, sitting low or getting out of a car, or clicking and catching can come from the hip joint itself: impingement or a labral tear in younger active adults, and arthritis from mid-life, a family-medicine review says. In 51 people whose hip joint was confirmed as the source by an injection, 55% felt it in the groin. In 120 people on surgical waiting lists, groin pain picked out hip arthritis rather than a narrowed spine in 84% of those with arthritis.

NICE (the National Institute for Health and Care Excellence) diagnoses osteoarthritis without a scan from 45 if the pain comes with activity and any morning stiffness lasts 30 minutes or less.

Sources 2, 8, 9, 10

A lump: a hernia, or swollen glandsStrong evidence

An inguinal hernia is a lump where the leg joins the tummy that may get bigger when you cough, sneeze or strain and smaller when you lie down, sometimes with a heavy, dragging feeling; the NHS says pain in or around a smaller hernia can be a sign it is being squeezed (strangulated). A femoral hernia is a small lump at the top of the thigh, in the groin, about the size of a grape, mainly in women over 50, and it needs treatment in hospital because it can become strangulated. Most hernias are diagnosed by examination, and an ultrasound is rarely needed, the international guideline says.

Men with a painless or barely painful inguinal hernia can usually wait safely: in a trial of 720 men, a hernia became trapped at a rate of 1.8 per 1,000 men for each year of follow-up, though 23% of those who waited went on to have surgery, mostly for more pain. Tender lumps that come with an infection are usually swollen glands, which go down within 1 to 2 weeks.

Sources 11, 12, 13, 14, 15

The testicles, the kidneys and the pelvisStrong evidence

Sudden, severe testicle pain can be a twisted testicle (testicular torsion), which can lose the testicle if it isn't treated quickly, the NHS says: in 81 teenagers, the chance of saving it fell the longer the symptoms had lasted. Other causes are an infection, an injury, a hernia, a cyst and swollen veins; pain alone isn't usually a sign of testicular cancer.

Kidney stone pain usually starts in the side of the tummy or the lower back and may spread to the groin, the testicles or the area around the opening of the vagina, and it may come and go. In women, pelvic pain can come from period pain, an ovarian cyst, endometriosis and, rarely, an ectopic pregnancy, which can cause pain low down on one side with a missed period, bleeding and pain in the tip of the shoulder. Two of those NHS pages are past their review dates, so this guide checks their wording against the NHS pelvic pain page.

Sources 16, 17, 18, 19, 20, 21, 22

PregnancyEmerging evidence

Pelvic girdle pain in pregnancy is felt over the pubic bone at the front, across the lower back, between the vagina and anus, and spreading to the thighs, and it is worse walking, on stairs, standing on one leg, turning over in bed and moving your legs apart, the NHS says (a page past its review date). Groin swellings in pregnancy are most often harmless swollen veins, the international hernia guideline says, and can be watched.

Sources 23, 13

Nerves and the backEmerging evidence

Rarely, a trapped obturator nerve causes inner thigh pain that comes on with exercise, starts near the adductor tendon and spreads down the inside of the thigh: one series described 32 athletes. Burning, tingling or numbness from the lower tummy to the inner thigh, often after a hernia repair, can come from the genitofemoral nerve, and the NHS lists pain or numbness lasting more than 3 months after a repair as a possible complication. Both rest on small series and reviews.

The back can send pain to the groin with or without back pain, NHS inform says, and 14% of 50 people with pain from the sacroiliac joint at the back of the pelvis felt it in the groin.

Sources 24, 25, 26, 4, 27, 1

Children and teenagers: the hip comes firstStrong evidence

The NHS asks for an urgent GP appointment or NHS 111 if a child gets sudden pain in the hip, thigh or knee, because hip problems can be felt there, or is limping or can't put weight on one leg. Irritable hip is the commonest cause and usually settles in 1 or 2 weeks; less common but more serious causes include an infected hip, a broken bone and Perthes disease. A slipped growth plate at the top of the thighbone and a piece of growth plate pulled off the pelvis (an avulsion fracture) are on the Doha agreement's list not to miss.

Sources 28, 1

A runner's groin pain that builds: the hip boneEmerging evidence

Stress fractures of the neck of the thighbone make up about 3% of sports stress fractures, most often in marathon and distance runners, and exercise-related groin pain is the commonest symptom, a review says. Delay in diagnosis is common and makes it more likely the bone will shift, which is why the warning signs ask a runner with groin pain that builds with every step or hurts at night to stop and get checked the same day.

Source 29

When a scan or test helpsStrong evidence

Most groin pain is sorted out from the story and an examination; tests for the hip joint are better at ruling it out than in. A hernia usually needs no scan. In pain just above the groin crease with no lump, an ultrasound that watches you strain rules out a true hernia, and a pelvic MRI (magnetic resonance imaging) helps when adductor or pubic pain is unclear or isn't improving. In sudden adductor injuries, the MRI grade didn't change the return time for most.

For the hip, standing X-rays come first, with MRI for a suspected labral tear, stress fracture or loss of blood supply to the bone, and NICE diagnoses osteoarthritis without imaging when the pattern fits. A suspected kidney stone in an adult gets a low-dose computed tomography (CT) scan within 24 hours (an ultrasound in pregnancy). A child may need an X-ray, and sometimes blood tests or other scans.

Sources 1, 13, 3, 30, 10, 2, 19, 28

How it usually goesEmerging evidence

In 81 male athletes with a sudden adductor injury on a criteria-based plan, most were pain-free in about 2 weeks and back in full team training in a median of 18 days; complete tears took about 2 to 3 months. Long-standing adductor pain needed an 8 to 12 week active programme in a trial. Many athletes with pain just above the groin crease improve with 4 to 6 weeks of physiotherapy, and hip-related pain is given at least 3 months of exercise.

Irritable hip usually settles in 1 to 2 weeks. After a hernia repair, recovery usually takes up to 4 to 6 weeks, and 10% to 12% have lasting pain that eases over time. No one can promise a date.

Sources 30, 31, 32, 33, 28, 14, 26, 13

What helps, and how strong the evidence is

Long-standing adductor pain: active strengthening beat passive treatmentEmerging evidence

In 68 athletes with adductor-related groin pain for a median of 40 weeks, an 8 to 12 week programme of active training for the strength and coordination of the muscles round the pelvis, especially the adductors, did far better than physiotherapy without active training: 23 in the training group against 4 got back to sport without groin pain. It is one trial in athletes, nearly all men. A 2025 family-medicine review recommends active, supervised physiotherapy first for adductor and pubic-related pain.

Sources 31, 3

A sudden adductor injury: move on by milestonesEmerging evidence

In 81 male athletes following a criteria-based plan, those with partial injuries were pain-free in a median of 13 days and back in full team training in 18; complete tears or tendons pulled off the bone took 55 and 78 days. Re-injury in the next year was 8%, and lower in those who reached the pain-free milestone before moving on. It was a cohort study, not a trial, so it shows what to expect rather than proving the plan.

Source 30

Preventing it: the Copenhagen adduction exerciseEmerging evidence

In 652 semi-professional male footballers in 35 teams, one exercise, the Copenhagen adduction, done three times a week in pre-season and once a week in season, cut the average share of players with groin problems from 21.3% to 13.5% (41% lower odds). The programme that prevented groin problems was a strengthening exercise, not a stretch.

Source 34

Pain just above the groin crease: rehabilitation firstEmerging evidence

A sports hernia is a strain or tear of the soft tissue in the lower tummy or groin with no visible bulge, the American Academy of Orthopaedic Surgeons (AAOS) says; the Doha term is inguinal-related groin pain. The AAOS suggests rest and ice for the first 7 to 10 days, physiotherapy from about 2 weeks, and says 4 to 6 weeks of physiotherapy resolves the pain in many athletes, with surgery considered if it returns with sport. The 2025 review advises core strengthening and movement retraining first once a true hernia has been ruled out.

Sources 32, 3, 1

The hip joint: exercise firstEmerging evidence

An international consensus on hip-related pain in young and middle-aged active adults (impingement and labral problems) recommends at least 3 months of exercise-based treatment, with physical activity, education and shared decisions; strong trial evidence for physiotherapy was lacking. For hip arthritis, NICE makes therapeutic exercise a core treatment, warns that pain may rise a little at first, and doesn't routinely offer insoles, braces or supports. NHS inform's hip exercises (a bridge, a standing hip extension, a standing hip abduction and a sit-to-stand to a chair) are a gentle start.

Sources 33, 10, 35, 36

Hernias: waiting is often safe, but not for every herniaStrong evidence

Men with a painless or barely painful inguinal hernia can usually wait safely, but most eventually need surgery, and a hernia that hurts should be repaired, the international guideline says. Women's groin hernias are preferably repaired by keyhole surgery, partly so a femoral hernia isn't missed, and femoral hernias need prompt treatment in hospital.

After an inguinal hernia repair, the NHS says recovery usually takes up to 4 to 6 weeks: walk from the start, but no heavy lifting or strenuous activity for at least 4 to 6 weeks, and follow your own surgical team's advice. Exercise can't close a hernia; our exercise with a hernia guide covers staying active with one.

Sources 14, 13, 12, 11, 26

The testicles, the kidneys and the pelvis aren't exercise questionsStrong evidence

Testicle pain, a suspected kidney stone and pelvic pain go to the health service, not to an exercise plan: see the warning signs. For a kidney stone, NICE recommends an anti-inflammatory painkiller first and urgent imaging.

Sources 16, 19, 20

How much pain is OK while you exercise?

3 out of 10 or less at first, then up to about 5; soreness from the Copenhagen exercise isn't groin pain; possible bone pain must be pain-freeEmerging evidence

This guide uses the hip hub's rule. During the exercise, pain up to about 5 out of 10 is acceptable. It should settle within an hour or so, and your hip should be no worse that night or the next morning. If it is, do less next time (fewer repetitions, a smaller range, a lighter load), not nothing. Pain can go up a little when you start a new exercise programme; guidelines for arthritis say so and still recommend keeping going. NHS inform's hip exercises use the same 0 to 5 limit.

In the first stage, keep pain at 3 out of 10 or less, as our groin strain guide does. Expect muscle soreness in the first fortnight of the Copenhagen exercise, but soreness isn't groin pain: a sharp pain at the pubic bone or in the groin means stop that exercise (our suggestion). In sudden adductor injuries, reaching a pain-free point before moving on went with fewer re-injuries.

Coughing, sneezing, sitting up from lying and a resisted sit-up bring on pain just above the groin crease; if they hurt more the next morning, the load was too much, so drop back a step (our sports hernia guide's suggestion). Groin pain that builds with every run, or hurts at night, isn't a pain to manage: stop and get it checked the same day. With any possible bone pain, the rule is no pain during, after or the day after loading.

The 5 out of 10 figure borrows from pain-monitoring studies in tendon pain and arthritis; it hasn't been tested in groin pain. In trials of long-lasting muscle and joint pain, exercise that allowed some pain did no worse than pain-free exercise. Testicle pain, a lump, tummy or pelvic pain, burning when you pee and a child's limp are never pain-rule questions: see the warning signs.

Sources 36, 10, 30, 37, 38, 29

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: squeeze and support

About the first 2 weeks: keep walking within the pain rule, drop sprinting, kicking, sudden changes of direction, sit-ups and wide, deep squats for now, and keep pain at 3 out of 10 or less, as our groin strain guide does. Testicle, hernia, kidney, pelvic and hip-bone warning signs come first. With a groin strain, a sports hernia, osteitis pubis, a hip flexor problem, hip impingement, a labral tear, hip arthritis or a stress fracture, that guide's plan can replace this one.

Lying adductor ball squeeze demonstrated on the 3D figure

3D demoLying adductor ball squeezeBeginner · Other / check instructions

5 to 10 holds of 5 to 10 s · As in our groin strain guide. Squeeze only as hard as you can without bringing on the groin pain, as our sports hernia guide says

Harder: Copenhagen plank

Supine heel slide demonstrated on the 3D figure

3D demoSupine heel slideBeginner · No equipment

10 slow reps each side, once or twice a day · The move page's dose, an editorial starting point; as in our hip pain guide's first stage

Harder: Hip windshield wipers

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 sets of 10 · As in our groin strain guide; NHS inform's bridge is the same movement

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

3 holds of 15 to 20 s each side · As in our groin strain guide

Harder: Side plank

Dead bug heel taps demonstrated on the 3D figure

3D demoDead bug heel tapsBeginner · No equipment

2 sets of 6 to 8 each side · As in our groin pain when running and sports hernia guides: trunk control with no curling up

Easier: Bent-knee fall-out · Harder: Forearm plank

Stationary cycling demonstrated on the 3D figure

3D demoStationary cyclingBeginner · Cardio machine

20 to 30 min, easy, if it's pain-free · As in our groin pain when running guide. Not with possible bone pain

Easier: Recumbent exercise bike · Harder: Air bike intervals

Move on when: A firm squeeze is pain-free and walking and stairs are comfortable (the groin pain when running guide's check); for pain just above the groin crease, coughing, sneezing and sitting up in bed no longer hurt (the sports hernia guide's).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: inner thigh, outer hip and trunk strength

About weeks 2 to 6, three times a week: strength for the muscles round the pelvis, especially the adductors, which was the focus of the active training trial. Keep walking or cycling.

Standing band hip adduction demonstrated on the 3D figure

3D demoStanding band hip adductionBeginner · A band + An anchor point

3 sets of 10 to 12 each side · As in our groin strain guide

Easier: Lying adductor ball squeeze · Harder: Copenhagen plank

Standing band hip abduction demonstrated on the 3D figure

3D demoStanding band hip abductionBeginner · A band + An anchor point

3 sets of 10 to 12 each side · As in our groin strain guide: a standing band hip abduction, for balance. NHS inform's standing hip abduction is the version without a band

Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

2 to 3 at a time, building to sets of 8, 2 to 3 times a day, up to 2 sets of 15 · NHS inform's sit-to-stand to a chair, with its pacing

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Side plank demonstrated on the 3D figure

3D demoSide plankIntermediate · No equipment

3 holds of 20 to 30 s each side · As in our groin pain when running and sports hernia guides

Easier: Knee side plank · Harder: Side plank with leg lift

3D demoDead bugBeginner · No equipment

3 sets of 8 each side · As in our sports hernia guide

Easier: Dead bug heel taps · Harder: Forearm plank

Cossack squat demonstrated on the 3D figure

3D demoCossack squatIntermediate · No equipment

2 sets of 5 each side, only as deep as is comfortable · As in our groin strain guide; the move page's own dose, 6 slow shifts a side, is more than this stage needs (our suggestion)

Easier: Sit squat (partial squat) · Harder: Pistol squat

Move on when: Side-to-side moves and squeezing the knees together are pain-free (the groin strain guide's check), a resisted sit-up no longer hurts (the sports hernia guide's), and 30 minutes of brisk walking is pain-free, the NHS sports medicine service's starting point for running.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Copenhagen, then running, kicking and turning

From about week 6: the Copenhagen adduction exercise three times a week, then once a week to keep it, as in the football trial. Running returns through the NHS service's walk-jog weeks, with speed changes, kicking and sharp turns last. With hip-related pain, keep the exercise going for at least 3 months, as the consensus advises.

Copenhagen plank demonstrated on the 3D figure

3D demoCopenhagen plankAdvanced · A bench or box

Short lever (the top knee on the bench) first: 1 set of 3 to 15 each side, 3 times a week, then once a week · As in our groin pain when running guide (our hamstring and groin workout's levels, from the Norwegian programme). Not during acute groin pain; expect soreness for a fortnight, as the move page says

Easier: Hip adduction machine

Single-leg Romanian deadlift demonstrated on the 3D figure

3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell

3 sets of 8 each leg · As in our groin pain when running guide

Easier: Dumbbell Romanian deadlift

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

Every other day for 30 min: jog 1 and walk 1 minute in week 1, 2 and 1 in week 2, 4 and 1 in week 3, 9 and 1 in week 4, 15 and 1 in week 5, then 30 minutes' jogging in week 6 · The NHS sports medicine service's programme: up a level after a week without pain, down a level with pain. Flat ground outdoors counts

Easier: Treadmill walking · Harder: Sprint intervals

3D demoSkippingBeginner · No equipment

3 runs of 20 m, then strides · As in our groin pain when running guide

Easier: Ankle bounces (mini pogo) · Harder: Alternate-leg bounding

Lateral bound (skater jump) demonstrated on the 3D figure

3D demoLateral bound (skater jump)Beginner · No equipment

3 sets of 6 to 8 bounds (3 or 4 on each leg), resting a minute between sets · The move page's dose, an editorial starting point. Last, once side-to-side moves are pain-free

Harder: Bench jump-over

Move on when: Our suggestion: running, sprinting, turning and kicking are pain-free at full effort, on the day and the next morning; then full training before matches. If pain still stops you training after 2 to 3 months of good rehab, see a specialist, as our sports hernia guide advises.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

What to change for now (written steps)

Our 3D figure can't show these changes. They come from the NHS, NHS inform, the AAOS and a hernia trial; where a step is our suggestion, it says so.

1. Load: keep walking, but drop kicking, sprinting, sudden changes of direction and sit-ups for now, and wide, deep squats while the inner thigh is sore (our suggestion, as our groin strain and sports hernia guides advise).
2. Sitting and carrying: the NHS hip page says don't carry anything heavy and don't sit in low chairs, which can put extra pressure on your hips.
3. Stairs: lead with your good leg going up and your sore leg coming down, and use the handrail (NHS inform).
4. A sudden pain just above the groin crease in sport: rest and ice for the first 7 to 10 days, then physiotherapy from about 2 weeks (the AAOS).
5. A hernia you've been told about: most people can stay active, and men with a painless or barely painful inguinal hernia can usually wait safely. A femoral hernia is treated in hospital.
6. After a hernia repair: walk from the start; the NHS says no heavy lifting or strenuous activity for at least 4 to 6 weeks. Follow your surgical team's advice.
7. Pregnancy: keep your knees together getting in and out of the car, and put a pillow between your legs in bed (the NHS).
8. Back to work: NHS inform says stay at, or return to, work if you can; it's the best way to get better.

Sources 35, 4, 32, 14, 12, 26, 23

Running, kicking and turning come back (written steps)

No trial has tested how to bring these back after groin pain as a location. These steps are our suggestion unless a source is named.

1. Running: start once 30 minutes of brisk walking is pain-free, then follow the walk-jog weeks in stage 3; after week 6, no more than about 10% more a week (the OxSport leaflet). Straight lines on the flat first.
2. Speed: strides, then sprints, building speed over sessions rather than within one.
3. Turning: wide, unhurried turns first, then sharper cuts.
4. Kicking: short passes with the inside of the foot, then longer passes, then shooting, last of all.
5. Keep the Copenhagen exercise going once a week in season (the football trial); our hamstring and groin injury prevention workout and the FIFA 11+ warm-up suit this stage.
6. After a sudden adductor injury: move on by the milestones, not the calendar. Most male athletes were back in full training in a median of 18 days, but complete tears took 2 to 3 months.
7. If it isn't improving: many athletes with pain just above the groin crease settle with 4 to 6 weeks of physiotherapy (the AAOS), hip-related pain gets at least 3 months of exercise (the consensus), and pain that still stops you training after 2 to 3 months of good rehab needs a specialist.

Sources 39, 34, 30, 32, 33

Positions to swap, and why

Habit or position	Why it matters	Instead
Kicking, sprinting, sudden turns and sit-ups through groin pain	They load the adductors and the lower tummy wall, which the Doha examination stresses with resisted squeezing and resisted sit-ups.	Walking or cycling, and the ball squeeze.Try: Lying adductor ball squeeze
Deep, wide squats while the inner thigh is sore	They take the sore tendon to the end of its range (our suggestion), and the programmes that helped built strength rather than range.	The ball squeeze, then band adduction.Try: Lying adductor ball squeeze
Long-lever Copenhagen planks while the groin is acutely painful	The move page says avoid it during acute groin pain, and start with tiny volume.	The ball squeeze now; the short lever later.Try: Lying adductor ball squeeze
Resting completely for weeks	Active training beat passive treatment for long-standing adductor pain, and most sudden adductor injuries were back in full training in about 18 days on a criteria-based plan.	The staged plan from the first week.
Low chairs and carrying heavy things with a painful hip	The NHS hip page says don't carry anything heavy and don't sit in low chairs, which can put extra pressure on your hips.	A firm, higher seat, and break up sitting.Try: Sit to stand from a chair
Running through groin pain that builds with every step or hurts at night	It can be a stress fracture of the hip, where delay makes it more likely the bone shifts.	Stop and get it checked the same day.
Heavy lifting or strenuous exercise soon after a hernia repair	The NHS says not for at least 4 to 6 weeks after an inguinal hernia repair.	Walk from the start, and follow your surgical team's advice.Try: Treadmill walking
Putting a groin lump or testicle pain down to a strain	A hernia, a twisted testicle and other testicle problems need checking, some within minutes.	See the warning signs.

Routines to follow

Hamstring and groin injury prevention

The Nordic hamstring and Copenhagen adduction programmes from the football trials: a 10-week build, three adductor levels, then once a week in season.

15 minIntermediate6 movesA wall, An anchor point

FIFA 11+ warm-up

FIFA's 11+ injury prevention warm-up as its manual sets it out: running drills, strength, balance and jumping at three levels, then faster running.

20 minBeginner20 movesCardio machine, A wall

Beginner core workout

A 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.

15 minBeginner6 movesNo equipment

Pilates for hip pain: a 20-minute class that spares the hip

A 20-minute Pilates class for hip pain: bridges, outer-hip holds, standing leg work and balance, without deep bends, crossed legs or lying on the sore side.

20 minBeginner14 movesA band, A wall

Run-walk intervals for beginners

A 30-minute beginner run-walk session: a brisk walk, then 1-minute jogs with 1-minute walks, building to 3-minute runs over your first three weeks.

30 minBeginner5 movesCardio machine, A wall

More moves for this area

Questions people ask

What causes groin pain?

In active people, it usually comes from the muscles and tendons of the inner thigh, the hip flexors, the lower tummy wall just above the groin crease or the pubic bone, or from the hip joint. A hernia, a testicle problem, a kidney stone, pelvic conditions in women and irritated nerves can cause it too. Where it hurts, what sets it off and what else is going on point to the cause.

When is groin pain in men an emergency?

Go to A&E or call 999 for sudden, severe pain in a testicle, testicle pain with feeling or being sick or tummy pain, or testicle pain that has lasted more than an hour or continues at rest: it can be a twisted testicle, which needs treating straight away. In 81 teenagers with a twisted testicle, the chance of saving it fell the longer the symptoms had lasted. A lump, swelling or a change in a testicle needs an urgent GP appointment or NHS 111.

What causes groin pain in women?

Often the same muscles, tendons and hip joint as in men, but pain low in the tummy can come from period pain, an ovarian cyst, endometriosis or, rarely, an ectopic pregnancy. Call 999 for severe pelvic pain with feeling faint, pain in the tip of your shoulder, difficulty breathing or heavy bleeding, and get help from NHS 111 for pelvic pain if you are or may be pregnant. A small lump at the top of the thigh, mainly in women over 50, can be a femoral hernia, which needs hospital treatment.

Is it a groin strain or a hernia?

A strain hurts in the inner thigh near the groin with kicking, sprinting and squeezing the knees together, and the tendon is tender. A hernia is usually a lump that gets bigger when you cough or strain and smaller when you lie down, sometimes with a heavy, dragging feeling. Pain just above the groin crease with coughing or sit-ups but no lump is often called a sports hernia, which isn't a true hernia.

Why does my groin hurt when I walk or lift my leg?

Pain at the front of the hip and groin when you lift the knee points to the hip flexors; a deep groin pinch with deep bending or getting out of a car suggests hip impingement, and a deep ache with stiffness from mid-life suggests hip arthritis. Groin pain in a runner or walker that builds with every step, or hurts at night, can be a stress fracture of the hip and needs checking the same day.

Can hip problems cause groin pain?

Yes. In people whose hip joint was confirmed as the source by an injection, 55% felt it in the groin, and groin pain was a good pointer to hip arthritis rather than a narrowed spine. NHS inform notes that hip problems can be felt in the buttock, groin, back, thigh or knee.

Can a kidney stone cause groin pain?

Yes. Kidney stone pain usually starts in the side of the tummy or the lower back and can spread to the groin, the testicles or the area around the opening of the vagina, and it may come and go. Ask for an urgent GP appointment or get help from NHS 111 for severe pain, or pain with a high temperature or feeling hot, cold or shivery.

How long does a groin strain take to heal?

In 81 male athletes with a sudden adductor injury on a criteria-based plan, most were pain-free in about 2 weeks and back in full team training in a median of 18 days, while complete tears took about 2 to 3 months. Long-standing adductor pain needed an 8 to 12 week active programme in a trial. Move on by milestones, not the calendar.

What exercises help groin pain?

Strengthening: in athletes with long-standing adductor pain, active training of the muscles round the pelvis got 23 back to sport without groin pain, against 4 after physiotherapy without active training. Start with gentle ball squeezes and bridges within 3 out of 10 pain, build to band work, then add the Copenhagen exercise, which cut groin problems by 41% in footballers. NHS inform's hip exercises are a gentle start.

Should I stretch a groin strain?

Gentle stretching is fine once it no longer hurts, but the programmes that helped and prevented groin pain were built on strengthening. Don't push into a painful stretch while the inner thigh is sore; squeeze and strengthen first.

Is groin pain in pregnancy normal?

Pain over the pubic bone, across the lower back or spreading to the thighs is common in pregnancy and is called pelvic girdle pain; keeping your knees together getting in and out of the car and a pillow between your legs in bed can help. Groin swellings in pregnancy are most often harmless swollen veins. With pelvic pain in pregnancy, get help from NHS 111, or from 20 weeks contact your midwife or maternity unit.

When should I see a doctor about groin pain?

Call 999 for sudden, severe testicle pain, a hernia with very bad tummy pain, being sick or not being able to fart or poo, or severe pain low in the tummy with fainting or heavy bleeding. Get help the same day for a painful hernia, kidney stone pain, a hot, swollen hip or a fever, or a child with a limp or hip, thigh or knee pain. See a GP for a lump in the groin, or pain that hasn't improved after 2 weeks of looking after it.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.