Groin pain from biking can feel like a bruised groin or general crotch pain, often caused by the shape and position of the saddle, which impacts how the sit bones bear weight and interact with the bike.
Groin pain from cycling often originates from the muscles and structures in the pelvic region, including the adductors, abdomen, and inside of the thigh, and is influenced by the unique anatomy of both the male and female cyclists’ pelvis. This pain can appear in various areas such as the pubic bone, groin muscles, and perineum. Cyclists sometimes experience specific discomfort in the gracilis muscle (a slender muscle running down the inner thigh).
Cleveland Clinic reports that groin pain is common globally, particularly among athletes, with about 10% of sports medicine clinic visitors in the U.S. experiencing this issue. In a 2020 cross-sectional study by Senior Biokineticist and Professor François du Toit from the University of Pretoria, South Africa, it was found that in cyclists, gradual onset injuries (GOIs) most commonly affected the lower limb (43.4%), followed by the upper limb (19.8%), lower back (11.5%), and hip/groin/pelvis area (10.7%).
In this article, we will explain the types of groin pain from cycling, symptoms, causes of the pain, treatment, if cycling can cause groin pain, how to relieve groin pain from cycling, how to prevent groin pain by adjusting bike fit, groin pain stretches and exercises, and if cycling is a good exercise for groin pain.
Table of Contents
Groin pain cycling types, symptoms, causes and treatment
The muscles primarily involved in causing cycling groin pain include the Pectineus, Adductor Brevis, Adductor Longus, Adductor Magnus, and Gracilis. Pain can be isolated to the left or right side of the groin and can be due to muscle, tendon, or ligament strain, all of which are subject to stress during cycling from repetitive pedaling motion and sustained pressure in the saddle area.
Types
Cycling groin pain types include Pubic and Adductor Related Groin Pain, Inguinal Related Groin Pain, Iliopsoas Related Groin Pain, and Hip Related Groin Pain.
- Pubic and Adductor Related Groin Pain: This type of groin pain is often caused by strain or overuse of the pubic and adductor muscles, common in cyclists due to repetitive pedaling motion and the sustained posture required during cycling, leading to discomfort or pain in the pubic area and inner thigh.
- Inguinal Related Groin Pain: This pain is associated with the inguinal region and can be due to hernias or muscle imbalances, often exacerbated by the prolonged flexed position of the hip during cycling, which puts additional stress on the inguinal area.
- Iliopsoas Related Groin Pain: Stemming from the iliopsoas muscle group, this pain is linked to the flexing motion of the hip while pedaling and can be aggravated by prolonged periods of cycling, especially if the bike fit is not optimal or if there is pre-existing tightness in these muscles.
- Hip-Related Groin Pain: This type involves discomfort originating from within the hip joint or surrounding structures, potentially due to conditions like hip impingement or labral tears, and can be worsened by repetitive motion and strain on the hips during cycling.
Orthopaedic Surgeon Dr. Darren de SA from McMaster University Medical Centre, Canada, in a 2016 study found that among 4655 athletes, intra-articular and extra-articular causes of groin pain requiring surgery were equal, with the top five causes being femoroacetabular impingement (32%), athletic pubalgia (24%), adductor-related pathology (12%), inguinal pathology (10%), and labral pathology (5%), of which 35% was specifically attributed to FAI.
Symptoms
Symptoms of cycling groin pain can vary widely but often include sensations like pulling, tearing, or tenderness, possibly with shooting pain or popping sensations during cycling. The discomfort might be most acute upon waking and getting out of bed, may worsen as the day progresses, and can range from a deep-seated ache to sharp, stabbing pains that spread to other areas, depending on the underlying cause such as groin strain, inguinal hernia, athletic pubalgia, hip osteoarthritis, hip labral tear, or a herniated disk.
What is groin pain ICD-10?
The ICD-10 code for groin pain, often used for medical billing and documentation, includes various classifications for the condition, and while it doesn’t specifically reference cycling, it’s relevant for cyclists as groin pain can be a common issue in this sport due to repetitive strain and biomechanical stress.
Where is cycling groin pain located?
Cycling groin pain is typically located in the region where the inner thigh meets the pelvic area, involving muscles such as the adductors and potentially affecting structures like the pubic bone, inguinal area, iliopsoas muscle group, and surrounding tendons and ligaments, often exacerbated by repetitive pedaling motion and prolonged sitting posture.
What does a strained groin from cycling feel like?
A strained groin from cycling typically feels like a sharp or pulling pain in the inner thigh or groin area, often exacerbated by pedaling or specific movements, and may be accompanied by swelling, tenderness, and reduced range of motion in the hip or leg due to the overstretching or tearing of muscles in that region.
Causes
Cycling groin pain can be caused by cycling-related injuries, athletic pubalgia (sports hernia), avulsion fractures, femoral neck stress fractures, groin strain, osteitis pubis, pelvic fractures, hernias like inguinal or femoral hernia, hip conditions such as bursitis, hip fractures, hip labral tear, osteoarthritis, nervous system conditions including herniated disks and nerve compression syndromes, and post-operative complications from surgeries like hip replacement.
- Cycling-Related Injuries: These are common among cyclists from hip-related issues and soft tissue discomfort, often aggravated by factors such as inappropriate saddle length, width, and position, prolonged and intense sessions on the smart trainer, and skin breakdown due to heavy sweating.
- Athletic Pubalgia (Sports Hernia): This condition involves the soft tissue of the lower abdomen or groin, often aggravated by the cycling posture.
- Avulsion Fractures: Can occur due to sudden, intense forces experienced during cycling accidents.
- Femoral Neck Stress Fracture: Resulting from repetitive stress on the hip joint, a common risk in endurance cycling.
- Groin Strain: Often caused by overexertion or improper biomechanics during cycling.
- Osteitis Pubis: Inflammation of the pubic symphysis, potentially aggravated by prolonged cycling.
- Pelvic Fractures: Though less common, they can occur due to trauma from cycling accidents.
- Hernias: Such as Inguinal or Femoral hernia, can be exacerbated by cycling activities.
- Hip Conditions: Including bursitis, hip fractures, hip labral tear, or osteoarthritis, which can be affected by cycling dynamics.
- Nervous System Conditions: Like herniated disks or nerve compression syndromes, that can be influenced by cycling posture and repetitive strain.
- Hip Replacement Surgery: Secondary groin pain can develop as a post-operative complication or due to the biomechanical changes post-surgery while cycling.
In a 2020 study by Medical Doctor Mackenzie Norman from Dartmouth Geisel School of Medicine, United States, it was highlighted that Perineal Nodular Induration (PNI), a benign pseudotumor associated with saddle sports and often presenting as groin pain in male cyclists, is poorly recognized in female cyclists, likely underdiagnosed, and can be more prevalent with the growing popularity of cycling, emphasizing the need for sports medicine clinicians to be aware of this condition.
Can back pain cause groin pain from cycling?
Yes, back pain can cause groin pain from cycling as issues in the lower back can refer pain to the groin area due to interconnected nerves and muscles.
Can hip pain cause groin pain from cycling?
Yes, hip pain can lead to groin pain from cycling because the hip and groin areas are closely linked anatomically and functionally, with pain in one area often affecting the other.
Can piriformis syndrome cause groin pain?
Yes, piriformis syndrome can cause groin pain as this condition, characterized by muscle spasms in the piriformis muscle located in the buttock region, can irritate nearby nerves leading to referred pain in the groin.
Can a pulled groin cause testicle pain from cycling?
Yes, a pulled groin can cause testicle pain from cycling as the strain and inflammation of the groin muscles and tendons can radiate to the testicular area, especially in activities involving repetitive leg movement.
Can bulging discs cause groin pain?
Yes, bulging discs can cause groin pain as they can compress or irritate spinal nerves that innervate the groin area, leading to referred pain.
Can sciatica cause groin pain from cycling?
Yes, sciatica can cause groin pain from cycling, as the irritation or compression of the sciatic nerve can lead to pain that radiates from the lower back through the buttocks and into the groin area.
What does it mean if your left groin hurts?
If your left groin hurts, it could indicate a range of issues such as muscle strain, hip problems, nerve irritation, or conditions specific to internal organs on the left side, and it’s essential to evaluate the pain in context with other symptoms and possibly seek medical assessment.
Treatment
Cycling groin pain treatment includes rest, ice, undergoing physical therapy, taking pain medications such as NSAIDs or acetaminophen, using nerve blocks, administering steroid injections, and, in severe cases, surgery.
- Rest: Essential for recovery, it allows the affected muscles and tendons to heal without additional strain.
- ICE: Helps reduce inflammation and pain in the groin area, particularly effective immediately after the onset of pain or post-exercise.
- Physical Therapy: Involves exercises and techniques to strengthen the groin area and improve flexibility, aiding in pain relief and preventing future injuries.
- Pain Medications (like NSAIDs or Acetaminophen): Useful for managing pain and reducing inflammation associated with groin injuries.
- Nerve Blocks: These can manage severe pain by temporarily numbing the affected nerves in the groin area.
- Steroid Injections: Help reduce inflammation and pain, often used when other treatments have not provided sufficient relief.
- Surgery: Considered in severe cases where conservative treatments fail, such as for significant muscle tears or hernias.
In a 2019 study by Professors S. G. Jørgensen, S. Öberg, and J. Rosenberg from Herlev Hospital, University of Copenhagen, Denmark, it was concluded that surgical treatments for groin pain, such as inguinal hernia repair or adductor tenotomy, are more effective in returning patients to habitual activities, reducing pain, and achieving satisfaction compared to conservative treatments.
When to see a doctor for groin pain female cyclist?
A female cyclist with groin pain should see a doctor when the pain is persistent, intensifies, interferes with daily activities or cycling performance, or is accompanied by other symptoms like swelling, redness, bruising, or if there’s a noticeable decrease in range of motion in the hip or leg joints.
How long does it take for a strained groin to heal?
It takes approximately 4 to 6 weeks for a strained groin to heal, because the recovery time depends on the severity of the strain, with mild strains healing faster, and this process can be aided by proper rest, physical therapy, and avoiding activities that exacerbate the injury.
Can cycling cause groin pain?
Yes, cycling can cause groin pain due to factors like riding posture and technique, saddle size (length and width), saddle angle and position, long and intense sessions on the smart trainer, and skin breakdown from heavy sweating.
- Riding Posture and Technique: Improper posture and pedaling techniques can lead to muscle strain and imbalances in the groin area, causing pain.
- Saddle Size (Length, Width): A saddle that’s too small or too large can create pressure points or improper weight distribution, leading to discomfort in the groin.
- Saddle Angle and Position: An incorrectly angled or positioned saddle can cause undue stress on the groin, leading to pain and discomfort.
- Long and Intense Sessions on the Smart Trainer: Prolonged cycling sessions, especially on a stationary bike or trainer, can lead to increased pressure and friction in the groin area, causing pain.
- Heavy Sweat Break Down Skin: Excessive sweating during cycling can lead to skin irritation and breakdown in the groin area, contributing to discomfort and pain.
Researcher Keira Bury from Curtin University, Australia in a 2020 study found that there is some evidence pointing to handlebar positioning and reducing perineal pressure, and common treatments including antibiotics, surgical intervention, and preventive measures like topical creams, good hygiene, appropriate clothing, leg elevation, and taking breaks from cycling.
Why do I have groin pain after mountain biking?
You have groin pain after mountain biking because the rugged and varied terrain requires frequent position changes and intense pedaling effort, which can strain the muscles and tendons in the groin area, and the continuous impact and vibration can also lead to discomfort and irritation in that region.
Why do I have groin pain after road cycling?
You have groin pain after road cycling because prolonged periods in a static cycling position, combined with continuous pedaling, can lead to muscle fatigue and strain in the groin area, and the pressure from the saddle, especially if improperly fitted, can cause discomfort and irritation in the groin region.
Why do I have groin pain after indoor cycling?
You have groin pain after indoor cycling because the stationary position and repetitive pedaling motion can cause muscle fatigue and strain in the groin area, and the lack of natural body movement often associated with indoor cycling can lead to increased pressure and friction in the groin region, especially if the bike or saddle is not properly adjusted to your body.
Why do I have groin pain cycling as a beginner?
You have groin pain as a beginner in cycling because your body, particularly the muscles and tendons in the groin area, may not yet be accustomed to the specific physical demands and posture of cycling, and improper bike fit or saddle choice can exacerbate this discomfort due to unfamiliar and sustained pressure in that region.
Why do my hip and groin hurt after cycling?
Your hip and groin hurt after cycling because the repetitive pedaling motion and sustained cycling posture can strain the muscles and tendons in these areas, and if your bike fit or riding technique is not optimal, it can lead to excessive pressure and misalignment, causing pain in both the hip and groin regions.
How long does groin pain last from cycling?
Groin pain from cycling typically lasts anywhere from a few days to a couple of weeks, because the duration depends on the severity of the strain or injury, the effectiveness of the treatment, and whether the cyclist takes adequate rest and modifies their cycling routine to allow for healing.
How to relieve groin pain from cycling?
To relieve groin pain from cycling, temporarily stop cycling activities, take an over-the-counter pain reliever such as ibuprofen or acetaminophen, apply an ice bag to the sore and painful area, engage in physical therapy, and perform stretches.
- Temporarily Stop: Pausing cycling activities allows the injured muscles in the groin area to rest and heal, reducing further aggravation of the pain.
- Over-the-Counter Pain Reliever: Medications like ibuprofen or acetaminophen can help reduce inflammation and alleviate pain in the groin area.
- Ice Bag for Sore and Pain Area: Applying ice to the affected area can reduce swelling and numb the pain, providing temporary relief.
- Physical Therapy: A physical therapist can guide you through specific exercises and treatments to strengthen the groin muscles and improve flexibility, aiding in recovery and preventing future injuries.
- Stretches: Gentle stretching exercises can help alleviate tension in the groin muscles, increase flexibility, and reduce the risk of further strain.
How do I stop my groin from hurting when cycling?
You can stop your groin from hurting when cycling by adjusting your bike fit for optimal posture, ensuring the saddle is the correct size and positioned properly, taking regular breaks during long rides to reduce sustained pressure, incorporating specific groin stretches and strengthening exercises into your routine, and wearing appropriate, well-padded cycling shorts to minimize friction and pressure.
How do you relieve pain in the left groin?
You can relieve pain in the left groin by applying ice to reduce inflammation and swelling, performing targeted stretches and strengthening exercises to improve flexibility and muscle balance in the area, and taking over-the-counter pain relievers like ibuprofen or acetaminophen to manage discomfort.
How to prevent groin pain from cycling?
To prevent groin pain from cycling, ensure proper bike fit by shortening cranks, raising handlebar and saddle height, performing groin stretches like Standing, Seated, and Squatting Groin Stretches, and incorporating strengthening exercises such as Straight Leg Raise, Resisted Hip Flexion, and Side-lying Leg Lift (cross over).
Bike fit for groin pain
To prevent groin pain from cycling, consider bike fit adjustments such as shortening cranks, raising handlebar height, keeping sit bones on the wider back part of the saddle, positioning the saddle not too far back, ensuring the handlebar is not too far forward, adjusting saddle height, widening stance by positioning cleats outward, using a fan aimed at your perineum, wearing bike shorts, and trying lubrication like chamois butter.
- Shorten Cranks: Reduces the range of motion required at the hip and groin, easing strain during pedaling.
- Raise Handlebar Height: Helps maintain a more upright posture, reducing pressure and strain on the groin.
- Keep Sit Bone on the Wider Back Part of the Saddle: Ensures optimal weight distribution and reduces pressure on the groin.
- Saddle Not Too Far Back: Prevents overreaching during pedaling, which can strain the groin muscles.
- Handlebar Not Too Far Forward: Helps maintain a comfortable riding posture without overstressing the groin area.
- Saddle Height (Too Low or High): Adjusting to the correct height prevents overextension or excessive bending of the legs, reducing groin strain.
- Widen Stance by Positioning Cleats Further Towards Outside of Shoes: This equipment adjustment can help align the legs more naturally during pedaling, reducing strain on the groin.
- Fan Aimed at Your Perineum: Reduces sweating and overheating in the groin area during indoor cycling, decreasing skin irritation.
- Wear Bike Shorts: Provide cushioning and reduce friction against the saddle, alleviating groin discomfort.
- Try Lubrication (Chamois Butter): Reduces friction and skin irritation in the groin area during long rides.
Stretches for groin pain
Stretches to prevent groin pain from cycling include Standing Groin Stretch Exercise, Seated Groin Stretch, Squatting Groin Stretch, Hip Adductor Stretch, Hamstring Stretch on Wall, Lying Down Butterfly Stretch, Knee Roll Out Stretch, Groin Squeeze, and Elbows on Thighs.
- Standing Groin Stretch Exercise: Targets the inner thigh muscles, improving flexibility and reducing tension in the groin area.
- Seated Groin Stretch: Effective for deeper stretching of the groin muscles, particularly beneficial after a long ride.
- Squatting Groin Stretch: Stretches multiple groin muscles simultaneously, offering a comprehensive stretch to the area.
- Hip Adductor Stretch: Focuses on the adductor muscles, crucial for cyclists to maintain hip flexibility and reduce groin pain.
- Hamstring Stretch on Wall: Stretches the hamstrings, indirectly relieving tension in the groin area by improving overall leg flexibility.
- Lying Down Butterfly Stretch: A gentle stretch that targets the inner thighs and groin, ideal for cooling down post-cycling.
- Knee Roll Out Stretch: Helps to release tension in the inner thigh and groin area, particularly useful after long periods of cycling.
- Groin Squeeze: Strengthens the inner thigh muscles, helping to prevent groin pain by improving muscle balance and stability.
- Elbows on Thighs: A stretch that provides a deep, focused stretch to the groin area, helping to alleviate tightness and improve flexibility.
In a study by Clinical Professor Per Hölmich, M.D., from the University of Copenhagen, Denmark, it was found that groin injuries in sports, particularly adductor-related pain, are common and challenging to treat, requiring accurate clinical examination, possible imaging for diagnosis, and a treatment approach that ranges from active rehabilitation exercises to surgery if nonsurgical methods fail, with prevention strategies including stretching and strength training of adductors and pelvic stabilizers.
Groin pain exercises
Exercises to prevent groin pain from cycling include Straight Leg Raise, Resisted Hip Flexion, Side-lying Leg Lift (cross over), and Copenhagen Adductor Plank.
- Straight Leg Raise: This exercise strengthens the hip flexor and thigh muscles, which support the groin area and reduce the risk of strain during cycling.
- Resisted Hip Flexion: By working the hip flexors, this exercise improves strength and stability in the groin area, helping to prevent pain from repetitive pedaling motions.
- Side-lying Leg Lift (Cross Over): Targets the inner thigh and groin muscles, strengthening them to prevent strain and overuse injuries common in cycling.
- Copenhagen Adductor Plank: A more advanced exercise that specifically targets the adductor muscles in the groin, improving their strength and resilience against the demands of cycling.
Clinical Researcher Zuzana Machotka from the University of South Australia in a 2009 study mentioned that exercise, especially strengthening exercises targeting the hip and abdominal muscles, appears to be an effective intervention for athletes experiencing groin pain.
Is cycling good for groin pain?
Yes, cycling can be good for managing groin pain because it is a low-impact exercise that doesn’t put excessive strain on the groin muscles, which can be beneficial for recovery and maintaining fitness without aggravating the condition.
Sports Physician Adam Weir from The Hague Medical Centre, Netherlands in a study found that cycling was the only allowed activity during the initial six weeks of a program for athletes with groin pain, and after four months, both groups in the study showed a significant decrease in pain scores, with those in the manual therapy group returning to sports quicker than those in the exercise therapy group.
Additionally, cycling helps strengthen the muscles around the hip and groin, which can aid in stabilizing the area and prevent future injuries. Moreover, with proper bike fit and posture adjustments, cycling can promote better alignment and reduce undue stress on the groin area. However, those with groin pain need to start slowly and adjust their cycling routine as needed to avoid exacerbating their symptoms.
Is it OK to cycle with a groin strain?
Yes, it is OK to cycle with a groin strain, but only with mild strains and if the cycling training is low-intensity, ensuring that the activity doesn’t exacerbate the injury, and adjustments are made to the bike fit to reduce strain on the affected area.
Is cycling good for neck pain?
Yes, cycling is good for neck pain if you maintain an ergonomic posture and ensure your bike setup minimizes strain on the neck.
Is cycling good for lower back pain?
Yes, cycling is beneficial for lower back pain as it strengthens the core and back muscles without putting excessive strain on the lower back.
Is cycling good for hip pain?
Yes, cycling can be effective for hip pain by promoting hip joint mobility and strengthening surrounding muscles, provided the cycling posture is correct.
Is cycling good for wrist and hand pain?
Yes, cycling is good for wrist and hand pain only if ergonomic adjustments are made to the bicycle’s handlebars and grips to ensure proper hand positioning and weight distribution, thereby minimizing nerve compression and strain on the wrist’s flexor and extensor muscles.
Is cycling good for knee pain?
Yes, cycling can be good for knee pain because of the low-impact nature of the exercise, which places minimal stress on knee joints while still allowing for effective muscle engagement and joint movement.
Is cycling good for foot pain?
Yes, cycling can help alleviate foot pain by improving blood circulation and strengthening foot muscles, especially with a well-adjusted pedal and shoe fit.
How do I protect my groin while cycling?
You can protect your groin while cycling by choosing a well-fitted saddle, wearing cycling shorts with adequate padding, using lubricants like chamois cream to reduce friction, adjusting your riding posture, and incorporating regular breaks and stretches during long rides.
- Choosing a Well-Fitted Saddle: Select a saddle that matches your sit bone width and riding style to distribute weight evenly and reduce pressure on the groin area.
- Wearing Cycling Shorts with Adequate Padding: Padded cycling shorts provide cushioning and reduce friction between your groin and the saddle, which can prevent soreness and irritation.
- Using Lubricants like Chamois Cream: Applying chamois cream can significantly reduce the risk of chafing and skin irritation in the groin area during long cycling sessions.
- Adjusting Riding Posture: Maintain an ergonomic cycling posture that minimizes strain on the groin area, potentially adjusting handlebar and saddle positions for optimal comfort.
- Incorporating Regular Breaks and Stretches: Taking short breaks during long rides to stretch and relieve pressure from the groin area can prevent pain and discomfort.