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introduction
Anatomically, the groin represents a clearly delimited area that is located in the lower and lateral area of the abdominal wall. The triangular area is delimited in the middle by the upper edge of the basin, the so-called "Symphysis“Above the pubic region and laterally through the two iliac crests, which are easily palpable as bone points in the lateral pelvis.
The abdominal wall is made up of many superimposed layers through which important anatomical pathways run.
The inguinal canal runs through the abdominal wall and contains blood vessels, lymph vessels and, in men, the spermatic cord. The layers of the abdominal wall protect the important anatomical structures from injuries.
Read more about the: Inguinal canal.
Anatomy of the groin
At some other places in the groin area, structures pull through the muscle walls to reach the pubic region and the legs. For this purpose, there are small holes in the connective tissue and muscular layers of the abdominal wall, which are also called "Lacunae"Are designated. Below the skin and the subcutaneous fatty tissue is a superficial covering made of connective tissue. This surrounds 4 large muscle layers, which enable the stability and movements of the trunk. Your most prominent representative is the "Rectus abdominis muscle", The relief of which is clearly visible on the middle abdominal wall in trained people as a so-called"Six pack“Is emerging. The abdominal cavity, which mainly contains the intestinal loops, then follows under a deeper layer of connective tissue.
The many anatomical pathways and the openings in the abdominal wall bring a higher risk of injury. Inguinal hernias in particular are a frequent complication. They arise mainly at the weak points of the abdominal wall, through which blood vessels and nerves pass, but also at the inguinal canal.
Blood vessels and nerves
Important anatomical pathways pass through the groin region at various points. These include arterial and venous blood vessels, lymphatic tracts with associated lymph nodes, nerves that mainly arise from the lowest sections of the spinal cord, ligamentous structures and the male spermatic cord.
The conduction pathways are surrounded by layers of the abdominal wall, which consist of muscular and connective tissue parts. These form channels or openings around the vessels. An important example is the inguinal canal. It runs through the anterior abdominal wall diagonally from the posterior, lateral pelvis, forward, centrally into the pubic region. In men, it mainly contains the spermatic cord that leads from the testicle to the urethra. In addition, it guides blood vessels and nerves in men and women, which supply the pubic region.
The lower edge of the groin region is limited by the inguinal ligament on both sides. It spans between the iliac crest on the respective side and the pubic symphysis, the so-called "Symphysis". Some essential blood vessels and nerves run below the inguinal ligament, some of which pull into the pubic region and mostly into the legs to supply the structures there. Through the so-called "Lacuna vasorum“Pull the main blood vessels of the leg. Large lymph nodes can also be found there, below the inguinal ligament.
If there is too much pressure on the groin region, for example from tightly lashed belts, sensitive nerves can be pinched off. There is often a tingling sensation in the front thigh.
Various complications can arise through the openings for the numerous vessels in the groin. Inguinal hernias in particular are a common problem in this region.
Entrapment of the nerve under the inguinal ligament
If a nerve is pinched in the groin area, numbness and abnormal sensations can occur in this area and on the front or side thighs. A pinched nerve can cause severe burning pain. The symptoms depend on the type of nerve. There are nerves that are responsible for muscle movements and there are nerves that are responsible for the sensitivity and the feeling of touch of an area of skin. Depending on which nerve is pinched, it can lead to paralysis or numbness and tingling. The pinching of a nerve under the inguinal ligament can occur as a result of compressive or tensile forces in the course of the nerve. The causes can be obesity, pregnancy or wearing too tight clothing (belts).
Lymph nodes of the groin
In the groin region, especially below the inguinal ligament, there are large collections of lymph nodes, which contain the lymph of the legs and partly of the pubic region. Even in healthy people, the lymph nodes can often be felt as small nodules. The lymph is collected all over the body and transported to the lymph nodes via the lymphatic system. These filter the entire lymph fluid for harmful pathogens and foreign substances before they lead them back into the blood via a large circuit of their own.
Lymph nodes can enlarge for a number of different reasons. With local accumulations of pathogens, the lymph nodes can become inflamed. In the groin you can feel it enlarged and the touch is often painful. In many cases, a painful enlargement suggests bacterial inflammation.
If the lymph node is enlarged but not painful, this may be an indication of a disease of the lymphatic system, for example a form of lymph cancer. If the patient notices a thickened lymph node, this is often no cause for concern, but the cause should be clarified by a doctor.
Differences between men and women
The structures of the groin differed only partially in men and women. Important nerves and blood vessels that supply the pubic region run through the groin region, in particular through the inguinal canal. This also means that the functions differ between men and women. If a nerve supplies the labia sensitively in women, it is mainly responsible for the skin of the scrotum in men.
The most important structure of the man, which is located in the inguinal canal, is the spermatic cord. During the sexual act, it guides the sperm from the testicles into the urethra and has to pull it obliquely through the abdominal wall. In women there is the maternal ligament, which consists of connective tissue. It moves from the ovary into the labia majora and forms the anatomical correspondence to the spermatic cord.
Figure groin pain
Pain in the groin
- Inguinal ligament -
Inguinal ligament - Inner inguinal ring -
Annulus inguinalis profundus - Inguinal canal -
Canalis ionguinalis - Superficial inguinal ring -
Superficial inguinal annulus - Spermatic duct (male) -
Deferens duct
5a. Round mother band (woman) -
Ligamentum teres uteri - Lymph nodes
- Colon - Intestinum crassum
- Front upper
Iliac spine -
Anterior superior iliac spine - Pubic bones -
Pubic tuberosity - Testicles / epididymis -
Testis / epididymis
Pain in the groin when:
A - cough
(Indication of an inguinal hernia)
B - lifting
(Pressure in the abdomen, athlete's groin)
C - During pregnancy
(Hormonal changes)
D - inflammation of the testicle
or the epididymis
E - Painful enlarged
Lymph nodes / diseases of the intestine
You can find an overview of all Dr-Gumpert images at: medical illustrations
Groin disorders
What is an inguinal hernia?
An inguinal hernia is an intestinal hernia (hernia) in the area of the groin. It is by far the most common hernia and is more common in men. It occurs with high pressures in the abdomen and an existing weakness of the connective tissue. In the area of the inguinal canal are the outer and inner inguinal rings, which represent a natural weak point.
In the case of a hernia, the intestine is usually everted in a hernial sac through a so-called hernial gap through the anterior abdominal wall in the area of the groin. Pushing out the intestines can be provoked in part by a squeezing maneuver or coughing. When lying down, the contents of the hernia can often be pushed back into the abdomen. A distinction is made between indirect and direct inguinal hernias.
Symptoms of an inguinal hernia are usually visible and palpable swelling and pain. Inguinal hernia pain occurs most often when lifting or carrying heavy loads. Even when pressing during bowel movements, the increase in pressure in the abdomen can lead to pain in the groin area. In the case of an inguinal hernia, however, there is no need for pain, often only a feeling of pressure in the corresponding area.
Read more about other symptoms of an inguinal hernia under: Symptoms of an inguinal hernia
An inguinal hernia should be examined by a doctor. Surgical repositioning of the intestine located in the intestinal hernia usually makes sense. If the hernia is not operated on in time, the intestine can become trapped and die.
Also read:
- Surgery for an inguinal hernia
- Causes of an inguinal hernia
Illustration of the types of an inguinal hernia
- Peritoneum cavity -
Cavitas peritonealis - Abdominal viscera
- Peritoneum -
peritoneum - Glued peritoneum protuberance
- Vas deferens -
Deferens duct - Epididymis -
Epididymis - Testicles -
Testis - Serous testicular envelope -
Tunica vaginalis testis - Scrotum - scrotum
- Inguinal ligament -
Inguinal ligament - Hernial sac
Inguinal hernia - Inguinal hernia
Inguinal hernia types:
a - Epigastric hernia
(in the upper abdomen on the midline) -
Epigastric hernia
b - umbilical hernia -
Umbilical and paraumbilical hernia
c - hernia
(at the location of a previous
surgical intervention) -
Cicatrica hernia
d - Direct inguinal hernia
(in the bar near the
Opening of the inguinal canal)
e - Indirect inguinal hernia
(in the bar at the opening
of the inguinal canal)
f - fracture of the femur
(in the thigh canal) -
Femoral hernia
You can find an overview of all Dr-Gumpert images at: medical illustrations
How do you recognize the inguinal fungus?
Inguinal fungi, like many other fungi or bacteria, like to grow in warm and humid places. The groin is therefore a suitable place for fungal growth. Inguinal fungus is usually ringworm and is also known as "tinea cruris" or "tinea inguinalis". It is common in middle-aged men. In addition to the groin, it can also develop on the thigh and buttocks. Scales in ring- or crescent-shaped patterns in these regions can be an indication of fungal growth. Itching, reddening or burning pain usually occurs at the same time. In addition, blisters can be seen on the outer edge of the reddening. Towards the middle, the skin can look a little pale and brownish. If such complaints occur, a doctor should be consulted for clarification and the exact type of fungus should be found out by means of a smear. In the case of a inguinal fungus, care should be taken to keep the region as dry as possible. There are also various shampoos or anti-fungal ointments that can be used to treat the area.
You might also be interested in: Skin fungi
Pain in the groin
Pain in the groin can occur centrally, on one side or on both sides. They can have a dull, persistent character or appear pungent to piercing. Depending on the cause and strength, they are permanently present or can be triggered by pressure or movement. The causes of pain in the groin can be different between men and women.
If the pain only occurs on the right side, it is not uncommon for appendicitis to be present. The pain can be exacerbated or triggered in a targeted manner by applying pressure to the right groin region.
But there can also be muscle tension, nerve inflammation, rheumatic diseases or a hernia.
An inguinal hernia must always be considered, especially in men, as this is not uncommon and occurs in 80% of cases in men. In fact, if the pain is on the left side, the inguinal hernia is the most common cause. However, there may be other causes here as well.
Pathogen-related inflammation of the groin can cause pain on both sides. Diseases of the bones and joints of the hips and lumbar spine can also cause pain that extends into the groin.
In women, there is rarely the possibility that the pain is caused by diseases of the internal genital organs. As a rule, they only occur on one side. In the same way, an injury to the testicle in men can cause acute or long-term pain that radiates into the groin.
Since most diseases in the groin region require treatment, a doctor should be consulted for clarification if the pain persists.
Read more about this topic on our website: Groin pain- what do I have?
Inguinal contusion
A bruise in the groin can result from blunt trauma, for example from a kick, fall or blow in the groin area. Usually pain occurs in the area, which is increased when moving. In addition, there is often a bruise. The symptoms can be alleviated by cooling. It is also important to relieve the region. Elevation and external pressure may also reduce the pain. A distinction must be made between inguinal bruises and groin strains, which are caused by excessive strain in sports. If the bruise is severe, it may be useful to see a doctor to rule out internal injuries and bleeding.
Groin pulled
A groin strain describes the overstretching of muscles in the groin region. In the groin there are some muscle groups that are responsible for movements in the trunk and legs. Vigorous and rapid leg movements, which are common in many sports, pose a risk of groin strains.
The strain is caused by sudden sideways movements, which can even lead to individual muscle fiber tears. Depending on the severity of the damage and the pain, the strain is divided into three degrees. The so-called "Adductor group“Which is responsible for pulling the legs up. The groin strain can be very painful and bruised.
In the event of a strain, it is important to take some immediate measures to prevent worse from happening. Sport or movement should be stopped immediately. The muscles of the leg must be relieved by lying up and then cooled and compressed. Cooling and applying pressure prevent bruising and swelling.
If there is a severe, very painful strain, a doctor should decide whether to start treatment. As a rule, the slow healing of the tendon can be supported and promoted by physiotherapy or heat treatments. In some cases, your doctor may advise you to take certain medications that can help the healing process. In most cases, further treatments are not necessary.
It takes some time for the tendon to fully regenerate and recover. During this time, you should refrain from further stretching the affected muscle, otherwise healing will be delayed. Since the healing time varies from person to person, your doctor should decide when you can start exercising again, taking the pain into account. Too often it comes to unauthorized exercise with only weak symptoms, which has a worsening and then a significant prolongation of healing as a result.
Read more about this on our website Groin strain
Lymph nodes swollen in the groin
Our whole body is permeated with lymph nodes, although there are large lymph nodes in certain places. There are particularly large lymph nodes on the groin. These inguinal lymph nodes (Nodi lymphatici inguinales) can be divided into deep and superficial lymph nodes. The so-called Rosenmüller lymph node, which is the largest lymph node in this region, also belongs to the deep lymph nodes in the groin.
The inguinal lymph nodes receive both the lymph fluid from both legs, the genitals and the lymph from the lower abdominal wall. The groin lymph nodes are an integral part of the clinical examination and are usually palpated.
In a healthy person, lymph nodes cannot be felt or can hardly be felt, they can be moved and are painless. If the lymph nodes are swollen and painful, this is a sign of infection. Not only are the lymph nodes in the groin area enlarged, but also those under the armpits and on the neck. Lymph nodes enlarge when the body's immune system fires up to fight possible pathogens such as viruses. Thus, lymph nodes are a good and reliable indicator of systemic infection of the body.
Read more on the topic: Lymph node swelling in the groin
Itchy groin
Itching in the groin region is very uncomfortable for the patient. Patients with these symptoms are often ashamed to see a doctor because they are afraid of being considered unhygienic. However, an itchy groin does not always have something to do with poor personal hygiene.
First of all, it should be noted whether a new shower gel or a new body lotion has been used recently. There may be an allergic reaction to the new product.
In more severe cases, there may also be an infection with a skin fungus. This is diagnosed by a smear that the doctor takes and sends to the laboratory. A fungus infection in the groin area is called tinea inguinalis. Another widespread group of fungi is the Candida group. This family of fungi includes various yeasts that cause so-called candidiasis. The bar is particularly suitable for mushrooms, as it is dark and damp there from wearing clothes. In individual cases, the skin fungus spreads to the genital region, which is an additional burden for the patient. The itchy feeling is aggravated by the clothing rubbing against the skin. A skin fungus is usually treated with an ointment that is directed against fungi. This is applied locally to the itchy area over a longer period of time.
What is a soft groin?
A soft groin is also called an athlete's groin, as it is usually found in competitive athletes. Athletes who are typically affected are track and field athletes, soccer players and tennis players. In these sports, the leg and pelvic muscles are increasingly stressed, so that a soft groin can result.
The soft groin is a preliminary stage of the real hernia and is characterized by pain in the groin region, which can radiate into the leg. In contrast to a real hernia, there is no bulging of the abdominal organs through the abdominal wall. This makes an athlete's bar difficult to diagnose. In addition to being palpated by a doctor, an ultrasound is often performed to confirm the diagnosis.
This type of inguinal hernia can either be genetically caused by weak connective tissue or by overloading the corresponding muscles. Usually the oblique abdominal muscles or the abdominal fascia are affected.
In most cases, a soft groin is treated with a minor surgical intervention. Here the inguinal canal is restored and the inguinal region as a whole is stabilized. The patient should have this procedure carried out as quickly as possible so that the consequential damage, such as irritation of the sciatic nerve, remains as low as possible. In the following weeks, the patient should refrain from sport and strenuous movements.
Which doctor treats groin disorders?
If you have complaints in the area of the groin, your family doctor can be seen first. The family doctor will decide what the most likely cause is and what the further course will be. In the case of an inguinal hernia, surgical treatment in a surgical hospital can be useful. Depending on the symptoms, the disease is treated in visceral surgery, urology, gynecology, neurology or orthopedics.
Read more about: Surgery for an inguinal hernia
Tape the bar
Groin strains can be easily relieved with the help of Kinesiology tapes to treat. These are highly elastic plasters that are stuck to the skin from the outside. The plaster is stuck along different muscle groups and is supposed to help them do their work support and from overstretching, swelling and inflammation protect. The elasticity causes it to no restriction of movement comes. With every movement, the skin is gently massaged and the lymph and blood flow are promoted.
It can also be used to treat groin strains or to prevent injuries while exercising. This can be done along the Adductor muscles glue, from the inner thigh to the inner area of the knee. It should tight applied, but without pulling on the leg. A tape can be purchased in any pharmacy, but it requires experience to apply it correctly.
Stretching exercises for the groin
The groin region should be stretched to prevent strains, especially before engaging in high-risk sports such as soccer, hurdling or skiing. If the sport takes place in a particularly cold environment, the risk of strains is particularly high. Therefore, the most important preventive measures are sufficient warm-up training including stretching the leg muscles.
The adductor group is stretched by standing with your legs apart and alternately kneeling with one leg until you pull your middle thigh. To do this, you should take enough time to stretch slowly and sufficiently. Fast, overzealous movements to provoke severe stretching pain should be avoided.
Another stretching exercise is to bend one leg back in a free standing position and draw the bent foot with your hand. There should be a slight stretching pain on the front of the thigh.
If you do sports that require other muscle groups, these muscles should also be pre-stretched so as not to pull or even tear through sudden movements.
Also read more about it Stretching exercises in general
