What is Groin Pull?
The iliopsoas muscle group is made up of the iliacus and psoas major muscles. The iliacus muscle attaches the lower surface of the hipbone to the inner side of the pelvis, while the psoas major muscle attaches the lower vertebrae of the spine to the pelvis. These two muscles join together to form a common tendon that attaches to the femur. Here, they externally rotate and flex the hip joint in order to move the hind limb forward. Injuries to the groin area can be in the middle of one of these muscles, where the tendon connects to bone, or most commonly, at or near the junction of the muscles and tendons.
Another factor that can contribute to these types of groin pulls is eccentric contraction, a normal event that occurs when the muscle contracts during a stretch. Traumatic incidents, such as jumping out of a vehicle or roughhousing with other dogs, can cause an injury that results in active eccentric muscle contraction that can cause acute lameness and predispose your dog to a groin injury. It is also common to see iliopsoas strains concurrent with other orthopedic conditions or after a recent surgery for those conditions, such as for a cranial cruciate ligament rupture.
While active dogs can certainly be susceptible to muscle injuries, the groin muscle, known as the iliopsoas muscle group, is the most commonly affected. The iliopsoas muscle group helps to move the hind limbs. An injury to these muscles generally occurs during highly athletic activity, such as agility training and quick ball chasing, and is usually painful.
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Symptoms of Groin Pull in Dogs
A pulled groin is a very painful injury, often causing lameness that varies in degrees and is exacerbated by activity. The pain your dog can experience from this injury is most notable when an attempt is made to move the hip in a backwards position or in a more normal position.
Symptoms of a groin pull include:
- Pain in affected limb
- Hind limb lameness, often persistent and intermittent
- Limb held in a “chicken-wing” position, or high up by the hip
- Favoring affected limb
- Reluctance to jump onto high places, such as a couch or vehicle
- Reluctance to climb stairs
- Vocalization during and after injury
- Swelling near injury
- Lack of appetite
- Behavioral changes
- Changes in performance, such as knocking bars with hind limbs, hesitation, and slowed responses and run times
Causes of Groin Pull in Dogs
Groin pulls in dogs are a direct result of the iliopsoas muscles being forcefully extended or stretched. This injury is commonly seen in sporting dogs who are subject to highly intensive and athletic activities. The excessive force can be from repetition of a highly athletic exercise, a repetitive activity without any variation, a slip or fall occurring without a proper warm up, or due to an underlying orthopedic condition that causes the dog to tighten the groin muscles during times of high activity.
Activities which can result in a groin pull include:
- Agility training and exercises
- Cross training
- Hard running
- Slipping into a splay-legged position
- Jumping off an elevated surface, such as a vehicle
- Excessive training or play
- Roughhousing with other pets
Diagnosis of Groin Pull in Dogs
If your active dog is suddenly crying out in pain, is showing changes in performance and activity levels, and can’t even walk up the stairs, it is time for medical intervention. Your veterinarian will begin by examining your dog, paying particular attention to the affected limb. A diagnosis will be based on a history of symptoms and findings of the exam. Palpation of various areas of the limb and pelvis may elicit pain and muscle spasms. Your vet will also attempt to extend the hip. Any areas of pain and spasms are noted, and often lead to a diagnosis of a groin pull.
Imaging techniques can be used to locate a specific injury to confirm a diagnosis. X-rays are not very helpful in visualizing an acute tear in the iliopsoas muscles, but they can reveal fractures in the femur at the point of iliopsoas tendon insertion in young dogs, and evidence of mineralization in chronic cases. Ultrasounds can be used to see lesions in a torn muscle or tendon, while CT scans and MRIs can be used to directly identify iliopsoas strains.
Treatment of Groin Pull in Dogs
Groin pulls, like most severe muscle strains and tears, can take some time to heal. Depending on the severity of the injury, and whether it is an acute or chronic strain, treatment can include house confinement, medications, rehabilitation, and surgery. There are many dogs who can temporarily improve, but may worsen after returning to activity too soon.
Initial Medical Treatment
The first step is to confine your dog to the house with only leashed trips outside to eliminate. Stop your dog from running, playing, climbing stairs, and jumping, including on the couch or in a vehicle.
With acute strains, a combination of rest, cold pack therapy, specific exercises, and medication is used as needed, such as anti-inflammatories including NSAIDs, tranquilizers, and muscle relaxants. Generally, activity is slowly increased if improvement within the first two weeks is seen. If your dog’s condition does not improve or begins to worsen, further testing is often recommended, and rehabilitation is the next step.
Chronic strains are treated slightly differently, as the goal is to re-initiate the inflammatory response to repair the tendon fibers. As such, NSAIDs are avoided as they prevent the inflammatory process from activating. Rehabilitation is essential in recovery from this type of injury.
Various rehabilitation methods are tailored to each case of both acute and chronic groin pulls. This is accomplished through trained veterinary physical therapists.
Acute injuries are often treated with laser therapy for pain relief, increased circulation, and to hasten healing. Other modalities include ultrasound, heat therapy, acupuncture, chiropractic adjustments, platelet-rich plasma, and massage. Passive range of motion (PROM) exercises help to maintain muscle flexibility, but care needs to be taken to not overstretch muscles, as micro-tears can occur which disrupt the healing process. In some cases, stretching may be avoided completely. After a few weeks, active range of motion exercises are often added.
Rehabilitation therapies for chronic sprains may include heat therapy, ultrasound, and massage, but other modalities such as cold laser therapy and stretching exercises can also be used.
Surgery is considered in certain situations, such as a failure to respond to more conservative treatments of medical and rehabilitation therapies, if nerve damage develops in the femur, if there is a recurrent injury in the same area, or if the tendon has sustained irreversible damage. Before any surgical procedure, the diagnosis is confirmed through imaging techniques such as a CT scan or MRI. A tenectomy is then performed, which involves cutting the tendon from the bone and removing as much muscle as possible. The hip can function normally without this muscle group, and recovery time ranges from 2 to 6 weeks.
Recovery of Groin Pull in Dogs
Recovery of a groin pull can take from 2 weeks to many months, depending on the severity of the strain, the treatment used to correct it, and your dog’s response to that treatment. While many dogs can recover, there are some who do experience a recurrent injury. Surgery carries a good to excellent outcome, though working dogs will need to have a reduced work load to prevent another injury. At home, you may be given medications to administer, or exercises to perform with your dog that will start slowly and progressively be more active over time. All agility and performance activities should be avoided during recovery.
You can help prevent a groin pull in your dog through exercise practices similar to those of human athletes. Warm-up exercises and massage for your dog should be performed before any exercise, training, or competition. End any active session with stretching exercises, paying specific attention to the muscles in the hips. These simple techniques can prevent a new injury or a re-injury from occurring.