Groin Anatomy

The groin region consists of ligaments, tendons, muscles and fascia around the inguinal ligament which attaches to the pubic bone. Exact knowledge of the anatomy of this region helps to understand what clinical problems sportsmen and women may suffer. The majority of groin pain arises fom the attachment of the inguinal ligament and lacunar ligament, the rectus muscle insertion, the pectineal fascia and ligament (also known as Cooper's ligament) as well as problems arising from the adductor tendon insertion. Exact knowledge of the groin will help in the dignosis of groin pain.

Central to the groin area is the inguinal ligament which marks the lower most fibres of the abdominal wall musculature. Inguinal hernias arise above this ligament. It plays a pivotal role in the causation of groin pain. The inguinal ligament attaches to the pubic bone, curls downwards as the lacunar ligament and joins the pectineal ligament (Cooper's ligament). The pectineus muscle attaches the femur to the superior pubic ramus. This muscle is covered by a thick fascia (pectineal fascia) which joins the pectineal ligament. Tension in any of these ligaments or fasciae will cause pain in athletes.

The adductor tendon inserts onto the front and underneath the pubic bone. The fascia arising from the adductor tendon and the inguinal ligament together with the fibres coming from the rectus muscle insertion form a continuous sheet of fibres. This may explain why it is quite difficult in some athletes to separate symptoms arising from the inguinal ligament/rectus attachment and the attachment of the adductor tendon fibres.