Techniques for groin/inguinal pain

[Sweet P]

I have had a few clients so far in my career that have complained of pain and ache in the inguinal area. Particularly today I had a lady who had undergone a full hysterectomy as well as 11-12 other surgeries, a few of which were abdominal. I am assuming that is the source of her pain in this area.

The inguinal region was taught to me to be an endangerment area because of the sensitivity of underlying structures, plus I am not going to massage someone in that area because of its proximity to genitalia. So far I have addressed this complaint with work addressing the hips, SI joint, glute stretches, basically anything connecting to the hips. I have also recommended stretches that address psoas and the groin area, but these stretches are usually intimidating to non=stretchers. Are there any techniques that are effective for treating this area that can be done in actual bodywork? I am also not comfortable working on the abdomen/psoas as I have never had a client request it. I haven't found any useful information on youtube so far.

Thanks for the help!!

 

[Musicisthebest]

Techniques for groin/inguinal pain

I have had a few clients so far in my career that have complained of pain and ache in the inguinal area. Particularly today I had a lady who had undergone a full hysterectomy as well as 11-12 other surgeries, a few of which were abdominal. I am assuming that is the source of her pain in this area.

The inguinal region was taught to me to be an endangerment area because of the sensitivity of underlying structures, plus I am not going to massage someone in that area because of its proximity to genitalia. So far I have addressed this complaint with work addressing the hips, SI joint, glute stretches, basically anything connecting to the hips. I have also recommended stretches that address psoas and the groin area, but these stretches are usually intimidating to non=stretchers. Are there any techniques that are effective for treating this area that can be done in actual bodywork? I am also not comfortable working on the abdomen/psoas as I have never had a client request it. I haven't found any useful information on youtube so far.

Thanks for the help!!

Yes, you need to exercise caution in that area, but sometimes you need to work there. Unfortunately, most of the MTs I know received very little training in this area during their initial massage education, so most new MTs simply don't go there (or rarely, if ever). For me, therapeutic massage for my psoas, iliacus, and inguinal ligament were critical to recovering from an old injury that had "caused" many other compensatory injuries and chronic pain issues.

My MT was well-trained and experienced, and had no hesitation whatsoever about doing the work I needed in that area. This is part of what inspired me to become an MT too. Now I do TONS of work in those areas, and occasionally teach workshops on it.

There are dozens of stretches that may help, ideally using an active method like Muscle Energy Technique, PNF stretching, Active Isolated Stretching, CRAC stretching, or the like. Each method has assisted versions you can do with the client, and also solo versions she can learn to do on her own. If you are skilled and comfortable with the stretch(es), you can eliminate the "intimidating" aspect so the client can benefit from the method.

However, you can also learn "indirect" massage/bodywork methods drawn from myofascial release, positional release, dermoneuromodulation, and others... the key piece being that such methods would not require trying to use direct pressure to penetrate deeply into the client's tissues. Instead, such methods work with lighter pressure applied at oblique angles, or by simply repositioning the client's limb. These take a bit of study and practice, but are highly effective for many, many people.

Since it sounds like working in the inguinal area intimidates you, I suggest that you refer this client to another MT for further assistance. If you can, first find one or more MTs that are skilled at working that area, preferably with stretching and/or indirect methods as described above. Educate the client that her complaint seems to be localized to a region of the groin that requires some specialized expertise, and that you want her to try that kind of work and then come back to see you for followup. In my experience, 1-2 sessions of working that area *should* be enough, and you could do the rest.

Also, get a massage from an MT who is experienced working that area and have them work the inguinal region and hip flexors on you. You will learn a lot, and don't hesitate to ask a lot of questions. If you are lucky, you might even find a mentor and/or CE class to learn more.

One other thing you can do is to offer abdominal work as a part of full body massages. It's a chance for you to practice, and for those clients to try something that most of them have probably never experienced. Do NOT insist upon including the abs, but suggest it and ask if they'd like to try it. (Practice how you drape for it beforehand.) You might be surprised at how many people go for it, regardless of their body type.

The sooner you can get over any hangups you might have about abdominal/inguinal work, the sooner you will feel confident helping clients like this one... and the fewer visits you will need to help them eliminate the problem.

 

[stormgale89]

Techniques for groin/inguinal pain

Thanks for the reply, Jason. Very helpful.

I'm sure I can find some info on AIS/PNF without shelling out for CE credits that I can't afford right now. If I find I am not being effective for that part of her problem then referring to another MT is the option, I suppose.

 

[Pompal 09.]

Techniques for groin/inguinal pain

You will find in your career that many basketball players need this type of work as well (I have found this to be the case especially with professional basketball players).

I fully believe that if you are to work here, you do need to have "...no hesitation whatsoever about doing the work..." . It's extremely important as it keeps the client comfortable and confident.

One thing you can do while learning how to work the area is to find someone you are comfortable with who will let you practice. Drape the area accordingly and perform "sham" work to the area in order to gain your confidence until you are able to take some course-work and do enough study on your own. It will prepare you for how the area feels, enlighten you as to your own personal energy you give off or take on and give you insight on how you view the purpose of the work - all the while, providing you with a "flow" for the region.

If I run across any helpful texts, I'll add that information to this post.

 

[EddieJ]

Techniques for groin/inguinal pain

Jason touched on indirect work. I use MFR daily for abdominal/pelvic work. With techniques such as these, releasing the abdominal scars can greatly reduce or eliminate the groin strain patterns. Application of a psoas/quad release, where you bridge the groin, would work well without compromising your work ethics.