Why Do Footballers Get Recurrent Groin and Hamstring Injuries?
Recurring groin and hamstring injuries in football often come down to how the pelvis and hips are aligned under load. Kicking, sprinting and cutting place extreme force through the adductors and hamstrings. If the pelvis is tilted or one hip moves differently from the other, these muscles are repeatedly overloaded, which is why the same injury keeps coming back.
Key takeaways
- Most recurring groin strains are not just "muscle tightness." They often involve pelvic and hip alignment problems.
- Hamstring reinjury rates in football are high because the root cause, often an asymmetry further up the chain, goes unaddressed.
- Lying-down scans can miss alignment issues that only appear when you are standing and weight-bearing.
- A standing whole-body image of the pelvis, hips and legs can reveal the mechanical reason behind repeated strains.
What actually happens when a footballer strains their groin or hamstring?
A football groin injury usually involves the adductor muscles, the group on the inner thigh that pull your leg inward. When you kick a ball, these muscles work at full stretch while also trying to stabilise the pelvis. If the force exceeds what the muscle can handle, fibres tear. The adductor longus is the most commonly injured.
Hamstring injuries happen in a different way. During a sprint, your hamstrings have to decelerate the lower leg just before your foot hits the ground. This is called eccentric loading, where the muscle lengthens while contracting. It is an enormous amount of force, and if the muscle is already fatigued or slightly overstretched by a pelvic tilt, it gives way.
The frustrating part is the pattern. You rest, you rehab, you return, and within weeks the same muscle goes again. Research shows hamstring reinjury rates in professional football can be as high as one in three. The reason is often that rehabilitation addresses the muscle but not the mechanical cause behind the overload.
What are the signs that your groin or hamstring problem is alignment-related?
Not every football groin injury is caused by alignment. But several patterns suggest the problem goes deeper than just muscle fatigue.
The injury keeps returning to the same muscle on the same leg, despite thorough rehabilitation.
A deep ache or sharp pull in the groin specifically during kicking or crossing, not just running.
One hamstring or adductor always feels tighter, even after stretching. This asymmetry is a clue.
Gym strength tests look good, but match load, especially cutting and pivoting, triggers the injury again.
If any of these sound familiar, the problem may not be the muscle itself. It may be how your pelvis and hips are positioned when you are on your feet and moving.
What causes recurring groin and hamstring strains in footballers?
Repeated adductor strain in football and recurring hamstring tears are rarely caused by one thing alone. They result from a combination of factors, many of which are hidden.
Even a slight tilt pre-loads one side, so the adductors or hamstrings on that leg are working harder before you take a single step.
Bony changes in the hip joint can restrict range of motion, forcing the groin muscles to overcompensate during kicking. Learn more about hip impingement (FAI).
A structural or functional difference in leg length changes how force travels through the chain with every stride.
If the hamstring is not strong enough while lengthening, it tears during high-speed running. Match load accelerates the problem.
Your body is a connected chain from your feet up through your pelvis and spine. A problem at the hip can make the groin compensate. A rotated pelvis can overload one hamstring. Pain often shows up away from its true cause. This is why addressing the muscle alone does not stop it coming back.
How does a standing scan help with recurring football injuries?
Standard imaging for a groin or hamstring problem is usually an MRI or ultrasound, done lying down. These are excellent at showing muscle tears and soft-tissue damage. But they do not show alignment, because when you lie down, gravity is removed, your muscles relax and the pelvis settles into a neutral position it may never actually hold when you are upright.
What it shows: A full weight-bearing image of the pelvis, both hips and the full length of both legs, captured in one exposure while you stand. This reveals pelvic tilt, rotation, leg length asymmetry and hip joint angles exactly as they are when you run and kick.
The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. The scan takes seconds and shows how your body actually loads under gravity.
What it shows: Excellent soft-tissue detail. An MRI can identify a torn adductor, inflamed tendon or labral tear. But it cannot reliably show whether your pelvis is tilted or whether one leg is functionally shorter than the other, because gravity is not acting on you.
This is why many footballers get an "all clear" on MRI yet still keep breaking down. The muscle heals, but the mechanical overload remains invisible.
ScanAlign standing EOS imaging captures the pelvis, hips and lower limbs in a single standing exposure. The report measures alignment, symmetry and joint positioning so that your physiotherapist, surgeon or sports medicine team can see exactly what is driving the repeated injury.
A note on MRI: EOS shows bones, joints and alignment. For soft-tissue injuries such as muscle tears, tendon damage or labral problems, MRI is usually the better tool. In many cases, both are needed. EOS finds the alignment cause; MRI finds the tissue damage.
What helps break the cycle of recurring groin and hamstring injuries?
ScanAlign is a diagnostic imaging clinic, not a treatment provider. But understanding the general approach can help you ask the right questions of your medical team.
- Identify alignment first. Before more rehab, find out whether a pelvic tilt, hip asymmetry or leg length difference is driving the overload. A standing whole-body scan is the most direct way to see this.
- Targeted rehabilitation. Once the alignment picture is clear, a physiotherapist can address the specific imbalance rather than applying a generic hamstring or adductor programme.
- Eccentric strength work. Nordic hamstring exercises and similar protocols are well supported by research, but they work best when the underlying alignment allows the muscle to load evenly.
- Return-to-play screening. A follow-up standing scan can confirm that alignment has improved before you return to match load, reducing the risk of reinjury.
For more on how imaging can form part of a structured approach, read about sports injury prevention.
Struggling with a recurring groin or hamstring problem? A free video consultation with our specialist radiographer can help you decide whether a standing alignment scan is the right next step.
Book a free video consultationFrequently asked questions
In many cases, rehab heals the muscle but does not address the underlying reason the muscle was overloaded. A pelvic tilt, hip asymmetry or subtle leg length difference can keep putting extra strain on the same spot, so the injury recurs once match load returns.
Yes. Conditions such as hip impingement (FAI) restrict how far the hip can move, forcing the adductor muscles to work harder during kicking and cutting. This extra demand often results in recurring adductor strain.
A groin strain is a tear of the adductor muscle fibres. A sports hernia, sometimes called athletic pubalgia, involves weakness or a tear in the abdominal wall near the pubic bone. Both can cause groin pain when kicking, and imaging helps distinguish between them.
Research shows the reinjury rate can be around one in three. The most common reason is returning to play before the muscle and the underlying biomechanical factors are fully resolved. Scar tissue, residual weakness and unaddressed pelvic asymmetry all contribute.
A standing X-ray, specifically an EOS scan, captures your pelvis, hips and full legs while you bear weight. This shows alignment and asymmetry that lying-down scans often miss. It helps your medical team understand the mechanical reason behind your repeated injury.
Yes. EOS uses about 90% less radiation than a standard X-ray, around ten times less. The scan is quick, painless and non-invasive.
No. ScanAlign accepts self-referrals. You can book a hip and pelvis scan directly after a free video consultation with our specialist radiographer.
Pricing details are available on our FAQs page. The initial video consultation is free and there is no obligation to proceed.
EOS is designed to show bones, joints and alignment. For soft-tissue injuries such as muscle tears or tendon damage, MRI is usually the better tool. In many cases, both types of imaging are valuable.
Sudden weakness, numbness, or any loss of bladder or bowel control alongside groin or hip pain requires urgent medical attention. Contact your GP, call 111, or go to A&E. Do not wait to book a scan.
Stop guessing why the same injury keeps returning
A free video consultation with our specialist radiographer can help you work out whether a standing alignment scan is the right next step for your groin or hamstring problem.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- Hölmich P. Long-standing groin pain in sportspeople falls into three primary patterns. British Journal of Sports Medicine. 2007;41(4):247-252.
- Ekstrand J, Waldén M, Hägglund M. Hamstring injuries have increased by 4% annually in men's professional football. British Journal of Sports Medicine. 2016;50(12):731-737.
- NHS. Sprains and strains. NHS.uk. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (accessed 2024).
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.