Patient’s Question: Why, When I Do Sit-Ups, Does My Crotch Get Tired Or Sore?

Dr. Spooner, DPT Answers: While this is not necessarily a common question I get in the clinic, off the top of my head I can think of three reasons why you may be getting a tired or sore crotch while crushing some sit-ups:

• First, depending on how you’re doing your sit-up, many people will rely on not just their abs but their *iliopsoas* - combo of two hip flexor muscles - to help leverage their body up and slowly lower them back down each rep. As you can see in the picture below, the iliopsoas attaches on your pelvis and the front of your lumbar spine, then extends downward and attaches to your leg deep in the groin. It could be related to a muscle strain due to fatigue or overuse.

• Second, if you’re holding your breath while doing a sit-up, it builds lots of pressure within the abdominal cavity, and all your “deep core” muscles (see picture below) squeeze to stabilize your trunk and provide support. If you’ve ever sat on the toilet and had to bear down to force a bowel movement, you’re using that same type of pressure to help force it out. So back to sit-ups, if you hold your breath while working hard it can force pressure against your pelvic floor and sphincter muscles and they may be getting tired and sore.

• Third and last, related to the second possible option, over time the muscles of the pelvic floor and lower abdomen can weaken and separation of those muscles can cause a hernia. Persistent soreness in the groin with sit-ups could potentially be early appearance of a hernia. Best to do some background reading on this and get it checked out by your primary care physician.

EXERCISE MODIFICATION

Stopping an exercise completely is rarely the best advice. Instead, exercise modification could be your best bet and is nearly always recommended.