When you get hurt so bad that the pain is equal to someone fucking your mother, usually used in past tense.
Guy 1:I got hit by a truck and broke my legs and right arm when I was young

Guy 2: Dam, that must have hurt like a motherfucker
by Irregulator July 3, 2011
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Feel so much grief or emotional wreck that your heart feels like it has shit its pants
Graduating high school and going to college is going to hurt like a motherfucker
by Daffy the Duck May 22, 2016
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