What is Groin Strain?

A groin strain occurs when the muscle-tendon unit is inflamed due to injury. This usually manifests as pain in the adductor region on resistance testing of the adductors or on palpation of the adductor tendons. There is a higher rate of groin strains in hockey and football.

A groin is a junction between the abdomen and thigh on either side of the pubic bone. The groin is also referred to as the medial compartment of the thigh.

Cause of groin strain:

Groin strains are common amongst athletes who compete in sports that involve repetitive twisting, turning, sprinting, and kicking such as football, hokey.

Injury mechanism can be classified into three groups:

  1. Direct blunt trauma
  2. Forceful contraction: Change of direction and kicking has been described as the main actions resulting in groin strain.
  3. Microtrauma by repetitive injury: For example overuse trauma, repeated minor injuries.

Clinical presentation of Groin Strain:

  • intense pain in the groin area
  • Tenderness in the inner thighs and pain along the tendon or at the insertion
  • The pain is exacerbated by adduction
  • Local hemorrhage
  • swelling
  • localized tenderness
  • difficulties to contract the hip abductors

Medical management of Gluteal Strain include:

  • Rest
  • Icing
  • compression
  • Analgesia (for example non-steroidal anti-inflammatory agents)
  • Physiotherapy

Physiotherapy Treatment of Gluteal Strain include:

  1. Injury Prevention program
  • Warm up- For example biking, adductor stretching, sumo squats, side lunges, kneeling pelvic tilts.
    • Strengthening program- For example, Ball squeezes, Adductions with a ball squeeze, concentric adductions against gravity, adductions in standing on a cable column or elastic resistance, adductions on a sliding board moving in the frontal plane, Using a sliding board in the sagittal plane, bilateral adductions and unilateral lunges with reciprocal arm movements.
    • Copenhagen adductor exercise
  1. Physiotherapy Management
  • When the injury is acute i.e up to 4-5 days frequent use of cold therapy is beneficial for example ice pack or Cryo-air machine therapy.
    • Isometric exercise within the pain limits.
    • After the initial phase, the application of heat is valuable. This can be administered by hot packs, therapeutic ultrasound therapy, TR therapy, etc.
    • Then, start the muscle training in a pain-free range of motion. Be careful about increased pain should not occur after activity.
    • During rehabilitation, mild pain is to be expected during exercise, but it should subside immediately after training stops.
    • Then the rehabilitation progressed to muscular recovery increased endurance and the full range of motion.

Groin strain, adductor injury program

  • Hip flexor strengthening
  • Hip hitched exercise and progression
  • Abdominal strengthening
  • Double leg squat
  • Lateral hip strengthening (for example banded squat)
  • Deadlift
  • Lunge
  • Plyometric exercises (for example spot hopping, line hopping, cone hopping).

Stretching Exercises

Transverse friction massage

Soft tissue massage/ soft tissue mobilization

High-intensity laser therapy

Extracorporeal Shock Wave Therapy

Hip abductor strengthening

Agility training, etc.