These exercises are often done as soon as possible after injury if pain will allow. The aim is to restore range of motion without putting any damaged tissues under stress. The exact exercises and how quickly you progress through will depend on the type and severity of injury. Active mobility exercises where the athlete physically attempts to move the joint through a range of motion are often the first step.
Isometric Groin Exercises
Isometric groin contraction exercises involve a contraction of the inner thigh muscles, without movement of the hip joint. They are a great way of starting to load the groin muscles in the early stages of rehabilitation. The athlete lies on their back with a ball (either a small football, medicine ball or swiss ball) between their knees. They squeeze the thighs into the ball, holding the contraction for a few seconds before resting and repeating. This exercise can be performed with the feet flat on the floor or with the feet raised and knees at 90 degrees.
Isometric Hip Abduction
Isometric exercises are muscle contractions without movement (static contractions). Isometric hip abduction means contracting the muscles which move the thigh outwards. The athlete sits in a chair with the knees bent and feet flat on the floor. The hands are placed either side of the outer knees, as shown. The athlete then uses their hands to resist as they try to push the knees (thighs) outwards. The contraction is held for 5 to 10 seconds, before they relax and then repeat the exercise.
Isometric Hip Extension
Isometric exercises involve muscle contractions with no movement of the body part (static contractions). Hip extension can be performed as shown here to work the buttocks! To begin to work the buttock and hamstring muscles, the athlete lies on their back. They push the leg down against the surface (floor or table). Ensure that the buttock muscles are contracted throughout.
Isometric Hip Flexion
Static contractions are muscle contractions with no movement of the limb. In this case, the hip flexor muscles are contracted against resistance. To begin to work the hip flexors at the front of the hip, the athlete is seated as shown. They use one hand on the lower thigh to provide resistance, as they attempt to lift the leg up. Avoid using the foot to push off. Hold for 5 or 6 seconds and gradually release. Repeat 10 times.
Straight Leg Raise Exercise
The straight leg raise (SLR) exercise is a common exercise which is used in the early to mid stages of rehabilitation for knee, hip and thigh injuries. It works the hip flexor muscles. The starting point is lying on the back with both legs out straight. One leg is then lifted a few inches off the couch/floor, keeping the knee straight. The position may be held for 2-5 seconds, before the leg is lowered slowly back to the floor.
Hip Extension from Prone
The hip extension in prone exercise may also be known as a reverse straight leg raise. It is a good starting point for strengthening the glute and hamstring muscles. To strengthen the hamstrings and buttock muscles the athlete lies on their front and raises the thigh upwards off the couch. Keep the knee straight throughout. Slowly lower the leg back down and then repeat. Ensure that the buttock muscles are contracted to initiate movement.
Hip Extension on all fours
Hip extension exercises such as this work the glute muscles (buttocks) and the hamstrings at the back of the thigh. This is an early stage exercise as no weight is added, only gravity is used as resistance. In an all fours position, the athlete raises one leg behind them, keeping the knee bent and moving the sole of the foot towards the ceiling. Once at the top of the movement, they may hold the position briefly before returning slowly to the starting position.
Hip Adduction Against Gravity
Hip adduction exercises involve moving the thigh inwards across the line of the body. Laying on the side of the leg to be worked means gravity can be used to increase resistance. Ankle weights can also be added. To strengthen the groin muscles the athlete lies on their side with the leg to be worked on the bottom. The top leg is bent out of the way as shown. The athlete lifts the bottom leg as high as is comfortable, keeping the knee straight.
The side-lying clam exercise strengthens the hip abductors such as gluteus medius. It is commonly used in rehabilitation of lower back pain and hip injuries. Lie on your side. Rest your head on your arm or hand as shown. Bend hips to approximately 45 degrees and bend your knees at 90 degrees. Make sure one hip is lying above the other. You should now be well aligned- your feet should be in line with your back. Float the upper leg upwards while keeping your feet in contact with one another. Inhale and as you the leg down to the starting position. Repeat 5- 10 times each leg.