Groin Strain Treatment and Rehabilitation

Groin strain treatment - stretching

Groin strains have a high rate or recurrence. Below we outline a groin strain rehabilitation program for mild, moderate and severe groin strain injuries.

The aims of any groin strain rehabilitation program are to reducing initial pain and swelling, improve the flexibility and condition of the muscle, strengthen and gradually return to full fitness. Groin strains are graded 1, 2 or 3 depending on how bad they are. It is important to get the correct diagnosis to base the rehabilitation program on.

Immediate first aid

Applying the PRICE principles (protection, rest, ice, compression and elevation) as soon as possible after injury is important. The treatment principles of PRICE should be used in the first 72 hours of an injury. Protection of the injured groin (adductor) muscle can be achieved by wearing a groin support and this will make the injured area feel more comfortable especially in more severe injuries. The muscle should be rested from all sporting activities in the early stages of healing and a cold therapy and compression wrap applied to the area, but for no more than 15 minutes at a time. Elevation of the injured limb should also be done in the early stages and this is best achieved by lying on a sofa with the leg rested up on 2 pillows.

Read more on PRICE princples.

Grade 1 groin strain rehab

Reducing pain and swelling

Rest, avoiding activities that produce pain. It may be necessary to rest grade 1 groin strains from competition or training for up to 3 weeks. A general guide for safety is 5 days, although if pain allows complete rest may not be necessary. A lower level of activity avoiding any painful movements may be all that is needed.

Apply ice or cold therapy with compression for 15 minutes every 2 hours for the first 24 to 72 hours. Wearing a compression support or apply a groin strapping to help reduce swelling. A groin support be worn all the time in the early acute stages. Later on they can be useful for supporting and keeping the muscle warm when returning to training.

Improving flexibility and muscle condition

Groin strappingStretching exercises may be done from day 1 as long as they can be done without pain. If pain is felt then stop and wait. Stretching should be done regularly - at least three times a day in the early stages of rehabilitation.

Sports massage techniques are exceptionally useful after the initial acute stage (usually 48 hours). This well relax the muscle, loosen and help prevent scar tissue formation and encourage blood flow and healing of the muscle.

Strengthening

Strengthening exercises are important to avoid re-injuring the muscles. It is especially important to strengthen the muscles in the same direction / way that they were injured. Light strengthening exercises can begin after the acute stage or as soon as pain allows. If they are painful then stop and wait. It may be 5 days before strengthening exercises may be started.

Exercises may be done on a daily basis in the early stages of rehabilitation and as intensity increases and full activity is regained they may be reduced to 3 times a week. Stretching exercises should be continued throughout the strengthening process both before and after a strengthening session.

Return to full activity

This should be a gradual process. Do not go straight back into sprinting immediately but build up gradually from slow jogging. When the athlete can jog for 20 minutes without problems then gradually build up speed. An example speed session might be 10 x 50m at 50% effort, day 2, gentle jog, day 3, 10 x 50 m at 70% effort and so on.

This stage of rehabilitation should also include more functional activities or those specifically related to the athletes sport. For example if your sport involves changing direction at speed then this should be included in the rehabilitation process with a gradual build up.

Only when the athlete can comfortably manage specific training and speed work should they be returned to competition. A return to full activity may take 1 to 4 weeks for a grade 1 groin strain.

Grade 2 groin strain rehab

Reducing pain and swelling

Apply ice or cold therapy with compression for 15 minutes every 2 hours for the first couple of days. Rest. Crutches may be require for 3 or 4 days. The athlete should expect to do no training (i.e. involving running) for at least 7 days. Wear a compression support for the first 5 days to help reduce swelling. If pain allows after day 3, flexibility exercises may begin.

Improving flexibility and muscle condition

Groin stretchingGentle stretching exercises may be done from day 3 as long as they can be done without pain. If pain is felt then stop and wait. Stretching should be done regularly - at least three times a day in the early stages of rehabilitation. Sports massage techniques are exceptionally useful after the initial acute stage (usually 48 hours). This well relax the muscle, loosen and help prevent scar tissue formation and encourage blood flow and healing of the muscle.

Strengthening

Strengthening the muscles is important to avoid re-injuring the muscles. It is especially important to strengthen the muscles in the same direction / way that they were injured. Static contractions should begin as soon as they can be done pain free. This may be started 5 days following injury, provided they are pain free. More advanced resistive rehabilitation exercises may begin from day 7 following injury. Stretching exercises should be continued throughout the strengthening process both before and after a strengthening session.

Return to full activity

This should be a gradual process. Do not go straight back into sprinting immediately but build up gradually from slow jogging. When the athlete can jog for 20 minutes without problems then gradually build up speed. An example speed session might be 10 x 50m at 50% effort, day 2, gentle jog, day 3, 10 x 50 m at 70% effort and so on.

This stage of rehabilitation should also include more functional activities or those specifically related to the athletes sport. For example if your sport involves changing direction at speed then this should be included in the rehabilitation process with a gradual build up. Only when the athlete can comfortably manage specific training and speed work should they be returned to competition. A return to full activity may take 3 to 8 weeks.

Grade 3 groin strain rehab

Reducing pain and swelling

Apply ice or cold therapy with compression for 15 minutes every 2 hours for the first 2 to 3 days. Rest. The leg might be totally immobilized to prevent further damage. Crutches should be used for 5 to 7 days. The athlete may expect to do no training for at least 2 weeks. Wear a compression support permanently for the first 5 days to help reduce swelling.

If advised by a professional, following day 14, a lower level of activity such as jogging, cycling or swimming may help prevent the muscle tightening up.

Improving flexibility and muscle condition

Stretching should be avoided in the early stages of rehabilitation. It may be 2 weeks before stretching can begin pain free. Sports massage is important for muscle recovery, however may be dangerous if performed too early. Light massage may be possible from day 5. This will relax the muscle, loosen and help prevent scar tissue formation and encourage blood flow and healing of the muscle.

Strengthening

Strengthening the muscles is important to avoid re-injuring the muscles. It is especially important to strengthen the muscles in the same direction / way that they were injured. Static contractions (isometric contractions) should begin as soon as they can be done pain free. It may be 2 weeks before any strengthening exercises can be performed pain free.

More advanced strengthening exercises should be incorporated when previous exercises are comfortable. Stretching exercises should be continued throughout the strengthening process both before and after a strengthening session.

Return to full activity

This should be a gradual process. Do not go straight back into sprinting immediately but build up gradually from slow jogging. When the athlete can jog for 30 minutes without problems then gradually build up speed. An example speed session might be 10 x 50m at 50% effort, day 2, gentle jog, day 3, 10 x 50 m at 70% effort and so on.

This stage of rehabilitation should also include more functional activities or those specifically related to the athletes sport. For example if your sport involves changing direction at speed then this should be included in the rehabilitation process with a gradual build up. Only when the athlete can comfortably manage specific training and speed work should they be returned to competition. A return to full activity may take 8 to 12 weeks or longer.