Groin Strain Phase 3: Mid Rehabilitation

The aim of phase 3 is to increase Groin muscle strength and endurance.

Treatment

To be done daily.

Cold therapy

Apply hot and cold alternating twice a day.

The ideal ratio is to apply the heat pack for 2 minutes followed by 1 minute for the cold pack.

Repeat this process 6 times giving a total of 18 minutes of treatment, twice a day.

Taping & bracing

Apply compression post exercise.

K taping for the groin can be done if available.

Massage

Apply Arnica-type cream as required.

Massage techniques may become deeper, but see how your muscles feel afterwards and the following day.

Stretching & mobility

Can be done daily.

Gluteal stretch

Teaching point:

  • On your back cross your right ankle over the left knee
  • Grip the thigh of your left leg and pull the knee towards you, lifting your foot off the floor
  • Pull the knee further towards you to increase the stretch
  • 3 sets and hold for 15 seconds

Calf stretch

Teaching point:

Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle.

Both calf stretches are 3 sets for 20 seconds, One to two times a day.

Calf stretch straight leg:

  • Place your hands on the wall and step forward with the foot you are not stretching
  • Keep your toes pointed forward and your back heel on the ground and lean into the wall without bending your back knee

Calf stretch bent knee:

  • Place your hands on the wall and step forward with the foot you are not stretching
  • Keep your toes pointed forward and your back heel on the ground and lean into the wall
  • Bend the knee and ease in to feel a stretch lower down at the back of your leg

Hip flexor stretch

Teaching point:

  • Kneel with one knee on the floor and the other foot in front with the knee bent
  • Push your hips forward and keep the back upright
  • 3 sets and hold for 15 seconds

Hamstring stretch

Teaching point:

There are 3 alternatives for hamstring stretches. Do whichever one you prefer.

Option 1: Standing

  • Place one foot in front of the other with hands on the floor
  • Straighten your legs keeping your hands flat on the floor
  • Feel a stretch on the back leg

Option 2: Sitting

  • Sit with one leg straight and one bent
  • Reach forward keeping head and chest up
  • Feel a stretch at the back of the straight leg

Option 3: Lying on back

  • Lie on your back
  • Use a band to pull your leg up
  • Feel a stretch at the back of the leg
  • 3 sets for 15 seconds

Adductor swings

Teaching point:

  • Swing the leg out sideways, making sure you rotate your leg so your toes point upwards as your leg swings upwards
  • 3 sets of 6 reps on each side

Note: Dynamic adductor swings must be done within a pain-free range of motion.

High knee reach-out

Teaching point:

  • Toes should be pulled up towards the ceiling
  • 3 sets for 15 seconds (daily)

Note: This exercise is good for hip mobility, quad, and glute activation.

Activation

Can be done daily.

Crab Walk With Band

Teaching Points:

  • Place a resistance band around your knees and walk sideways flat-footed
  • This gets the hip muscles firing and fatiguing under bodyweight load
  • Make sure they are done pain-free on the knee
  • Perform 3 sets of 5 metres each way

Ice Skaters

Teaching Points:

  • Place a resistance band around your knees to increase the load on your lateral hip muscles
  • Walk forward and backward
  • Maintain a good posture by keeping your head and chest up
  • 3 sets of 4 steps forward and backward over 10 metres

Strengthening

3 to 4 times a week

Isometric ball squeeze 70-85%

Teaching point:

  • Lie on your back with a ball (either a small football, medicine ball or swiss ball) between the knees
  • Squeeze the thighs into the ball, holding the contraction for a few seconds before resting and repeating
  • This exercise can be performed with straight legs or the feet raised and knees at 90 degrees
  • 5 x 5s in 0/45/ and 90/90 position

Short lever adductor hold

Teaching point:

  • Lie on your side supported by your elbow with your knee on the bench and the other leg straight under the bench
  • Hold this position keeping your back straight and your shoulder, hip, and knee aligned
  • Weight should be going through your knee on the top leg
  • Hold for 25-30 seconds
  • 3 sets of 5 reps

Adduction in standing

Teaching point:

  • Take a resistance band and loop it around one end of a stationary object and the other around your ankle
  • Move your leg in front of your body across the non-working leg and then back again
  • The working leg is the one with the band around it and is kept straight
  • The standing leg should be slightly bent
  • 3 sets of 12 reps

Bodyweight squat

Teaching point:

  • Start with your feet shoulder-width apart
  • Sit back – make sure to move your butt backwards, don’t just bend your knees
  • Go as deep as you feel comfortable
  • Tense your abs and keep your knees in line with your toes
  • 3 sets of 12 reps

Note: Look straight ahead and don’t round your back.

Bodyweight squat

Teaching point:

  • Start with your feet shoulder-width apart
  • Sit back – make sure to move your butt backwards, don’t just bend your knees
  • Go as deep as you feel comfortable
  • Tense your abs and keep your knees in line with your toes
  • 3 sets of 12 reps

Note: Look straight ahead and don’t round your back.

Bodyweight RDL (Romanian deadlift)

Teaching point:

  • Stand with your feet hip-width apart, keeping your back straight and legs slightly bent
  • Lower yourself from the waist as far as you feel comfortable
  • Keep your back straight with this exercise
  • You should feel a little stretch through the hamstring
  • As you progress you can add weight with a barbell
  • 3 sets of 12 reps

Single leg bridge

Teaching point:

  • Lie on your back, knee bent, and push the hips upwards to work the gluteal muscles and hamstrings
  • Use one foot on the floor pushing up
  • Hold the position briefly and then lower
  • 3 sets of 12 reps

Note: Make sure you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise.

Functional exercises

To be done 2 to 4 times a week

Quick feet & hold

Teaching point:

  • Lie on your back, knee bent, and push the hips upwards to work the gluteal muscles and hamstrings
  • Use one foot on the floor pushing up
  • Hold the position briefly and then lower
  • 3 sets of 12 reps

Note: Please make sure you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise.

Forward T

Teaching Points:

  • Perform in a slow and controlled way
  • Stand on one leg with your knee slightly bent
  • Lean forwards, open up your arms pulling the non-supporting leg backward to make the shape of a ‘T’
  • Maintain balance for 4 or 5 seconds and repeat
  • 3 sets of 8 reps

Fitness

Every other day

Jogging

3 times per week maximum

Run for 3 min at 50% pace, walk for 1 min – Repeat this 4 times

Exit criteria

To move onto the next phase you must meet the following:

  • Pain-free stationary bike
  • Pain-free 24hrs post bike
  • Pain-free isometric groin contraction
  • Pain-free to touch
  • Pain-free stretching
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