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