Groin Strain Phase 2: Early Rehabilitation

This is the early rehabilitation phase. The aim of phase 2 is to continue to protect the area and improve the condition of the muscles.

Treatment

To be done daily.

Cold therapy

Heat for 10 mins or alternate hot and cold. The ideal ratio is to apply the heat pack for 2 minutes followed by 1 minute for the cold pack. 1-2 times/day.

Taping & support

Continue compression especially if you are on your feet a lot. This will support and protect the muscle.

Massage

Massage Arnica-based cream or similar into the area. Note: Avoid deep tissue massage techniques.

Stretching

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 stretches

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.

All stretches are 3 sets for 15 seconds.

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

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 for 6 reps

Note: Stay within a pain-free range of motion.

Activation

Can be done daily.

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 5 metres

Side strike

Teaching point:

  • Try and keep the legs straight
  • Lead leg goes quickly and the trail leg goes slowly
  • 3 sets of 5 metres each way

Strengthening

Can be done daily.

Isometric ball squeeze

Teaching point:

Isometric ball squeeze in 3 positions. Must always be done in the PAIN-FREE range of movement.

You can use either a small football, medicine ball, or swiss ball for this exercise.

All exercises are 5 sets for 5 seconds in each position.

1) Legs at 90 degrees:

  • Lie on your back with a ball between the knees
  • Squeeze the thighs into the ball, holding the contraction for a few seconds before resting and repeating

2) Legs straight:

  • Lie on your back keeping your legs straight with a ball between your knees
  • Squeeze the thighs into the ball, holding the contraction for a few seconds before resting and repeating

3) Legs bent at 45 degrees:

  • Lie on your back with a ball bending the knees at 45 degrees
  • Squeeze the thighs into the ball, holding the contraction for a few seconds before resting and repeating

Core strengthening

Teaching point:

All exercises are 3 sets for 15 seconds.

Front plank:

  • Lie facedown with legs extended and elbows bent
  • Feet hip-width apart, and elbows shoulder-width apart
  • Contract your core and hold the position for 15 seconds

Side plank:

  • Lie on your right side with your legs extended and forearm flat on the floor
  • Lift your hips off the mat so that you’re supporting your weight on your elbow and the side of your foot
  • Keep your top hand on your hip, engage your core and hold the position for 15 seconds

Note: You can reach up to the ceiling to make it harder.

Dead bug:

  • Take the opposite arm to the opposite leg into an extended position
  • Straighten the leg while extending the opposite arm
  • Continue this for 15 seconds

Adductor drag

Teaching point:

  • Take the affected leg out to the side (foot or two)
  • Drag it in with the resistance of the floor
  • 3 sets of 8 reps

Long lever adductor hold

Teaching point:

  • Lie on your side supported by your elbow with one leg extended on the bench and the other under the bench
  • Hold this position keeping your back straight and your shoulder, hip, and knee aligned
  • Weight should be going through the foot that’s on the bench
  • Hold for 10 seconds, progress up to 25-30 seconds
  • 3 sets of 8 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 8 reps

Fitness

2 to 3 times a week.

Arm only swimming

Non-impact cardiovascular training such as arm-only swimming can be done.

10 to 30 minutes depending on fitness levels.

Exit criteria

To move on to phase 3 you must meet the following:

  • Injury must be pain-free to touch
  • Pain-free isometric groin contraction
  • Pain-free groin stretches
  • Pain-free cycling
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