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