Groin Strain Phase 5: Return To Play/Training

This is the late rehabilitation & return to full training phase.

Treatment

As required

Hot & cold therapy

Heat before, cold after training as required.

Taping

K Tape for running sessions if available.

Apply compression post exercise to help recovery.

Massage

If available – deeper techniques

Stretching & mobility

To 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

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

Quadricep stretch

Teaching point:

  • This stretches the quadriceps muscles without needing to bend the knee as much
  • 3 sets for 15 seconds with a short break in between

Calf stretches

Teaching Points:

  • Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle
  • 3 sets each 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 10 swings

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

Strengthening

To 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.

  • Contract the muscles, hold and relax
  • Legs bent at 45 degrees
  • Legs straight
  • Legs at 90 degrees

Note: Maximum effort

Lateral lunge

Teaching point:

  • Step to the side keeping the toes forwards and the feet flat
  • Whilst keeping the involved leg straight, squat through the hip of the involved leg ensuring that the knee is in line with the foot
  • 3 sets of 12 reps

Single leg squat

Teaching point:

  • Stand next to a wall with a gym ball between you and the wall
  • Perform a quarter squat on one leg using the ball for support
  • This targets the posterior chain and gets the muscles firing as they work to stabilize your hip
  • 3 sets of 12 reps

Adduction in standing

Note: Increase the strength of the resistance band, or better still use a pulley machine in the gym.

Single leg RDL

Teaching Points:

  • Standing leg stays fairly straight
  • Reach out and backward with the free leg
  • Challenges stability around your hips
  • 3 sets of 12 reps

Side plank Copenhagen

Teaching point:

If you find this too easy you can bring your arm up towards the ceiling, or bring the top leg up and down.

Functional exercises

Pogos

2 to 4 times a week

Teaching point:

  • Jump on the spot
  • Forward jump
  • Backward jump
  • Triple jump
  • Side-to-Side jump

Running progressions

Stage 1

  • Linear Based running (50% max speed)
  • Aim for 3 to 4km
  • No sprinting –––––––––––––––

Stage 2

  • Introduce controlled multidirectional movements (50-60% max effort)
  • Increase linear speed (60-70%)
  • Aim for 4 to 5km
  • No sprinting –––––––––––––––

Stage 3

  • Increase speed of multi-direction work (60-75% max effort)
  • Linear speed to 70-80% max effort
  • Introduce reactive and uncontrolled movements and drills
  • Aim for 5km total distance –––––––––––––––

Stage 4

  • Linear speed up to sprint 80-95% max effort
  • Uncontrolled and reactive change of direction at speed (80-90% max effort)
  • Introduce technical and sport-specific drills
  • Aim for 5 to 6km plus –––––––––––––––

Stage 5

  • Replicate training demands of your sport
  • Max speed sprints

Exit criteria

To move on to the next phase you must meet the following criteria:

  • Pain free through exercises
  • Pain-free exercises
  • Pain-free plyometrics
  • No pain during run
  • No pain post-run (24hrs)
  • No pain on touch
  • Strength is the same on each side

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