Groin Strain Phase 1: Acute Management

Phase 1 is the acute stage and begins as soon as possible following injury. The aim of phase 1 is to reduce pain and inflammation and allow the muscle to heal. The emphasis is on rest and protection to enable healing to begin to take place.

Treatment

To be done daily.

Cold therapy

Apply a cold therapy and compression wrap for 10 minutes every 2 hours for the first 24 hours. Reduce frequency as symptoms improve to a minimum of at least 3 times/day.

Taping & Supports

Apply strapping, taping, or a compression bandage to support the injured muscle and reduce swelling.

Rest

Complete rest from running and offload as much as possible. Avoid anything that might aggravate your symptoms. DO NOT STRETCH YOUR ADDUCTOR MUSCLES AT THIS STAGE!

Stretching

Do not stretch your adductor muscles! Other stretches can be done 2 to 3 times per week.

Gluteal stretch

Teaching points:

  • 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
  • Hold for 15 seconds and repeat this 3 times

Calf stretch

It is important to allow your muscles to heal before you start stretching them.

Teaching point:

  • To stretch the big gastrocnemius muscle the back leg must be kept straight
  • Stand with the leg to be stretched at the back and put your hands on a wall at shoulder height
  • Bend the front knee and lean forward, keeping the back knee straight and pushing the heel down into the floor
  • When you can feel a stretch, hold for 20 seconds
  • If the stretch eases, lean further forward until you can feel it again. But do not push too far in the early stages

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
  • Hold for 15 seconds and repeat 3 times

Hamstring stretch

Teaching point:

  • Place your foot on a table or similar and lean into the stretch, keeping your leg straight and chest up
  • Take the stretch as far as is comfortable and hold relaxing into the stretch
  • Aim to stretch forward from the hip rather than the shoulders
  • A gentle stretch should be felt at the back of the leg but it should not be painful
  • Hold for 15 seconds and repeat 3 times

Strengthening

Perform these 2 to 3 times per week.

Clam in flexion with band

Teaching point:

The clam works the muscles on the outside of the hip.

  • Lie on your side with your knees bent and slightly forwards so your hips are in flexion
  • Raise your knee up in a slow, controlled movement and return to the start position

Clam in extension

Teaching point:

  • Performing the clam exercise with your knees moved further back places your hips into extension
  • This targets the muscles on the outside of the hip in a slightly different way
  • It is important to do these exercises on both sides
  • Start with the weaker side and do the same number of reps on the strong side

Ice skaters

Teaching Points:

  • Place a resistance band around your knees to increase the load on your lateral hip muscles
  • Walk forward and backwards
  • Maintain a good posture by keeping your head and chest up
  • 3 sets for 8 reps

Step Down counterbalance Squat

Teaching Points:

  • Hold a stick or pole directly out in front of you at chest height
  • Step down using the pole as a counterbalance
  • Perform the movement slowly and controlled
  • 2 sets of 8 reps

Exit criteria

In order to progress to phase 2 you must:

  • Have complete rest for at least 3 days post-injury.
  • Apply cold & compress for a minimum of 3x/day for 2 days.
  • Walk pain-free for 15 mins.
  • Have no pain to touch.
  • Pain-free standing adductor stretch
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