The aim of phase 4 is to increase Groin muscle strength and endurance and prepare for a return to training/play. Check the Exit Criteria to see when to move on to phase 5.
Treatment
As required
Hot & cold therapy
Apply heat for about 10 mins before training to warm the muscle up and ice after for 10-15 minutes.
Taping & support
Apply K taping before exercise to ‘activate’ the muscles and compression post-exercise to aid recovery.
Massage
Apply light massage techniques if available.
Stretching & mobility
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
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.
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
Strengthening
To be done daily
Long lever adductor holds
Long lever adductor holds into Copenhagen
Teaching point:
- Weight should be going through the foot that’s on the bench
- Hold for 10 seconds, progress up to 25-30 seconds
Single-leg hamstring bridge
Teaching point:
- Using a step or box to raise your elbows, alternate putting each heel to the floor
- It is important to maintain good core stability and keep your hips and shoulders still
- As your heel touches the ground the gluteal muscles and hamstrings have to work isometrically to keep your body stable
Note: This works the hamstring muscles in a position similar to how they are when sprinting or accelerating.
Isometric ball squeeze 100%
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
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 12 reps
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
Adduction in standing
Teaching point:
- 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
Plyometrics
2 times a week
Side jump
Teaching point:
- Perform a jump with a lateral movement to your side
- Continue this movement back and forth
- 2 sets of 8 reps on each side
Running
3 times a week maximum
Jogging
Teaching point:
- 3 x / week maximum
- Stage 1: 1 min jog 4 min walk repeat x 4
- Stage 2: 2 min jog 3 min walk repeat x 4
- Stage 3: 3 min jog, 2 min walk repeat x 4
- Stage 4: 4 min jog, 1 min walk repeat x 4
- Stage 5: 20 min Jog
Exit criteria
To move on to Phase 5:
- Exercises should be pain-free including plyometrics
- No pain during runs
- No pain post-run (24hrs)
- No pain on touch
- Strength should be 80-90% of uninjured side