Groin Strain Phase 4: Late Rehabilitation

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.

  1. Legs bent at 45 degrees
  2. Legs straight
  3. 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
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