March 10, 2020,
You know one when you have one. Big time.
It gets your attention. All of it.
They hurt like crazy.
Groin injuries are no laughing matter.
They are a grimacing matter.
If you have a strong exercise program, most likely you work out and stretch during your routine but one of the muscles that so many overlook during their program is stretching the groin muscle.
This is also known as the medial compartment of the thigh that consists of the adductor muscles of the hip or the groin muscles. A pulled groin muscle usually refers to a painful injury sustained by straining the hip adductor muscles.
When you have an injury sometimes it may be confusing to tell the difference between a groin injury and a hernia.
At health.harvard.edu they educate, “The abdomen is covered by a wall of muscle. A hole in this muscle wall is called a hernia. This can occur near an incision, the belly button, the upper stomach, or (most often) the groin area.
Groin strains commonly occur in the upper thigh muscles, such as the adductor longus muscle that helps your thigh move from side to side, or in one of the tendons that attaches the adductor to the pelvis.”
We didn’t realize how closely they are related though a hernia issue seems far more serious and can require surgery.
So prevention is the key.
Once it occurs the following is a suggestive plan to heal and relieve a groin strain.
A Complete Treatment and Management Plan for Groin Strain
By Brad Walker
The following is a very thorough and detailed management plan for the full recovery and rehabilitation of a groin strain.
Considering this management plan was written over ten years ago, my only addition would be the reduction of ice therapy and the addition of massage and heat therapy during the 2nd, 3rd, and 4th phase. Regardless of my suggestions, the following will be extremely useful for anyone who is, or has suffered from a groin strain.
A women varsity basketball player had a history of tightness in her groin. During a game she suddenly rotated her trunk while also stretching to the right side. There was a sudden sharp pain and a sense of “giving way” in the left side of the groin that caused the athlete to immediately stop play and limp to the sidelines.
Symptoms & Signs:
As the athlete described it to the athletic trainer, there was severe pain when rotating her trunk to the right and flexing her left hip. Inspection revealed the following:
- There was major point tenderness in the groin, especially in the region of the adductor magnus muscle.
- There was no pain during passive movement of the hip, but severe pain did occur during both active and resistive motion.
- When the groin and hip were tested for injury, the hip joint, iliopsoas, and rectus femoris muscles were ruled out as having been injured; however, when the athlete adducted the hip from a stretch position, it caused here extreme discomfort.
This detailed management plan comes from one of my old university text books, called Modern Principles of Athletic Training by Daniel D. Arnheim. It’s one of those 900 page door-stoppers, but it’s the book I refer to most for information on sports injury prevention and rehabilitation. It’s extremely detailed and a valuable resource for anyone who works in the health and fitness industry. So…
Based on the athletic trainer’s inspection, with findings confirmed by the physician, it was determined that the athlete had sustained a second-degree strain of the groin, particularly to the adductor magnus muscle.
Management Phase: Goals: To control hemorrhage, pain and spasms. Estimated Length of Time (ELT): 2 to 3 days.
Therapy: Immediate Care: ICE-R (20 min) intermittently, six to eight times daily. The athlete wears a 6-inch elastic hip spica.
Exercise Rehabilitation: No Exercise – as complete rest as possible.
Management Phase: Goals: To reduce pain, spasm and restore full ability to contract without stretching the muscle. ELT: 4 to 6 days.
Therapy: Follow up care: Ice massage (1 min) three to four times daily. Bipolar muscle stimulation above and below pain site (7 min).
Exercise Rehabilitation: PNF for hip rehabilitation three to four times daily (beginning approx. 6 days after injury)
Optional: Jogging in chest level water (10 to 20 min) one or two times daily. Must be done within pain free limits. General body maintenance exercises are conducted three times a week as long as they do not aggravate the injury.
Management Phase: Goals: To reduce inflammation and return strength and flexibility.
Therapy: Muscle stimulation using the surge current at 7 or 8, depending on athlete’s tolerance, together with ultrasound once daily and cold therapy in the form of ice massage or ice packs (7 min) followed by light exercise, two to three times daily.
Exercise Rehabilitation: PNF hip patterns two to three times daily following cold applications, progressing to progressive-resistance exercise using pulley, isokinetic, or free weight (10 reps, 3 sets) once daily.
Optional: Flutter kick swimming once daily.
General body maintenance exercises are conducted three times a week as long as they do not aggravate the injury.
Management Phase: Goals: To restore full power, endurance, speed and extensibility.
Therapy: If symptom free, precede exercise with ice massage (7 min) or ice pack.
Exercise Rehabilitation: Added to phase 3 program, jogging on flat course slowly progressing to a 3-mile run once daily and then progressing to figure-8s, starting with obstacles 10 feet apart and gradually shortening distance to 5 feet, at full speed.
Management Phase: Goals: To return to sport competition.
Exercise Rehabilitation: Athlete gradually returns to pre-competition exercise and a gradual return to competition while wearing a figure-8 elastic hip spica bandage for protection.
Criteria for Returning to Competitive Basketball:
- As measured by an isokinetic dynamometer, the athlete’s injured hip and groin should have equal strength to that of the uninjured hip.
- Hip and groin has full range of motion.
- The athlete is able to run figure-8s around obstacles set 5 feet apart at full speed.
Article by Brad Walker. Brad is an internationally recognized stretching and sports injury consultant with 20 years of practical experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming and triathlon coaching. He has worked with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention. Brad is also the author of The Stretching Handbook, The Anatomy of Stretching and The Anatomy of Sports Injuries.
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