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Treatment and Prevention of Groin Pulls

What should you do if you’re the unlucky recipient of a groin pull? And even more importantly how can you prevent a groin pull from happening altogether. A “groin pull” (aka groin strain) is often a bruise, stretching, or tearing of the muscle fibers that run from the front of the hip bone to the inside of the thigh.

These “hip-adductor” muscles move the thigh toward the center line of the body (adduction) and also help to control and limit movements of the thigh away from the body’s center line.

Thus, the adductor muscles stabilize the hip and leg during any activity which involves running. In some groin pulls, the muscles themselves are okay, but the tendons attaching the muscles to the front of the hip bone are stretched and inflamed.

What causes a groin pull?

Overuse
Since the adductors must stabilize the hip with each foot strike during running, they are subjected to vertical-impact, front-to-back, lateral-plane, and rotational forces.

A lot of running (especially running with mutiple changes of direction- basketball, football, soccer, etc) can put great strain on the adductors, and if the recovery periods between workouts do not permit adequate restoration, the adductor muscles and tendons may become increasingly more irritated.

Inadequate warm-up prior to running or sporting events
If the adductor muscles are not warmed and loosened up prior to activity, or if the warm-up fails to prepare the nervous system to control the adductors in an optimal way, sudden movements may place too great a strain on the adductors, leading to tearing.

Sudden dynamic movements
Such as initiating a sprint, changing direction powerfully, leaping to catch a ball, surging up a hill, or hitting the ground after a jump. All of these activities subject the adductors to greater-than-normal force loads, which may produce a groin pull.

Poor mechanics while lifting heavy objects
When a large weight is hoisted, there is a tendency for the thigh to undergo abduction. If this is not controlled, the adductors may experience excessive strain resulting in a groin pull.

Forceful contact with an external object
Such as a soccer goal post or another competitor’s leg. When groin pull occurs, the leg is usually struck from the inside and driven away from the centre of the body.

How to recognize a groin pull

During your sporting activity, if you feel a sudden sharp pain in your groin area which causes you to stop – or at least slow down – your movement, you can be fairly confident that you have suffered a groin pull.



Motion at your hip joint will usually produce pain, and your groin area will become tender to the touch. Within 24 hours, you’ll often be cursed with significant swelling and inflammation, and the injured area may feel warm to the touch.

The swelling may spread downward, and discoloration can appear within 48 hours (and also may spread downward). Walking creates pain, and quality running is usually impossible.

What to do if you suffer a groin pull

As soon after the injury as possible, you should elevate the injured-side leg and apply ice (put a styrofoam cup filled with water in your freezer; once the water is frozen, peel away the top edge of the cup to expose a core of ice, and gently rub this nub on the injured area for about 12 minutes at a time, recovering for 20 minutes between rubbings).

You’ll want to stay away from walking, jogging, and running for as long as moderate-to-severe pain persists. Some therapists believe that very gentle manual massage, working from the lowest area of discoloration toward the central area, may be beneficial. You should also take an anti-inflammatory to help with the healing process.

The length of time you’ll be out of action depends on whether you have a first, second, or third-degree groin pull.

Types of groin pulls

Generally, first-degree groin pull are simple bruises of the adductor muscles (or hip bone), with possibly a stretched tendon or a few stretched muscle fibers.

A second-degree groin pull involves stretched tendons, stretched or torn muscle fibers, and often bruising of the hip bone and its muscular attachments. They are usually symptomatic for two to three weeks.

Lastly, a third-degree groin pull is represented by many ruptured muscle fibers, severely stretched tendons, and perhaps separation of a tendon from either its muscle or hip attachment. Consult with your doctor if you have significant discoloration and bruising to see if you have a third-degree groin pull. Your doctor may request an MRI if a third-degree groin pull is suspected.

When can you return to action following a groin pull?

Knowing when you can return to running or your sport is fairly easy. When all of the movements associated with your sport can be performed without significant pain, you may return to participation. If your sport requires frequent and forceful changes of direction, as in soccer, for example, such movements must be painless when performed.

The return-to-action criteria is usually a bit different for the runner. If a distance runner can move along without pain during straight-ahead running, he/she usually has the green light to resume training.

Recovery/prevention with adductor stretches

Once the symptoms of your groin pull have subsided, you may engage in stretching exercises after your workouts.

Groin and hamstring stretch
Simply sit on the floor with your legs extended forward and spread sideways as far as possible. Turn your toes upward, and bend forward at the waist to grasp your feet, flexibility permitting, or else your ankles. Bring your forehead as close to the floor as pain and flexibility permit, and hold this position for about 15 seconds, before returning to the starting position and resting for a short period. Perform this sequence about 10 times after a workout is over.

Groin stretch
Sit on the floor with your head up and your back straight. Then, flex your knees and bring the soles of your feet together. Place your hands on your knees, and press your knees gently toward the floor as far as flexibility and pain permit. Hold this position for about 10 seconds, and then return to start position, resting briefly. Also perform this sequence 10 times after workouts.

Adductor Strengthening Exercises

Inward leg presses
Simply sit on the floor, and place a volleyball, soccer ball, basketball, medicine ball, or even a large, tightly rolled towel between your knees. Squeeze your knees together as forcefully as possible. Hold this position for 15 seconds, return to the start position, and rest for a few seconds before repeating. Complete this exercise 8-10 times.

Indian-hop
To Indian-hop, jog for a few strides and then jog diagonally to the right with your right foot. When your right foot makes contact with the ground, hop in place. When your right foot comes down to the ground, explosively hop diagonally to the left, landing on your left foot. When your left foot strikes the ground, hop once in place and then explode diagonally to the right. Repeat. Stay relaxed at all times as you carry out this drill. Try to move in a coordinated and rhythmic manner. Stop the exercise if groin discomfort arises. Carry out this exercise several times a week, but only after a thorough warm-up.

Shane Doll is a certified Charleston Personal Trainer, fitness expert, speaker, author, and founder of Shaping Concepts Personal Training Studios. Learn more how you can receive a FREE no-obligations trial of his Charleston personal training programs and experience the Shaping Concepts difference for yourself.

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Category: Corrective Exercise.