5 Groin Strain Rehabilitation Exercises

What is groin strain?

A groin strain usually involves a tear or injury to the muscles of the inner thigh. You may feel pain, decreased strength within the legs, weakness, tightness, stiffness, cramps, swelling, bruising, limping or difficulty with walking or running. Pain may be apparent on certain actions such as raising the knee and closing and opening the legs. 

Causes of groin strain

Sudden movements such as falling, kicking, twisting, jumping, a change of direction whilst running, or high intensity exercise can trigger a strain. Athletes are more likely to experience groin strain. A soft tissue occupational therapist will be able to assess and diagnose groin strain correctly.

Muscles of the groin

These muscles are the adductor muscles, which are located in the inner thigh. The muscles are:

  • Adductor Brevis 
  • Adductor Longus 
  • Adductor Magnus 

Other muscles that may be affected, but commonly less so:

  • Gracilis 
  • Pectineus

The main function of the three adductor muscles are to adduct your leg. This is the movement of bringing your legs close together. These three muscles also assist you with balancing on both feet or on moving surfaces, such as escalators. Please see the graphs below explaining the movements of each muscle:

Adductor BrevisAdduction, hip flexion
Adductor LongusAdduction, lateral rotation
Adductor MagnusAdduction, hip flexion and hip extension
GracilisAdduction, hip flexion and medial rotation
PectineusAdduction, hip flexion and external rotation
MovementMovements explained
AdductionThis is the movement of bringing your widespread legs close together.
Hip flexionThis is the movement of lifting or raising your leg in front of you. When you make a kicking motion, that is the movement of hip flexion.
Hip extensionThis is the movement of lifting or raising your leg behind you.
Medial rotationThis is the movement of rotating your leg to point your knee inwards.
External rotationThis is the movement of rotating your leg to point your knee outwards. When your cross your legs by placing your ankle above your knee in a loose 4, your leg is externally rotated at the hip.

Here is a list of the muscle attachments on your body:

Adductor BrevisAnterior surface of the inferior ramusLesser trochanter and the linea aspera of the femur 
Adductor LongusPubic body below the pubic crestLinea aspera
Adductor MagnusPubis, ischium tuberosityLinea aspera and the adductor tubercle of the femur
GracilisIschiopubic ramus Tibia
PectineusSuperior pubic ramus Pectineal line of the femur

Muscle trigger point referrals

A trigger point is tightened area within your muscle fibers and may be very sensitive or painful to the touch. Trigger points may be more commonly referred to as muscle ‘knots’. These trigger points can cause pain referrals outside of the affected muscle, as shown in the diagrams below. A soft tissue occupational therapist will resolve this pain through the use of trigger point therapy. 

The above images shows the pain referrals for the adductor magnus muscle. Pain can radiate along the entirety of the inner thigh and is caused by the trigger points marked ‘X’. 

The above image shows the pain referrals for adductor longus and adductor brevis. The pain will refer from the front of your hips, alongside the entirety on your inner leg, and may also cause pain just above the knee. 

Pain relief for groin strain

  • Heat therapy

Apply a heat pack to the inside of your thighs. You can also take a hot shower or a warm bath. The heat allows your tense muscles to relax and increases blood circulation in the area to allow for muscle repair. Your muscles should feel more flexible and have more range in movement. Heat therapy should be limited to 15-20 minutes at a time, as to not aggravate your skin too much and accidentally cause superficial burns. 

  • Why you shouldn’t use ice therapy

Avoid using ice as it reduces the healing response of the body and causes your muscles to tighten, potentially making trigger points and making pain symptoms worse. Ice therapy is usually recommended to help alleviate swelling and pain within the muscles. However, recent evidence states that ice delays the healing response. Inflammation is a necessary component within the muscle healing response, as it encourages the activity of your immune system to repair damaged tissues. In other words, inflammation is a good thing! By placing ice on an inflamed body part, you reduce this positive immune response, reduce the blood flow to the area and cause further tightening of the damaged muscle your body is trying to heal. Ice is only helpful to alleviate pain – this can be managed by anti-inflammatory medication instead. In the long term, ice is detrimental to healing. 

  • Elevation

If you are experiencing swelling, it is important to elevate your legs. You can do this by placing your legs on pillows when you are lying in bed or on your couch at home. You want to elevate your legs to be above the level of your heart. By propping up your legs, gravity helps assist your body by helping remove the fluid from the area, moving it towards the heart and reduce swelling within the affected area. 

  • Rest

If you have recently sustained groin strain, you will need to stop whatever activity or exercise caused the injury in the first place. Taking a break is needed to prevent further injury to the body and allows for better healing. Having that initial time to stop and rest will prevent your recovery from being prolonged. Too much rest is detrimental, so after a few days of sustaining the injury or after your swelling has reduced, you may begin to gently mobilise and start moving again. However, this is best under the advice of a medical professional. Please see below for a list of rehabilitative exercises for groin strain. 

Groin Strain Rehabilitation Exercises 

These exercises are fantastic to return your muscles back to their normal strength. However, it may be wise to continue with these exercises in the future as to prevent further groin strain injury.

Typically, it is safe to begin groin strain rehabilitation exercises a few days after your injury, but discuss with your exercise physiologist regarding when you should begin these exercises. 

Begin with these two stretches:

Adductor stretch

  • Begin by sitting on the floor. 
  • Bend your legs so that you can place the soles of your feet together. Your legs should resemble a diamond shape. 
  • Gently press down on your knees. You should feel a stretch on the inside of your thighs.
  • Hold for a minimum of 30 seconds and stop if you feel any pain. 

Hamstring stretch

  • Begin by sitting on the floor, with your legs straight ahead of you.
  • Lean forward to try and touch your toes. 
  • You should feel a stretch at the bottom of your thighs. If you can’t touch your toes, that is okay! Just lean forward as far as you are able/when you feel a gentle stretch. 
  • Hold this position for a minimum of 30 seconds and stop if you feel any pain.

5 Groin Strain Rehabilitation Exercises 

Here are some groin strain rehabilitation exercises to strengthen your muscles. Stop if you feel any pain.

Straight leg raise

  • Begin by lying on the floor, face up, with your unaffected leg bent.
  • Raise your affected leg by a few inches, keeping your leg straight and your hips flat on the ground.
  • Place it back on the floor.
  • Repeat this exercise 15 times, twice a day. 

Knee squeeze

  • Begin by sitting in a chair, with a soft stress ball or rolled towel between your thighs.
  • Gently squeeze your thighs together.
  • Repeat this 10 times, twice a day. Aim to for 20 repetitions three times a day.

Hip adduction

  • Begin by standing on the spot. You may want to have a table nearby to hold onto for balance.
  • Lift your affected leg sideways, keeping it straight.
  • Hold this position for 3 seconds.
  • Return your affected leg back to standing. 
  • Repeat this exercise 10 times a day and work your way up to 15 times three times a day.

Hip adduction against gravity

  • Begin by lying on your floor, on the side of your affected leg. There should be a chair placed at your feet, with your unaffected foot resting on the seat. This starting position should make your legs look similar to a ‘V’.
  • Raise your affected leg to reach your unaffected leg on the chair.
  • Lower your affected leg. 
  • Repeat this exercise 10 times a day and work your way up to 15 times three times a day.

Side body lift

  • Begin by lying on the floor.
  • Prop your upper body up on your elbow, which should be in line below your shoulder. 
  • Lift your hips off the floor, keep your legs straight. You should be balancing on your elbow and foot.
  • Hold for 3 seconds.
  • Lower yourself back down.
  • Repeat this exercise 10 times a day and work your way up to 15 times three times a day.

See an exercise physiologist

Exercise physiologists use exercise as therapy, in other words, prescribe exercise as ‘medicine’. They will assist with preventing injury, managing injury, and improving physical functioning. Their therapy is ‘hands-off’ as they provide you with appropriate exercises and stretches individualised to your needs.

Soft tissue occupational therapy treatment

Soft tissue occupational therapy treatment focuses on treating musculoskeletal disorders of the body through diagnosis, treatment, and rehabilitation. The overall aim of therapy is to heal and restore function to injured and weakened body parts, as well as to aid and promote wellbeing. A soft tissue occupational therapist will be able to provide groin strain pain relief through hands-on massage treatments such as trigger point therapy, dry needling and myofascial release.

If you would like treatment, book in to see our friendly and experienced soft tissue occupational therapist or exercise physiologist at Urban Health HQ. You can make an appointment today or contact us by calling 0411 563 391 or email kristen@urbanhealthhq.com.au 

Published by Urban Health HQ

We are a health and fitness centre offering Occupational Therapy, Exercise Physiology, Personal Training and Group Fitness classes.

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