Groin Strain Treatment

By Joni Levine

Groin strains are one of the more common muscle injuries in the lower limb typically found in sports involving multidirectional movements (e.g. football, rugby, netball). They have been reported to be as high as 10% of all injuries in various sporting codes, with men being more than twice as likely to sustain a groin strain versus women (Orchard, 2015). Thankfully, groin strains can be easily managed with various physiotherapy interventions.

Physiotherapy treatment for groin strains can be divided into the following categories: strength exercises, stretching, massage, advice and education, electrotherapy and taping. All of these treatments can help with groin strain recovery and are often used in combination to maximise the effectiveness of the rehabilitation. Our physiotherapists at Graceville Physio Pain Slayers will be able to identify which of these treatments are best for you.

Strength exercises:

There are several ways to strengthen the groin muscles, with the choice of exercises dependent on the equipment available and the rehabilitation stage. Initially, exercises such as placing a ball between your legs and gently squeezing your legs are a good place to start. Moving into the later stages of rehabilitation, exercise progressions, including the below, are great ways to progress groin strength to ensure full healing and to minimise the risk of re-injury:

• Adductor strengthening machines at a gym,
• Starting in a “splits” position, bring one foot back in towards the other on a slippery surface
• “Copenhagen adductor exercises”

Your physiotherapist will guide you through a strengthening program for your groin muscles and address other surrounding muscle groups that can be affected due to a groin injury or could be weak and may have contributed to the injury (e.g. core muscles, gluteal muscles).

Stretching:

The groin is not just one muscle – five muscles create the collective groin muscle group. This means several stretches can be done that target various muscles and will, therefore, feel different for each person. Such examples include:

• Standing side lunge
• Butterfly stretch
• Frog stretch

Consensus is varied for stretching parameters, but 20 to 30-second holds up to three times a day is generally acceptable. When performing these stretches, they should feel comfortable and only mildly uncomfortable. Your physiotherapist will be able to show you which stretches are most appropriate for you.

Massage:

Massage is an effective way to help reduce pain and tension due to groin injuries. As well as massaging the groin muscle, other muscles in the area, such as the hamstrings and quadriceps, can also be massaged to help secondary regions of tension forming. Your physiotherapist will know which muscles need to be massaged and will ensure the right amount of pressure is applied.

Advice and education:

Advice and education is an important part of any physiotherapy treatment plan. With groin injuries, your physiotherapist will cover the following aspects, ensure you understand everything discussed, and this will help speed up your recovery:

• The anatomy of your injury
• How long it may take to get better
• Some simple things you can do at home, e.g. apply an ice pack
• Things to avoid whilst you are recovering

Electrotherapy:

Some patients may respond well to electrotherapy, consisting of therapeutic ultrasound and interferential treatment. Therapeutic ultrasound uses sound waves to help stimulate healing in the muscle. Interferential treatment does a similar process but uses electrical impulses applied via electrodes. Both treatments are generally well tolerated; your sports physiotherapist can apply these as required.

Taping:

Some patients may respond well to taping of the groin muscles. The tape that patients will generally require is Kinesio tape, which is a flexible tape that supports the muscle as it is moving. It can remain on for a few days to help reduce strain on the muscle. Your physiotherapist can apply this tape and advise you when you no longer require taping, as most patients should get to a point in their rehabilitation where they no longer need it.

The information above is a general guide and should not replace individual physiotherapy assessment and treatment. Please get in touch with us if you have groin pain and are looking for an effective management plan to help reduce your pain and return to activity.

References:

Almeida, M.O. et al (2013). Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain. Cochrane Database of Systematic Reviews, (6):CD009565.

Harøy et al. (2018) The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. British Journal of Sports Medicine, 53, pp.145-52.

Orchard, J.W. (2015). Men at higher risk of groin injuries in elite team sports: a systematic review. British Journal of Sports Medicine, 49(12), pp.798-802.