What a groin strain is
A groin strain is usually a strain of one of the adductor muscles on the inside of the thigh. It typically happens when sprinting, kicking or changing direction, and it shows up as a sharp pull or an ache high on the inner thigh. It hurts when you squeeze your knees together, lift your knee or push off sideways.
How long it takes depends on how bad it is. Mild strains often settle in a couple of weeks. Bigger tears can take a couple of months. The harder problem is not the first few weeks. It is that groin strains so often go again the first time sport gets hard.
Why it goes again
Most groin strains get managed until they stop hurting, then sport restarts. But pain-free is a long way from ready. The adductors have to take sprinting, kicking and sudden direction changes, and a muscle that has only been rested has not been rebuilt for that. So it goes in the first hard session back.
The fix is not more time off. It is rebuilding the strength to take the load, in steps, before returning to full sport.
Strain, or something else?
The inner thigh is not the only place groin pain comes from. The hip joint, the lower back (see sciatica if it runs down the leg), the pubic bone area and a hernia can all cause pain in the same spot. Clues pointing away from a simple strain:
- A deep pinch at the front of the hip, especially in a deep squat (see hip impingement and labral problems)
- Pain at the front of the hip when lifting the knee, more than on the inner thigh (see hip flexor pain)
- A bulge in the groin, or pain that is worse with coughing
A bulge in the groin, testicular pain or swelling, or groin pain with a fever or feeling unwell should be seen by a doctor promptly.
What rehab involves
First few days. If it is sharp, avoid sprinting, kicking and stretching into the pain. Walk if it is comfortable. Ice or compression is fine if it helps you feel better, but neither rebuilds the muscle.
Early loading. Gentle holds first, such as squeezing a ball or pillow between your knees at a comfortable effort. Resting completely for weeks tends to leave the muscle weaker.
Strengthening. Build the adductors through side-lying and Copenhagen-style exercises, lateral lunges and loaded hinges, adding load as pain allows. The hips, glutes and trunk matter too, because they share the work.
Running, then direction changes, then sport. Straight-line running first, then speed, then changes of direction, then kicking or the skills of your sport. Each step should be comfortable the next day before moving on.
When is it safe to go back?
I want to see the squeeze test pain-free, strength close to the other side, and sprinting, cutting and kicking comfortable in training at close to full intensity before a game. A date on the calendar is not a criterion. The reasons that standard clearances fail are covered in cleared to play, too early?.
How long will mine take?
It depends on the grade of strain, how long you have had it and what your sport demands, so it can’t be known without an assessment. As a rough guide, mild strains are often back in training within a few weeks, and more serious ones take a couple of months or longer. A recurring groin strain usually means the rebuild was cut short.
When to get it checked
Get it assessed if you can’t put weight through the leg, there is bruising or swelling, it has not improved after a week or two, or it has happened before. If you are in Adelaide, I treat groin and hip pain at my clinic in Hampstead Gardens. For the full picture, see hip and groin physio.