Overview Video
Introduction
Figure 1
Groin strains are synonymous with injury to the Adductor muscles which are located around the inner thigh, for this reason Physiotherapists will often refer to this injury as Adductor-related groin pain. However, as figure 1 demonstrates this is a region where numerous other parts of our anatomy (not just muscles) have the potential to generate pain.
Diagnosis
Seeking advice from a musculoskeletal specialist is recommended. At Pure Physiotherapy, our clinicians complete a thorough assessment which facilitates in making an accurate working diagnosis and the subsequent development of an individualised, condition specific rehabilitation protocol.
Following assessment, if an Adductor muscle has been found to be the source of pain your clinician will inform you of the suspected grade of your injury. Grading refers to the level of injury to the muscle, this grading system further enhances the clinician’s ability in developing appropriate treatment strategies.
Potential Contributing Factors
There are a number of ways in which Adductor-related groin pain can occur. Injury can occur after a forceful contraction of the Adductor muscle group, alternatively injury might be caused by repetitive smaller injury (often referred to as microtrauma), less typically injury might result from a direct blunt trauma.
Forceful contraction and microtrauma are both examples of what would be referred to in the literature as a ‘load tolerance’ issue. Load tolerance simply refers to a muscles ability to cope with a specific demand, if the demand exceeds the muscles capability then injury may be the outcome.
Treatment & Management
Adductor-related groin pain requires active rehabilitation to improve load tolerance, strength and address any potential impairments.
Rehabilitation should be based on a person’s ability to perform certain criteria rather than time-based progression. If someone is wanting to return to running for example it is recommended, they start with slow straight line running and progress time and speed. Then the introduction of slow side steps, forward-backward and zig-zag runs prior to increased acceleration/deceleration might be implemented.
If this criteria is met, the individual may then be deemed suitable to return to full intensity running. This example very briefly highlights what might be used with a runner, it is not comprehensive as a runner’s rehabilitation will look very different to a non-runner, nor does it reflect the variety of other treatment methods a clinician would use.
Regardless of your goal, our clinicians are well placed to provide an individualised condition specific assessment and treatment.
To finish with the good news is that once you have recovered from your initial Adductor-related injury, randomised controlled studies have demonstrated that simple exercise completed once a week significantly reduce the on-going incidence of this injury (Harøy et al., 2019; Hölmich et al., 1999).
References
Harøy, J., Clarsen, B., Wiger, E. G., Øyen, M. G., Serner, A., Thorborg, K., … & Bahr, R. (2019). The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. British journal of sports medicine, 53(3), 150-157.
Hölmich, P., Uhrskou, P., Ulnits, L., Kanstrup, I. L., Nielsen, M. B., Bjerg, A. M., & Krogsgaard, K. (1999). Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. The Lancet, 353(9151), 439-443.
