I have to laugh when friends ask me, “what’s the big deal about a simple groin strain?!”  My reply is always the same and their answer is always “No“.

I simple ask them, “You’ve never strained your groin before have you?”

If they had ever experienced either a groin strain or had an M80 explode in their front pocket, they’d have no need to ask such a question.

A groin strain is a painful injury and a troubling problem for skilled athletes who’s sport or position requires them to change directions quickly.  If you’re looking to ink that huge fantasy football trade this week with your friend in the marketing department, you might want to avoid the star running back or the speedy wide receiver with the bad hip adductor strain.

The Five Muscles of the Groin

Most people assume “the groin” consists of one (1) muscle when it is actually formed by the following five (5) muscles:

  • Adductor Brevis
  • Adductor Longus
  • Adductor Magnus
  • Gracilis
  • Pectineus

Understanding the Groin

The main role of the groin, commonly referred to as the hip adductors, is to both pull the leg inward.  This inward motion is also referred to as adduct the lower extremity.  Based on the position of these muscles, they also control the speed and direction the leg is allowed to move outward.  In other wards, when any combination of the groin muscles contract and shorten, the leg is pulled inward towards the midline of the body.  When any combination of the groin muscles are contracted and lengthen, the leg is allowed to move away from the midline in a controlled manner.

To complicate it even more, the varying angles and attachments of these five (5) muscles also directly or indirectly controls rotation of the entire lower extremity.

If you’re saying to yourself, “these muscles sure do just about everything”, you’re correct!  Vision a defensive back or a running back on any given play changing direction and aggressively rotating over their leg.   Now you can get a better understanding of the important role these muscles have and how debilitating an injury it is for such an athlete to have a weak and painful groin strain.

Does this give you more insight as to why my answer to the question; “what’s the big deal about just a groin strain?” is so easy?

Not All Groins are Created Equal

As a runner, triathletes and adventure racer, most of my training and racing is done in a straight line.  I learned this fact the hard way.  In 1996, I ran in the Empire State Building Run-up in NYC, the New Zealand Ironman Triathlon in Auckland, NZ and the Boston Marathon in my home-state of Massachusetts….all withn 6 1/2 weeks.  During the historic 1ooth running the Boston marathon I was position in the very back with my Dana Faber Cancer Marathon teammates.  Because of the large number of runners and my position in the back of the pack, I started weaving and zig-zagging through the 42,000 or so runners.  Based on my finishing time of 3:13, I had weaved around approximately 20,000 runners.

By the time I reached the base of the famous Heartbreak Hill at mile 18, both of my groins were in spasm and extremely painful.  I had not trained to move side-to-side nor weave like I was doing and my groins made that point loud and clear.  Although I had already completed two other extremely intense races in the previous 45 days, my groins were by far the most painful part of my body after the race.

Hockey players and soccer players tend to have the strongest hip adductors based on the demands of their sports.  They rely on their groin muscles so they address them with their strength work, their flexibility and their preventative rehabilitation.  If I suffer a strained groin in a marathon, I’m slowing down.  If they suffer a pulled groin in a hockey game, they’re game is over and they start rehab 5 minutes later.

The Lingo

A muscle “pull” or “tweak”, the non-medical terms, is the same as a “strain”, the proper medical terminology.   So the next time you hear someone say, “it’s not a pull, it’s just a tweak” know that’s someone just trying to make their coach feel better.

The Solution

Depending upon how badly it’s injured, the length of time for return to play will vary.  After suffering a hip adductor strain, the two key steps to take immediately are:

  • Ice your groin for 10-15 minutes no less than 5 times per day.
  • Do not stretch the groin muscles for at least 3 days.

I list these two sports medicine rehab tips on their own for one simple reason: If you implement them immediately after you suffer a pulled groin, you can literally cut your rehab time in half!  Think about that for a minute.  In other words, if you accidentally do the opposite and put heat on the injury and start aggressively stretching a tweaked groin, the bleeding will worsen and the downtime will be lengthened.  No one wants that to happen.

Bike riding, pool running, elliptical trainer, single/double leg balance drills, flexibility work around the injured muscles, massage and aggressive core stability should be included in every rehab plan that involves a lower extremity soft tissue injury.

As for returning to their sport, the athlete should initially start with straight ahead running and then progress with more side-to-side movements.  Progressing with speed, intensity and the number of reps can all be used to both evaluate and rehab an injured groin.

The next time you read about athlete with the “bad groin”, now I hope you show him some love!