Groin Strain (Adductor Strain)
A groin strain involves injury to the adductor muscles of the inner thigh, which pull the legs together and stabilise the pelvis. It is common in sports involving kicking, sprinting, and rapid changes of direction such as football, soccer, and AFL. Adductor injuries respond well to progressive strengthening but can become persistent if not rehabilitated thoroughly.
Understanding the Injury
The adductors work hard during kicking, twisting, and cutting movements. Strains range from minor overstretching to partial or complete tears.
Grading
- Grade 1: Mild strain with minor fibre damage
- Grade 2: Partial tear with pain and weakness
- Grade 3: Severe or complete tear
Signs and Symptoms
- Pain in the inner thigh or groin
- Sharp pain during kicking or sprinting
- Tenderness along the adductor muscles
- Weakness when squeezing the legs together
- Pain with change of direction or acceleration
Causes and Risk Factors
- Kicking and sprinting sports
- Sudden change of direction
- Reduced adductor strength
- Previous groin injury
- Inadequate warm-up or fatigue
- Training load spikes
Assessment
- History and mechanism: How the injury occurred
- Palpation: Locating the injured muscle
- Strength testing: Adductor squeeze testing and grading
- Functional assessment: Movement and sport-specific testing
- Screening: Ruling out related hip and groin conditions
Physiotherapy Treatment
Early Phase
- Protecting the muscle and managing pain
- Pain-free movement and gentle loading
Strengthening Phase
- Progressive adductor strengthening (e.g. Copenhagen exercises)
- Hip, core, and pelvic stability work
- Building strength through full range
Return to Sport
- Running, kicking, and agility progression
- Sport-specific drills
- Objective strength and function testing before return
Preventing Recurrence
Adductor strength programs are highly effective at both rehabilitating and preventing groin injuries. Ongoing strength maintenance is recommended for athletes in high-risk sports.
Expected Outcomes
With progressive rehabilitation, most athletes return to full sport with restored strength and a reduced risk of recurrence.
