I have been in the rehab field for the better half of a decade.
During that time, I have treated high level athletes with groin pain. I have also published research articles on groin pain in hockey players. In fact, I have invested so many hours into mastering my craft that I have been fortunate to speak publicly about groin pain in hockey players.
But do you want to know a secret?
When it comes to acute groin strains, I actually use the same 5-step progression I’ve adapted from Andreas Serner every time. You can apply this framework to different sports.
Step #1: Early ROM & loading
Consists of:
- Gentle range of motion exercises
- Sub-maximal loading (ie. Isometrics)
- Running movements (ie. A march)
Progress when:
- Minimal discomfort on adductor palpation
- >90% passive abduction
- >90% bent knee fall out (BKFO)
- Minimal discomfort with short lever adductor squeeze (2-3/10)
- Minimal discomfort with isotonic band exercises (2-3/10)
Step #2: Clinically pain-free
Consists of:
- Inner & outer range isometrics
- Strengthening through full range (ie. bands, pilates rings, slider lateral lunges)
- Controlled running/sprinting/skating movements
Progress when:
- Painfree adductor palpation
- Full abduction and BKFO
- Pain free maximal isometric in outer range
Quick note: Don’t stop here. That’s a mistake. Continue the following steps. They work better for return to sport and reducing risk of re-injury.
Step #3: Return to performance training/controlled sports training
Consists of:
- Exercise progressions of Step #2
- Return to modified team performance training
- Return to controlled sport skills
Progress when:
- Inner range LSI >90%
- Pain free run
- Pain free change of direction
Easy, right?
Step #4: Return to Sport
Here’s how it works:
- Return to full team performance training
- Return to controlled practice
- Build tissue capacity controlled setting
Progress when:
- Outer range LSI >90%
- Pain free sprint @ 100% intensity
- Pain free change of direction @ 100% intensity
So close, I hear the fans cheering.
Step #5: Return to Sport Performance
Here’s how it works:
- Return to uncontrolled practice
- Build tissue capacity in uncontrolled setting
- Return to games
That’s it!