A groin strain, often described as a “pulled groin,” occurs when one of the adductor muscles in the inner thigh is overstretched or torn. This injury commonly affects the adductor longus muscle and typically happens during activities that involve sudden acceleration, kicking, or rapid changes in direction, such as in soccer or hockey. Managing this injury, from immediate pain relief to long-term recovery, significantly influences the healing process and helps prevent future recurrence.
Initial Steps for Acute Pain Relief
Immediately following the injury, the primary focus is managing pain, swelling, and preventing further damage within the first 48 to 72 hours. This acute phase requires relative rest, meaning you must stop any activity that causes pain, though complete immobilization is not needed. If walking is painful, you might need to use crutches briefly to avoid putting weight on the injured leg.
Applying a cold compress or ice pack to the affected area helps reduce inflammation and internal bleeding. The ice should be wrapped in a thin towel and applied for 10 to 15 minutes at a time, repeated every one to two hours during the initial day. Compression using an elastic bandage or compression shorts can further limit swelling. Ensure the wrap is snug but not so tight that it causes numbness or increased pain.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can be taken to help manage short-term pain and swelling. These medications are helpful for comfort during the acute phase, but they should only be used as directed and generally not for more than 10 consecutive days without professional advice. Avoid using heat on the injury during this initial period, as it can increase blood flow and potentially worsen swelling.
Safe Return to Movement and Strengthening
Once the sharp pain of the acute phase has subsided, usually after two to three days, the next phase involves a gradual, pain-free return to movement and strengthening. The initial focus should be on gentle, static stretching, performing movements only within a comfortable range.
Initial Static Exercises
Start with simple exercises to restore muscle length and strength.
- Supine hip adductor stretch: Lie on your back with your knees bent and allow them to gently fall open, holding the position for 15 to 30 seconds.
- Adductor squeeze: Lie on your back and gently press a small ball or rolled towel between your knees to activate the adductor muscles without movement.
This isometric contraction should be held briefly and repeated in sets, always ensuring the effort is submaximal and pain-free.
Dynamic and Functional Movements
As comfort improves, typically in the first week, introduce low-load dynamic exercises to build endurance and strength. Straight leg raises and side-lying hip adduction lifts are excellent starting points, where the injured leg is slowly lifted and lowered against gravity. Progressing further involves incorporating functional movements like mini-squats and lateral lunges, which prepare the muscle for greater load and movement across different planes.
Advanced Strengthening
Later-stage rehabilitation includes more demanding strengthening. This involves resistance band hip adduction, where you move the leg inwards against the band’s tension. Advanced exercises like the Copenhagen Adduction Exercise, a side plank variation, provide a high-level challenge to the adductor group and are beneficial for preventing recurrence. A return to running or sport-specific activity should only occur once these strengthening exercises are completed without any pain.
When Professional Medical Consultation is Necessary
While many mild groin strains can be managed at home, professional medical evaluation is necessary for certain symptoms. Seek immediate care if you experience sudden, severe pain that prevents you from walking or bearing any weight on the leg, as this suggests a more significant muscle tear or other injury.
A physician or physical therapist should be consulted if the pain does not improve after three to five days of self-management, or if it persists for longer than two to three weeks. Other warning signs include new or increased swelling, a lump in the groin area, or any numbness or tingling in the leg.