Groin strain
A groin strain involves an overload or minor injury to the muscles on the inside of the thigh, commonly the adductor muscles. It often occurs during rapid changes of direction, acceleration or kicking.
Mild pain or tenderness in the groin, mainly during sprinting, changes of direction, kicking or resisted leg adduction. Normal walking is usually possible.
A groin strain often occurs when the adductor muscles are loaded rapidly or forcefully, particularly when the leg moves outward while the muscles have to control the movement.
Common football situations
- •Rapid changes of direction
- •Acceleration and sprinting
- •Powerful passes and shots
- •Overstretching the leg sideways
- •A sudden increase in training volume or intensity
- •Insufficient recovery after previous groin problems
Risk can be reduced through gradual loading and regular strengthening of the adductors, hip and trunk. It is particularly important to prepare the body for sprinting, changes of direction and football-specific movements.
- •Regular adductor strengthening, such as the Copenhagen adduction exercise
- •Strength training for the hip and trunk
- •Gradual progression of sprinting and change-of-direction load
- •Adequate warm-up before high-intensity activity
- •Return to full loading only after previous groin problems have been properly rehabilitated
Stop the activity that provokes pain and reduce the load. Cold, compression and elevation may be used for symptom relief during the early phase. Avoid aggressive stretching of the painful area.
Pain control and load modification
Reduce provoking activities while maintaining pain-free movement and light muscle activation.
Goals
Reduce pain and restore normal movement without a significant increase in symptoms.
Progression criteria
Walking and daily activities are tolerated without significant pain and light adductor loading is tolerated.
Strength and control
Progressive strengthening of the adductors, hip and trunk with gradually increasing load.
Goals
Restore strength and control for movements required in football.
Progression criteria
Strength exercises and more dynamic movements can be performed without significant pain or worsening the following day.
Running and football-specific loading
Progress from running to acceleration, changes of direction, passing and shooting.
Goals
Tolerate progressively higher speed and football-specific loading.
Progression criteria
Full-speed running, changes of direction and football-specific activities can be completed without pain or a significant reaction afterward.
- Pain-free or nearly pain-free during daily activities
- Adequate strength and control of the adductors and hip
- Sprinting and changes of direction can be performed at full intensity
- Passing and shooting can be performed without pain
- No significant worsening after a full football training session
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Groin strain
A groin strain involves an overload or minor injury to the muscles on the inside of the thigh, commonly the adductor muscles. It often occurs during rapid changes of direction, acceleration or kicking.
Mild — Ofta några veckor vid en lätt sträckning, men tiden varierar beroende på skadans omfattning och rehabiliteringens progression.
Symptoms
Mild pain or tenderness in the groin, mainly during sprinting, changes of direction, kicking or resisted leg adduction. Normal walking is usually possible.
Acute Treatment
Stop the activity that provokes pain and reduce the load. Cold, compression and elevation may be used for symptom relief during the early phase. Avoid aggressive stretching of the painful area.
Rehabilitation
Reduce provoking activities while maintaining pain-free movement and light muscle activation.
Goals
Reduce pain and restore normal movement without a significant increase in symptoms.
Progression criteria
Walking and daily activities are tolerated without significant pain and light adductor loading is tolerated.
Progressive strengthening of the adductors, hip and trunk with gradually increasing load.
Goals
Restore strength and control for movements required in football.
Progression criteria
Strength exercises and more dynamic movements can be performed without significant pain or worsening the following day.
Progress from running to acceleration, changes of direction, passing and shooting.
Goals
Tolerate progressively higher speed and football-specific loading.
Progression criteria
Full-speed running, changes of direction and football-specific activities can be completed without pain or a significant reaction afterward.
Return to Play
- ☐ Pain-free or nearly pain-free during daily activities
- ☐ Adequate strength and control of the adductors and hip
- ☐ Sprinting and changes of direction can be performed at full intensity
- ☐ Passing and shooting can be performed without pain
- ☐ No significant worsening after a full football training session
Moderate — Ofta flera veckor och ibland längre. Återhämtningstiden beror på skadans omfattning och hur snabbt full belastning kan återintroduceras.
Symptoms
More pronounced groin pain, often with pain during running, acceleration, changes of direction or powerful kicking. Strength and function are reduced.
Acute Treatment
Stop sporting activity and reduce load on the painful area. Cold and compression may be used for symptom relief if needed. Medical assessment should be considered when there is clear functional impairment or persistent symptoms.
Rehabilitation
Reduce sprinting, changes of direction and other movements that clearly provoke pain.
Goals
Reduce pain and restore tolerance for daily movements.
Progression criteria
Daily walking and basic strengthening exercises are tolerated without significant symptom aggravation.
Progress adductor, hip and trunk training from low to high loads.
Goals
Restore strength, endurance and control.
Progression criteria
Higher loads and more explosive exercises are tolerated without significant pain or post-exercise reaction.
Gradual return to running, acceleration, changes of direction and ball-related activities.
Goals
Restore full capacity for the demands of football.
Progression criteria
Full-intensity football activities and training are tolerated without pain or significant worsening afterward.
Return to Play
- ☐ Adequate strength compared with the uninjured side
- ☐ Pain-free sprinting and acceleration
- ☐ Pain-free changes of direction
- ☐ Passing and shooting at full intensity
- ☐ Full football training without significant reaction afterward
Severe — Ofta flera veckor till månader beroende på skadans omfattning. Större muskelskador kan kräva längre rehabilitering.
Symptoms
Severe pain, clear functional loss and difficulty walking or bearing weight. A more significant muscle injury may cause marked tenderness, swelling or bruising.
Acute Treatment
Stop the activity and reduce load on the leg. Avoid stretching, massage and repeated testing of the muscle during the acute phase. Severe pain, major functional loss or suspected significant tearing should be assessed by a healthcare professional.
Rehabilitation
Protect the injured area and control loading until pain and function improve.
Goals
Reduce pain and restore basic movement capacity.
Progression criteria
Normal walking and light muscle activation can be performed without significant worsening.
Progressive strengthening of the adductors, hip and trunk is adapted to the extent of the injury.
Goals
Restore full strength and load tolerance.
Progression criteria
High loads and explosive movements are tolerated without pain or post-exercise reaction.
Gradual return to sprinting, changes of direction, shooting and full training.
Goals
Restore full capacity without symptoms.
Progression criteria
Full football training can be completed without pain or significant reaction afterward.
Return to Play
- ☐ Medical assessment when a significant muscle injury is suspected
- ☐ Adequate strength and movement control
- ☐ Pain-free sprinting, acceleration and changes of direction
- ☐ Pain-free passing and shooting at full intensity
- ☐ Full training is tolerated without a significant reaction afterward
When to Seek Medical Care
Seek medical care if pain is severe, there is significant functional loss, or symptoms do not improve despite modified loading.
- Difficulty walking or bearing weight
- Extensive bruising or significant swelling
- Suspected significant muscle tear
- Persistent or recurrent groin symptoms
- Pain that does not improve with rehabilitation
References
- Adductor injuries and groin problems in athletes — Aspetar (https://www.aspetar.com/en)