Groin strain: causes, rehab and prevention

What a groin strain is

The adductors are a group of muscles on the inside of the thigh that pull the leg in towards the body and help stabilise the pelvis when you run, cut and kick. A groin strain is damage to some fibres of these muscles or their tendons, most often adductor longus near where it attaches to the pubic bone.

Strains range from mild, where you can usually keep walking comfortably, to severe, with a large tear, significant bruising and difficulty walking. Most sporting groin strains are mild to moderate.

How it happens and who gets it

Groin strains are very common in football, rugby, hockey, ice skating and martial arts, where sharp changes of direction, kicking and sliding put a lot of load on the adductors. In the gym they can happen with lateral lunges, wide-stance squats, sled work, jumps or sprinting, especially when you are fatigued or have not warmed up well.

In HYROX-style training, the adductors also work hard in sandbag lunges and sled pushes, particularly when legs are tired and technique starts to fade. A wide, sprawling stance under fatigue is a common trigger for a sore groin the next day.

• A previous groin injury, which is one of the strongest risk factors
• Weaker adductors compared with the muscles on the outside of the hip
• A sudden increase in sprinting, kicking or change-of-direction work
• Coming back to sport after a break without building up gradually

Not all groin pain is a strain. Pain can also come from the hip joint, from the area where the abdominal muscles attach near the groin (sometimes called inguinal-related groin pain), from the pubic bone, or from a hernia. That is why pain that does not behave like a straightforward strain should be assessed.

Typical symptoms

• Sudden pain in the inner thigh or groin during a sprint, kick or change of direction
• Pain squeezing your knees together
• Pain with side-stepping, kicking or getting out of a car
• Tenderness on the inner thigh near the pubic bone
• Bruising on the inner thigh in more significant strains

Longstanding groin pain that has built up gradually over weeks or months, especially in footballers, is a different picture and often involves several structures. It usually needs a longer, more structured plan than an acute strain.

What a physio assessment looks at

Your physio will test adductor strength, often using a squeeze test between the knees, feel for the tender area, and check hip movement, the abdominal wall and the lower back. They will ask about coughing or straining causing pain and check for a lump that could suggest a hernia. They will also look at your running and change-of-direction mechanics if you are returning to sport.

A scan is rarely needed for a typical strain. It may be considered for severe injuries, suspected tendon avulsion from the bone, or pain that is not settling as expected.

What usually helps

Early, pain-guided loading is the backbone of rehab. In the first few days, avoid sprinting, kicking and wide lunges, walk within comfort and start gentle isometric squeezes. Over the following weeks, strengthening progresses to side-lying adduction, sliding lunges and the Copenhagen plank, then running, cutting and kicking drills.

Research in football has shown that an adductor strengthening programme built around the Copenhagen exercise reduces groin problems, so the rehab exercises double as long-term prevention. Manual therapy can ease pain and tension but works best alongside loading. Unilateral training such as split squats and lateral lunges helps rebuild control once pain allows.

What you can start with at home

1. Isometric adductor squeeze: lying on your back, knees bent, squeeze a ball or pillow between your knees at a comfortable effort for 20 to 30 seconds, 4 to 5 times.
2. Side-lying adduction: lying on your side, lift the bottom leg, 3 sets of 10 to 12.
3. Short-lever Copenhagen plank with the knee on a bench, 3 sets of 10 to 20 seconds each side, once squeezes are comfortable.
4. Glute bridges and gentle walking to keep the rest of the leg working.
5. Gradual lateral movement: side steps, then lateral lunges, then shuffles.

Keep discomfort mild, around 3 or 4 out of 10 at most, and check it settles by the next day before progressing.

Returning to sport is the last stage, not a moment. Once squeezes and Copenhagen planks are pain-free, build up straight-line running, then gradual changes of direction, then kicking or explosive lateral work. Each step should feel comfortable during and after before adding the next. Rushing this stage is the most common reason groin strains come back.

Recovery time and when to get help

Mild strains often settle in 1 to 3 weeks and moderate strains in around 4 to 8 weeks. Severe strains, tendon injuries and longstanding groin pain can take several months. The on-site physio at Lycan Strength can build a return-to-sport plan with you, with 20% off for members, and you can book a physio appointment online.

• Go to A&E if you have a painful groin lump that you cannot push back, especially with vomiting or feeling unwell, as this can be a trapped hernia.
• Go to A&E immediately for sudden, severe testicular pain or swelling.
• Go to A&E if you cannot bear weight after an injury or fall.
• Call NHS 111 or see a GP if you have fever, a hot swollen area, or a groin lump that comes and goes.
• See your GP if pain is constant, severe at night or getting worse despite rest.

Questions