The following is a very comprehensive and detailed management plan for complete recovery and rehabilitation from a groin strain.
Considering that this management plan was written over ten years ago, my only addition would be the reduction of ice therapy and the addition of massage and heat therapy during the second, third, and fourth phases. Regardless of my suggestions, the following will be extremely helpful to anyone who has or has had a groin strain.
A varsity basketball player had a history of snout tightness. During a game, she suddenly turned her head as she also stretched to the right side. There was a sudden sharp pain and “giving out” sensation in the left groin that caused the athlete to immediately stop playing and hobble toward the sideline.
Symptoms and signs:
As the athlete described it to the physical trainer, she had intense pain when rotating her trunk to the right and flexing her left hip. The inspection revealed the following:
- There was a significant point of tenderness in the groin, especially in the region of the adductor magnus muscle.
- There was no pain during passive movement of the hip, but there was severe pain during active and resistive movement.
- When the groin and hip were examined for injuries, injuries to the hip joint, iliopsoas, and rectus femoris were ruled out; however, when the athlete adducted the hip from a stretched position, this caused extreme discomfort.
This detailed management plan comes from one of my old college textbooks called Modern Principles of Athletic Training by Daniel D. Arnheim. It’s one of those 900 page books, but it’s the book I refer to the most for information on sports injury prevention and rehabilitation. It is extremely detailed and a valuable resource for anyone working in the health and fitness industry. So…
Based on the athletic trainer’s inspection, with findings confirmed by the physician, it was determined that the athlete had suffered a second degree strain in the groin, particularly the adductor magnus muscle.
management stage: goals: To control bleeding, pain and spasms. Estimated Time (ELT): 2 to 3 days.
Therapy: immediate care: ICE-R (20 min) intermittently, six to eight times a day. The athlete wears a 6-inch hip elastic spike.
rehabilitation exercise: No exercise: stay as full as possible.
management stage: goals: To reduce pain, spasm and restore full ability to contract without stretching the muscle. ELT: 4 to 6 days.
Therapy: follow-up care: Massage with ice (1 min) three to four times a day. Bipolar muscle stimulation above and below the pain site (7 min).
rehabilitation exercise: PNF for hip rehabilitation three to four times daily (starting approximately 6 days post-injury)
Optional: Jogging in water at chest height (10 to 20 min) once or twice a day. It must be done within pain-free limits. General body maintenance exercises are performed three times a week as long as they do not aggravate the injury.
management stage: goals: To reduce inflammation and restore strength and flexibility.
Therapy: Muscle stimulation by means of shock current at 7 or 8, according to the tolerance of the athlete, together with ultrasound once a day and cold therapy in the form of massage with ice or ice packs (7 min) followed by light exercise, two or three times a day.
rehabilitation exercise: PNF hip patterns two to three times a day after cold applications, progressing to progressive resistance exercises with cable, isokinetics or free weight (10 repetitions, 3 sets) once a day.
Optional: Flutter kick swimming once a day.
General body maintenance exercises are performed three times a week as long as they do not aggravate the injury.
management stage: goals: To restore full power, endurance, speed and extensibility.
Therapy: If you do not have symptoms, precede the exercise with an ice massage (7 min) or an ice pack.
rehabilitation exercise: Added to the Phase 3 program, jogging on a flat course and slowly progressing to a 3-mile run once a day and then progressing to a figure 8, starting with obstacles 10 feet apart and gradually shortening the distance to 5 feet, full speed.
management stage: goals: Back to sports competition.
rehabilitation exercise: Athlete gradually returns to pre-competition exercise and a gradual return to competition while wearing a spike-shaped figure-8 elastic hip wrap for protection.
Criteria to return to competitive basketball:
- As measured by an isokinetic dynamometer, the athlete’s injured hip and groin should have the same strength as the uninjured hip.
- The hip and muzzle have a full range of motion.
- The athlete is able to run in a figure 8 around obstacles placed 5 feet apart at full speed.