Whether you play hockey or your foot slips while you’re walking across an icy driveway, stretching one of your inner thigh muscles past its normal limits can cause significant pain.

Most groin pulls occur when you move your leg with a fast and forceful motion or your leg changes direction rapidly. The level of pain accompanying a groin pull depends on the severity of the adductor muscle injury. Like other strains, groin pulls are diagnosed using a graded scale.

  • Grade 1 – The adductor injury is classified as a slight tear. After the initial sharp pain, a small tear in the adductor may cause mild discomfort, but does not usually affect a person’s ability to walk.
  • Grade 2 – The adductor has more than 25 percent of its muscle fibers torn. This type of strain causes pain, swelling and bruising. There may be a substantial amount of pain during movement or exercise, especially when moving the leg in front of the body.
  • Grade 3 – The most severe adductor injury severs all or nearly all of the muscle fibers. A grade 3 injury should be assessed by a healthcare professional and may require the use crutches for a few weeks.

What Causes a Groin Strain?

Groin strains usually happen when the adductor muscles get stretched too far and begin to tear. Strains also can occur when the adductor muscles suddenly have stress put on them when they aren’t ready for it (as when someone doesn’t go through a proper warm-up before playing) or when there’s a direct blow to one of the muscles.

Some of the risk factors that can make a groin pull more likely include:

  • Sports that require sprinting, bursts of speed, or sudden changes in direction. Examples include track and field, particularly the hurdle and long jump events, basketball, soccer, football, rugby, hockey, and skiing.
  • Tight muscles. Muscles that haven’t been warmed up and stretched properly are more likely to tear. This is especially true in cold weather.
  • Poor conditioning or fatigue. Weak muscles are less able to handle the stress of exercise, and muscles that are tired lose some of their ability to absorb energy, making them more likely to get injured.
  • Returning to activities too quickly after an injury. Groin strains need time and rest to heal completely. Trying to come back from a strain too soon will make you more likely to injure your groin again.

How Can You Prevent a Groin Strain?

The main thing you can do to help prevent a strained groin is to warm up and stretch before any exercise or intense physical activity. Jog in place for a minute or two, or do some jumping jacks to get your muscles warmed up. Then do some dynamic stretching (ask a physical therapists, athletic trainer, or sports medicine specialist to show you how to do this type of stretching).

Some other things you can do to try and prevent groin strains include:

  • Keep your muscles strong and flexible year round. Get regular exercise (even in the off-season) and follow a good stretching program.
  • Increase the duration and intensity of your exercise slowly. A good rule of thumb is to make sure you add no more than 10% each week to the miles you run or the time you spend playing a sport.
  • If you feel pain in your groin, stop your exercise or activity immediately. If you’re worried that you might have strained your groin, give it time to rest, and don’t resume your activity until you are pain-free and your injured adductor muscles feel as strong as the uninjured ones.
  • Learn and use proper technique when exercising or playing sports. Your coach or trainer can give you pointers and tips for your sport.
  • Wear shoes or skates that fit correctly and offer your feet good support. Replace shoes with a new pair when they show signs of wear or the soles start to lose their shape. The same goes for skates — you want to be sure they maintain good ankle and foot support.

How Can a Physical Therapist Help?

Your physical therapist will design a specific treatment program to speed your recovery. This program will include exercises and treatments you can do at home to help you return to your normal lifestyle and activities.

The First 24 to 48 Hours

Immediately following your consultation, your physical therapist may advise you to:

    • Rest the area by avoiding walking or any activity that causes pain. Crutches may be recommended to reduce further strain on the muscles when walking.
    • Apply ice packs to the area for 15 to 20 minutes every 2 hours.
    • Compress the area with an elastic bandage wrap.
    • Consult with another health care provider for further services, such as medication or diagnostic tests.

Your physical therapist will design an individualized treatment plan for you based on your unique condition and goals. Your plan may include treatments to:

Reduce pain. Your physical therapist can use different types of treatments and technologies to control and reduce your pain, including ice, heat, ultrasound, electrical stimulation (TENS), taping, exercises, and hands-on therapy, such as massage. These treatments can lessen the need for pain medication, including opioids.

Improve motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the leg and hip. These might begin with “passive” motions that the therapist performs for you to gently move your leg and hip joint, and progress to active exercises and stretches that you perform yourself.

Improve strength. Certain exercises will benefit healing at each stage of recovery; your physical therapist will choose and teach you the appropriate exercises to steadily restore your strength and agility. These may include using cuff weights, stretchy bands, weight-lifting equipment, and cardio-exercise equipment, such as treadmills or stationary bicycles.

Speed recovery time. Your physical therapist is trained and experienced in choosing the right treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

Promote a safe return to activities. Your physical therapist will collaborate with you to decide on your recovery goals, including your return to work or sport, and will design your treatment program to help you reach those goals in the safest, fastest, and most effective way possible. Your physical therapist will apply hands-on therapy, such as massage, and teach you exercises and work retraining activities. Your therapist also may teach you sport-specific techniques and drills to help you achieve any sport-specific goals.

Prevent future reinjury. Your physical therapist can recommend a home-exercise program to strengthen and stretch the muscles around your hip, upper leg, and abdomen to help prevent future reinjury of your groin. These may include strength and flexibility exercises for the leg, hip, and core muscles.

If Surgery Is Necessary

Surgery is rarely necessary in the case of groin strain, but if a groin muscle fully tears and requires surgical repair, your physical therapist will help you minimize pain, restore motion and strength, and return to normal activities in the speediest manner possible after surgery.