Groin Pull Therapy & Treatment

What is a groin strain?

A groin strain is in an injury of the muscles in the groin area. The location of the groin is area where the upper abdomen area meets the top of the thigh, and where the inner thigh muscles meet the pubic bone of the hip. Groin pulls tend to happen more to athletes and usually happen through forceful movements of the thigh – usually through running, jumping, and kicking. 10% of all hockey injuries are groin strains and 5% of all soccer injuries are groin strains. Non-athletic injuries include lifting heavy items, slipping while walking, or climbing high objects.

The biggest defense and remedy of groin strains is physical therapy – not only do we provide manual therapy for healing of soft tissues strains, but also proper exercises to promote better form and avoid further re-injury.

In a groin pull, muscles of the inner thigh and the front of the hip get overstretched during activity and there is is some muscle fiber and tendon micro tears as a result. Groin strains can make walking difficult as the patient lifts the knee for ambulation. Moving the leg away and to the side can also be either painful or difficult.

Muscle strains can generally be graded according to the severity of muscle damage:

      Grade 1: The damage or tear on the muscle fibers are mild and partial. The muscle will be painful and tender to the touch but can maintain its normal strength. The patient may report impaired use of the leg, but walking gait is more or less normal.

      Grade 2: The tear is moderate as there is more muscle fiber torn. There is more tenderness and pain and loss of strength. Occasionally there will be bruising from torn capillaries as result of the injury. Use of the leg will definitely be impaired and the patient will limp when he/she is walking.

      Grade 3: The tear in the groin muscle or tendon is severe, or may be complete. The patient may report a “popping” sound during the injury. Bruising is present, as is a divet in the muscle can be felt underneath the skin. Moving the leg will be very difficult and weight bearing can also be very painful.

A groin strain feels usually feels sharp in nature, especially when trying to walk or move the leg – either in lifting it up, or in bringing the knees together. The pain can be intermittent, or it can be constant and persistent depending on severity and inflammation, which can feel like throbbing. The groin muscles can feel weak or tight and may cause the muscles to spasm further.

How Is A Groin Strain Diagnosed?

A groin strain can be easily diagnosed by a physical therapist, and need not further imaging if the patient is able to walk and weight bear. During your initial evaluation, your groin pull physical therapist will conduct a thorough subjective evaluation and ask you about the nature of the pain you have experienced. These are some things he/she would want to know:

  • Injury specifics – what activity and what motions you were doing.
  • The location of the groin pain, and if a pop was heard during injury.
  • If any swelling as formed after the first 2-3 hours after the injury.
  • What movements are impaired and what can’t you do as a result of the strain.

Your groin injury physical therapist will then perform an objective exam to test the strength and range of your muscles. A palpation exam would also allow him/her to see the severity and location of the potential muscle/tendon tear and feel for any active inflammation. Additionally, your PT may also conduct further tests to see how involved are other areas including your hip or lower back.

If the groin injury is less severe, or if the injury is verging on chronic (>4 weeks old), your physical therapist may ask that you gently repeat the movements and motions that injured you in the first place. This is a movement analysis and will allow your PT to see whether range and strength can be gained in other parts of your body, so you prevent from straining your groin muscle again.

If the strain is severe, your PT may choose to refer you to an orthopedist or physician to conduct further tests such as an X-Ray or MRI to confirm a more severe or full tear. A groin strain can sometimes feel very much like an abdominal hernia so this needs to be ruled out by a physician as well.

A Typical Groin Pull Physical Therapy Treatment Plan

There are several goals that a physical therapist establishes for your plan. In the beginning of treatment, pain modulation and range of motion is more important as it respects the healing phase. Exercises and manual therapy may get more intense as pain diminishes and the patient is re-integrated into sports or physical activities. Your PT will likely prescribe home exercises – these are crucial for proper healing and will definitely speed up the process.

The First 1-2 days after injury:Physical Therapist treating a groin pull

It is important to immediately rest the limb and avoid prolonged walking or any activities or motions that illicit the pain. Cold therapy is very useful in controlling inflammation, so apply as needed for 10-15 minutes at a time. Consult with a physician if you think you need pain medication or if you feel that you might have a severe tear.

PT Goal: Reduce Groin Pain

Your physical therapist will use several different tools to help modulate the pain. Cold therapy, heat therapy (if injury is chronic in nature), TENS electric stimulation, taping to help support the tissues, or hands-on manual therapy to ease tissue tension and spasm can all help to modulate the pain after a groin strain.

PT Goal: Improve Range of Motion

Your physical therapist will construct and exercise and stretching plan for you that will aim to improve hip mechanics and range of motion. Initially, if the region is painful, these maneuvers will be passive where the PT will move the leg for you. As pain diminishes, active stretching and exercises will be progressed.

PT Goal: Improve Strength

Because deconditioning and atrophy of muscles always occur after an injury, it is important to re-strengthen these muscles so that you can return to your sport or activity. As the muscle heals, exercises need to be progressed gradually so that the muscle can take the load of being forcefully pushed again during sports. The PT may use resistive weights, machines, cardio machines or functional calisthenics to achieve this goal.

PT Goal: Return to Activities

Your physical therapist will be closely collaborating with you on your return to sport and other activities. As mentioned before, practicing the motions that hurt or injure can give the PT more insight as to how the injury occurred. For e.g. if kicking a soccer ball was the injury, then the PT might want to look at your frontal plane dynamics and how your balance affects how muscles move and recover from the motion. When balance or strength is gained in other parts of your body like your abdomen and your glutes, the use of groin muscles can be reduced and therefore prevent further re-injury down the road.  

If Surgery Is Necessary

Surgery is rarely needed in the healing of a groin strain, but will be necessary if there is a full thickness muscle or tendon tear. Your physical therapist can help you recover and heal from surgery, taking the above goals into consideration and with more respect to surgical repair healing times.  

Can Groin Strains Be Prevented?

The following tips may help you avoid having them in the first place:

  • Increase the intensity and frequency of the activity gradually. Pushing yourself too hard and too fast too soon will put excess strain on soft tissues that have not been given time to adapt and grow in strength.
  • Warming up before playing a sport is helpful in getting blood flow to muscles pre-game.
  • When performing sports, do not ignore sports conditioning. It may be boring and cumbersome, but following a consistent strength and conditioning program in adjunct to your sport will allow for a stronger body and better your biomechanics when you’re on the field.  
  • Make sure your footwear has adequate tread in them. When shoes wear out tread, the tendency to slip and strain your groin increased.
  • Use proper posture and lifting techniques when lifting heavy weights. When in doubt, ask a physical therapist!

For the best groin pull treatment please visit one of our Portland clinics today!

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Alice Holland, DPT

Doctor of Physical Therapy, Director at Stride Strong Physical Therapy
Alice earned her Doctorate of Physical Therapy from USC in 2007, and have practiced Physical Therapy for 12+ years in the Outpatient Orthopedic Setting. Certified in ASTYM, she also has been a featured expert on Physical Therapy on numerous publications including health.com, healthline.com and yahoo.com.
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Latest posts by Alice Holland, DPT

Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
Lindsay Nied
Lindsay Nied
23:33 18 Dec 17
I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
JoAnn Hatch
JoAnn Hatch
08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
Clare Perry
21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
Joyce Heideman
Joyce Heideman
08:28 11 May 18
After foot surgery I went to Stride Strong for therapy with Alice Holland. She helped me reach my full mobility again by continuously introducing new and challenging exercises. The entire staff is friendly and professional. They are always on time and do not rush. I look forward to doing 1/2 marathons again and riding my recumbent trike. Thank you Stride Strong for your care and high level of expertise.
Suad Daher
Suad Daher
20:48 28 Feb 18
The best physical therapy ever. Both JP and Sydney were a great PT, they helped me understand how I can help treat my injury and how it may have caused. And also they informed about so many techniques that I can use to help my injuries or any other injuries I get in the near future. They are both friendly and nice to talk too, and verbunformative. And there is also Krystal, she is the best front desk receptionist ever, she is nice and friendly and can easily manage your schedule based on the patients comfort if they want to schedule or not. She can help and she replies fast to any patients email. And she is easy to talk to. Thank you Stride Strong Physical Therapy.
Amanda O'Rourke
Amanda O'Rourke
21:38 15 Jun 18
In just a month I've seen great progress! I've been incorporating the exercises taught to me into my daily workout routine. Im very happy with my continued results.
Albert Szal
Albert Szal
23:43 10 Jun 18
Mary Szal here: I've had three sessions with Brittany at the Hillsboro location. I can say that she has been the most effective and instructive physical therapist I've ever experienced. Her personality, energy, knowledge and results are top notch.
Osa Phiangdae
Osa Phiangdae
00:05 22 Mar 18
Awesome place for PT. Hillsboro location has plenty of parking and very spacious. I had the pleasure to work mostly with Dr. Alice Holland and JP. I came in with a shoulder injury and thank goodness they understood what I was going through. They are the best of what they do, I would recommend Stride Strong to anyone who needs PT.
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