Recurring Groin/adductor Strain

[omargue]

Hello,

I am suffering from recurring Groin/adductor strains. I play ice hockey in an adult league and pulled my groin (right adductor)about 2 months ago playing. I do not have health insurance and was not able to go to the doctor. When the injury occured, I felt a strong pain in my groin and knew right away it was a strain. It hurt to walk for a couple days but I used the RICE technique and rested. I thought I was able to play the following week (which I wasn't) and my second shift I had my groin hurting again. Me being VERY stubborn, I finished the game playing at a 60% as I could not any more. It again hurt to walk and was very tender. I rested it for 3 weeks, RICE treatment for the 1st week and worked on stetching and strengthing it. I went back to playing again once a week and wear a compression shorts and wrap it with an Ace bandage to extra compression. I felt fine playing and skating hard again. The first couple weeks I returned I played more at 75-80% just because I didn't want to re-injure it. The 3rd week back playing I felt fine once again and I was back at skating at 100%. I wear the compression short and wrapped it. No pain or discomfort during or afterwards. I usually ice my groin after every game and workout to lower any swelling if any (More as prevention). The following day, as the day went on, I felt my groin was becoming sore and I felt I had strained it again! It doesn't hurt on the touch, but is definitely a strain.

I have done alot of research and as well as my prior knowledge is that if the pain occured the day after, it was most likely a grade 1 strain. RICE and rest for 1-3 weeks and should be back.

Well, I rested it another 3 weeks, was stretching it out and strengthening it as well in the gym. (I go to the gym 3 days a week and would say I am in good shape). I felt 100% again at this point, as I was able to squat heavy, box jumps, side jumps, lunge jumps, jog...etc. My 1st game back, I forgot my ace bandage but did have my compression shorts. Well While playing I didn't have any pain but towards the end I has some VERY MINOR discomfort if you would even call it that. I was skating very lightly as we were winning and did not want to injure it towards the end. I stretched after the game and feel fine, but I did have a bad feeling I had strained the muscle again. Unfortunately I did, same thing as the last time, I started to feel the pain the following day and I immediately started putting ice for 20 min every 1-2 hours. I was able to workout in the gym 2 days later, and felt fine once I had warmed up. I was able to squat the same weight and about 5 days later I was able to light jog for 1 mile with no pain. These last 2 weeks I have been constantly wrapping my groin with an ACE bandage and applying heating pads. I also started using my foam roller strictly every day and before I workout in the gym to start massaging the groin area and help with myofascial release. I was feeling about 95%, I was thinking about making a comeback for my hockey playoffs next week so I increased intensity as the gym. Instead of a standard full body weight training, I added sets of lunge jumps and side jumps, I also capped my workout with HIIT on the stationary bike for 20 min. I used the foam roller after my workout for 10-15 minutes, working on my groin, front hip flexors, rear hip flexors, side hips, glutes and felt fine. I applied ice when I got home and ice it 2 times. Today I feel my groin stain AGAIN!

I will rest as long as it takes this time. But how will I know when I am really 100%? When I feel 100%, I play and re injure myself. I know I must have alot of scar tissue built up and the scar tissue is not as flexible as muscle tissue. I try and give myself deep tissue massages using my foam roller to break down the scar tissue with myofascial release. I also purchased a muscle roller stick to bring to work.

If anything is different, This time the pain from the stain is more on my front hip flexor. I don't feel much pain when I try and close my legs with resistance, but more when walking up stairs and resistance pushing my leg up. Also, for the last week for using the foam roller daily on my whole hip region, the side of my hips have been very tender, more on my right side where the injury occurred.

I will have a very basic health insurance starting on the end of August, I hope for the General Practice doctor to give me an MRI and a referral to a Physio. My referral appointments will be expensive and I will not be able to afford 2-3 times a week. Other than rest, what else can I do? I am willing to miss as much time from not playing hockey, to just be 100% and be able to play hard again. My summer league is almost over and if I sit out and rest until the fall/winter season begins, it will be about 7 weeks. If I continue to rest, stretch, strengthen, and foam roll, will this be enough? I will see the doctor ASAP too, but I am very depressed that I cannot play the game I love.

Also, I am 30 years old and take the following supplements/vitamins: Protein, BCAAs, Multi-vitamin, Glucosamine/condrotin/msn, Super Cissus, Vitamin E, fish oil.

Thank you

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[rorykc]

Sounds like you had an acute strain as there was an incident where you "felt it go".
Muscle healing at a base level for a grade 1 strain - takes ~21 days just to heal,if it it was a bigger tear, add 1-2-3 weeks on to the healing time frame. we cannot play god here unfortunately. The body heals at its own pace, regardless of autologous blood injections, technology etc etc. We may be able to speed it up by 1-2 days, but for cost/benefit... just let your body do what it does best.

Function is a good indicator for healing, as well as timeframes.
Inidcators for healing and return to play
1) >21 days to heal - with no "tweaks in this time" otherwise start process again, likely you re-strained it. Therefore start from that date, not initial strain.
2) Adductors - you can often get away with straight line movements, but change of direction +/- speed +/- game play and unpredicatbility will be the real test
3) As a general rule
- Sensiitivty: Squeeze test - minimal/no pain or discomfort >250-300 strength useing sphygmometer, No tenderness on palpation
- Function: Progress from straight lines - slow, to increase speed, to add in change of direction, to then add in match play.. use tightness/fatigue as a guide to when the muscle has had enough. Give it a day off in between sessions to heal.
- Return to play: If you =can get through a full week of training with minimal discomfort you can play. After Re-straining it, I would aim to have 2 weeks full training to return to play. If that takes 4 weeks.. take 4 weeks.. if 6... take 6. listen to your body
- Treatment wise - give it the time to heal, loosen up through lower back, hips. Groin is the gutter i.e the victim not the culprit - may need to retrain lumbo-pelvic mechanics functional to ice hockey as a long term preventative measure. Pace yourself slowly into training (as above), listen to you body - tightness/fatigue = bodies had enough. Go cross train to keep moving in the mean time - avoid repetitive hip movements if cross training though.
- Reformer - Sliding exercises on high and low tension are great rehab exercises specific to skating - the hips and the groin. See Alison Grimaldi from AUS.

hope that helps.

[omargue]

Sounds like you had an acute strain as there was an incident where you "felt it go".
Muscle healing at a base level for a grade 1 strain - takes ~21 days just to heal,if it it was a bigger tear, add 1-2-3 weeks on to the healing time frame. we cannot play god here unfortunately. The body heals at its own pace, regardless of autologous blood injections, technology etc etc. We may be able to speed it up by 1-2 days, but for cost/benefit... just let your body do what it does best.

Function is a good indicator for healing, as well as timeframes.
Inidcators for healing and return to play
1) >21 days to heal - with no "tweaks in this time" otherwise start process again, likely you re-strained it. Therefore start from that date, not initial strain.
2) Adductors - you can often get away with straight line movements, but change of direction +/- speed +/- game play and unpredicatbility will be the real test
3) As a general rule
- Sensiitivty: Squeeze test - minimal/no pain or discomfort >250-300 strength useing sphygmometer, No tenderness on palpation
- Function: Progress from straight lines - slow, to increase speed, to add in change of direction, to then add in match play.. use tightness/fatigue as a guide to when the muscle has had enough. Give it a day off in between sessions to heal.
- Return to play: If you =can get through a full week of training with minimal discomfort you can play. After Re-straining it, I would aim to have 2 weeks full training to return to play. If that takes 4 weeks.. take 4 weeks.. if 6... take 6. listen to your body
- Treatment wise - give it the time to heal, loosen up through lower back, hips. Groin is the gutter i.e the victim not the culprit - may need to retrain lumbo-pelvic mechanics functional to ice hockey as a long term preventative measure. Pace yourself slowly into training (as above), listen to you body - tightness/fatigue = bodies had enough. Go cross train to keep moving in the mean time - avoid repetitive hip movements if cross training though.
- Reformer - Sliding exercises on high and low tension are great rehab exercises specific to skating - the hips and the groin. See Alison Grimaldi from AUS.

hope that helps.

Thank you for your response. I'm not 100% sure if my initial strain was a grade 1 or 2 but I did feel good with 3 weeks of rest. Since I have now strained my groin (most likely grade 1) 4-5 times now, would it be safe to say I have a lot of scar tissue built up that needs to be broken down? Since I won't be able to see a physio for some time, how soon can I start with foam rolling my groin area? And how often? I have read a lot about myofascial release and how it breaks down scar tissue. Would this be a good method to help rehad time?

Also I have been reading a lot about RICE vs MEAT for sports injuries. I have always used RICE, should I stick with this or is MEAT better?

How soon can/should I start working out my lower body? I am somewhat a 'gym rat' and workout using a fullbody strength routine. I do lots of sports specific workouts, and I like to do lots of heavy squats, deadlifts, front squats...etc for lower body. I also like to add in explosive movements (box jumps, lunge jumps, side jumps), which I will shelf for awhile. I also want to start light jogging as well. It has only been 2 days from ny last initial injury. I will take awhile to get back into playing hockey, but is your timeline to rest for the 21 days, then begin with jogging, change directions, game play?

Sorry for so many questions. I appreciate all the help you given already. Thank you.

[omargue]

Is it possible I have a Sports Hernia?

I have been reading alot about sports hernias and am thinking it may be it. Also I'm not sure if now that I have read the sports hernias symptoms, that it is causing me to be more aware of my own. With the following symptoms, can someone be able to cancel out the either groin strain or sports hernia?

-Initial injury was pain in groin during a game.

-Rest 1 week and played again, pain in groin throughout the game.

-Rest 3 weeks, returned to play for 3 weeks and felt groin pain the following day

-Initial discomfort hours after game mostly in front hip flexor region, then Groin pain became worst 1-2 days later and groin was Tender

-Rest 3 weeks, (was able to jog after week 1) returned to play and felt no discomfort while playing....then again with initial front hip flexor discomfort then groin pain and groin tenderness 1-2 days later. slight pain when walking and going upstairs.

-Rest 2 weeks, feel good again, in gym working on explosive movements. Felt fine in the gym, same as the last 2 times. Hours later (around 8), initial discomfort/pain in front hip flexor, then more profound pain in groin. Groin pain/tenderness persisted longer than normal this time. Range of motion of groin has been the same after every injury.

That was 1 week ago, I have been noticing slight testicular discomfort on the same side and slight oblique/top of front hip flexor discomfort. Are sports hernias associated with delayed groin tenderness?

I still don't have insurance probably until the end of September, but I am trying to do the best I can to stay active. I still have not tried to jog because I am scared to re-injure my groin again. It was been 6 times in the past 3-4 months.

[mayhew]

I too appear to have this issue. Did your medical issue ever get resolved? What did you do to solve the issue? Thanks.