I need Adductor Strain help!

[InjuredAndy]

I strained my left adductor muscles (pulled my groin) back in June, and they still aren't 100%! What can I do? Is it really just a strained adductor, or is it something else?

The cause was likely doing "sprinting drills" without warming up properly - I am a 30 year old distance runner, never done a sprinting practice in my life. This was back in mid June.

I continued to run daily, in spite of the pain, for about 3 weeks afterwards. I then stopped running daily and ran only once a week until about August. Around this time, I used the internet to learn what I could have, and believed it to be a strained adductor.

My symptoms included discomfort when walking, inscreasing pain while running. Pain while going up stairs using my left leg. Pain while moving my leg into various positions (i.e. the ones a doctor would use to test for a groin strain which I saw on the internet).

In late September, I went to a Sports Clinic, and the doctor confirmed my suspicion and said I had an adductor strain. I then began stretching excercies and muscle therapy at the direction of a therapist at the clinic.

Now it is November, and there has only been slight improvement. Pressing my knees together still hurts. There is pain after even light jogging. There is slight pain while "forward adducting" (i.e. raising the knee hip-high and bringing it across center). There is worse pain while "rear adducting" (i.e. extending my left leg straight behind me, and then bringing the foot across center). It also hurts to flex my left leg and twist my hips.

Sorry for the long post, but I thought describing the situation would help in determining what I should do. Is it really just an adductor strain? How soon can I return to running? Is it chronic (i.e. permanent)? Should I go to a better Sports Clinic?

Thanks for any help and advice!

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[physiofixme]

Hi

I think to be on the safe side you need to rule out a couple of things. Your symptoms (especially seeing as they haven't improved with stretching etc) could be related to a hip joint problem. You can get a synovitis of the hip joint which is basically inflammation of the joint or bursitis which is also an inflammatory condition affecting the bursa (fat pad) around the hip. Given the fact that you are a distance runner and engaged in sprint training which is unfamiliar to you a hip joint problem is quite feasable as they tend to manifest themselves after a period of altered use or prolonged use!! You can also get stress fractures in and around your hip so I think it is probably wise to see someone and rule out the possibility that there is something else going on other than a groin strain.

If it does turn out to be a straight forward groin strain - they can be tricky to resolve. A really good stretching and strengthening programme is vital! There is an active training programme documented by Homisch et al in a study published in the Lancet. Sorry - I don't have a link to this article but you could try searching online to see if you can track it down.

Hope this helps.

Rachael
Rehabilitate prevent perform physiofixme

[sami.crpt]

hi dont feel sorry for writing a long description...cos it helps with a history taking.
i understand the condition has turned chronic.cos u had problem in aug & still exist with pain on particular movements. groin starin does take some time to heal cos usually along with addoctor muscle the ligaments(pubofemoral lig)too may get stained .It is important to rest following the injury to allowed the injured muscle to properly heal. Allow pain to guide your level of activity; this means that activities which cause symptoms should be avoided.

Stretching gently is helpful, but it should not be painful. Stretching excessively can be harmful and slow the healing process.

• Adductor stretches

Heat Applications
Before activities, gentle heating can help loosen the muscle. Apply a heat pack to the groin prior to stretching or exercising. As a general rule of thumb, remember to heat before, and ice after.

• Know when to ice and when to heat an injury

Anti-inflammatory Medications
Oral anti-inflammatory medications (such as Ibuprofen, Aleve, or Motrin) can help relieve symptoms of pain and also calm the inflammation.
Physical Therapymodalities such as ultrasound, therapeutic massage, and specific exercises particularly helpful. You should visit a physical therapist to determine if these would be appropriate for your condition.
hope these r helpful

[InjuredAndy]

Thanks for your replies. Actually, I am doing those stretches already. I had been even before going to the clinic. That's why I'm worried. It definately doesn't feel like a hip problem. When I move my leg around, I feel the adductor pulling. Is it just "rusty" from disuse? The doctor at teh clinic I went is supposedly qualified (I'm in Japan, so I can't be sure) - and he believed it was an adductor strain. I just wonder if he knows what he's talking about. No X-ray or MRI was done. Should I go to a better hospital and get those done?

About those other conditions (synovitis and bursitis), wouldn't they have healed by now? Remember, I'm not running any more. Some cycling and walking is all I do (in addition to the stretches and adductor strengthening exercises). I should also add I am not taking any kind of medication. I do ice my leg after stretching it though, as well as after long periods of cycling.

I will look up that article though. Thanks for your advice, and let me know if there's anything else you would suggest!

[TheSportsPhysiotherapist]

Hi Andy,

I agree with the advice given by the guys above, but there are a few more things you may need to consider.

Diagnostically, you may have a presentation known as Osteitis Pubis - google it for more info - but it can be involved in "chronic groin strain" presentations. A CT may diagnose this. In this case, a comprehensive exercise program is your first option. If this fails to resolve you may consider "prolotherapy" which has shown to be effective in chronic adductor treatments. I talk about it a bit here Prolotherapy Or AND here RICE or MEAT Protocol for Acute Ligament Sprain Treatment | The Sports Physiotherapist.

With reference to your current exercise program, you seem to be concentrating on "stretching" the groin/adductor muscles. You may find greater benefit with the addition of some or all of these exercise to your program (check out YouTube for examples):
Groin Strengthening - e.g. Theraband Adduction in Standing
Gluteal Stretches (as tightness in the gluts will synergistically increase groin strain)
Core Stability Training
Femoral Nerve Tensioners

I really hope this helps. If you require clarification send me an email and I'll flick you some links to good youtube clips ([email protected]).

The Sports Physiotherapist

[sami.crpt]

andy; y dont u go for an MRI or C.T if ur physician too is confused of ur state...
are u married? if u dont mind;lemme tel u 'missionary position' during mating shud be avoided for a while .
usually for example v do tell pt abt bak care & wt liftg when they hav bak strain or any bak dysfntion.but they dont mind liftg their child who might be over 12-15 kg!!!(cos they dont remember that too is a 'weight'!)so i felt its important to giv u a chance to chek ur daily activity positions which may b a reason which is preventing frm proper healing...
tak care

[InjuredAndy]

Thanks again for your replies. Actually, the fear of having Osteitis Pubis hit me months ago (August) when the injury didn't heal and I googled about groin/adductor pain and found it had similar symptoms. I don't experience pain to the degree suggested on wikipedia's info on Osteitis Pubis. There's no pain standing up for instance. Also, there HAS been improvement, just very slight (i.e. before, it hurt to go up stairs but now it doesn't).

Some symptoms of Osteitis Pubis are similar to those I am experiencing though, so I may try to seek out a better doctor. I was relieved to hear I had an adductor strain from that first doctor though, since from what I read about Osteitis Pubis, it seems very sports-career ending in many cases.

I have been doing strengthening excerices though. Not just stretching. I do a lot of squats, forward, side, and X -lunges, and a few others meant to strengthen the back and stomach and the side of the stomach, as well as the adductors specifically (sorry I forget their names).

On the few times I run even briefly, it has caused pain the next day. I've been trying to do more MEAT then RICE though, as I hate resting.