groin injury

[megmoo]

Hi,
About 4 weeks ago playing soccer I pulled my groin muscle. I rested it and last week I did some light jogging and it felt fine. However, last night I went training with the club I play with and I lasted an hour when it pulled again. Has anyone any ideas on what I should do.

Cheers

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[misssaf]

Hi
its really important you find out exactly what you pulled!
rest alone is not enough, you need to rehab the injury so that it can strengthen as it heals. RICE is still applicable to a re-injury. there are some great websites on groin injury, check them out. good luck
s

[megmoo]

Hi Misssaf,
Can u let me know these sites please
thanks

[friendlypain]

Hi Megmoo,

Ah... it is that wonderful season of soccer and the groin pulls that come along with it. Protect, Rest, Ice, Compress, and Elevate (PRICE) is a little complicated when it comes to a groin injury. The muscles affected are located deep in the abdominal cavity and very difficult to get cold. The tendon of the hip flexor (the muscle injured with a groin pull) is located in an area with alot of blood flow and the heat that's associated with it. Again, very difficult to get cold. The only way to "ice" the hip flexor is to sit in an ice bath for no more than 10 minutes and at least 5... But this wont fix your issue and you WILL re-injure it again... maybe even after the first week you are back playing.

What to do? Well.... I dont have you in front of me so I cant give you a specific way of fixing you as I need to do special testing but I will give you my advice.

A groin pull mostly happens when you apply an explosive deceleration force on the hip flexor. This comes from not jogging out a sprint (ie. DONT STOP when the attacker you have been shadowing passes the ball to a team mate... instead jog until you are almost walking) or when you dont finish off your kick (ie. DONT STOP your leg when your foot has contacted the ball... instead follow through so that it looks like you are doing a kung fu kick instead). When you stop suddenly, you exert loads on the muscle which will eventually weaken it and cause an injury.

Just because you can run does not mean you can sprint or kick the ball. The way you move your legs is very different between running and playing soccer. Runners are horrible soccer players because they have a reduced arc of leg range of motion strength. As an example, a runner needs to conserve energy for the 10k run so the runner (subconsciously) reduces the range in which the leg moves so that the large muscles are not over utilized. If this runner does this over a long period of time, the hamstrings learn to fire first before the glutes which will weaken the hip flexor. Now the runner is playing soccer and, as you know, soccer is not an endurance sport. It is all power. The body of the runner (trained for endurance) cant cope with explosive force as it has not trained for it and injuries eventually occur.

To fix your issue, you need to find a local trainer that specializes in soccer related exercises. If you play for a team ask your coach. I am sure they will point you in the right direction and offer tips for you to cope. I also tape my players before they play which takes some of the load off the hip flexor during the game or practice. Your coach should know how to do this or your local sports therapist.

I hope this helps and if you have any questions just ask.
Adamo

[misssaf]

Try physioroom, sportsinjuryclinic or emedicine. sportsinjurybulletin gives a nice description of structures, but they arent really a substitute for getting some proper treatment.

[megmoo]

Hi Adamo,
I sent you a pm......

[physiosmith]

Friendlypain,

Pardon my ignorance, but why do you assume it is a hip flexor problem, rather than an adductor strain?

Assuming it is a hip flexor problem, your advice to jog out a sprint is impractical - the defender needs to track the player he is marking, which will involve multiple short, sharp stops and starts.

Megmoo, I would suggest that whatever you pulled you returned to sport too soon, without having done any appropriate rehabilitation. Bite the bullet and get some advice/treatment from a good sports physio in your area, it will be money well spent in the long run - you don't want to get in to a cycle of groin injuries, which can severely hamper your ability to enjoy your football.

[summaryman]

Hi Megmoo,
I too have being suffering from groin strain and i totally understand your frustration.
I have being going to physio and I am now on my third session and I do feel alot better. However, I am worried that my muscle is still a little sore when doing strengthening excercises. Is this normal. My physio says it is but I would like a second opinion.

[friendlypain]

Hey physiosmith,

My experience with athletes and amature athletes is that they usually know what is bothering them as they have had experience in the past with the same injury or they know their anatomy because of their trainers and coaches. As he is only experiencing pain while playing soccer and not running, it is safe to assume that the hip flexor is the issue. Of course there is no way to know for sure unless an assessment is done but I am not going to parrot other advice that has been given here.

To assume the adductor is the primary cause MAY be too premature as the functions of the adductors and abductors are to stabilize the leg, to aim it if you will, for the major movements of soccer. Remember there are cleats at the bottom of those boots (main causes of all kinds of injuries btw!!!!!)so the adductors dont have to provide stability in the same way the skaters do and dont suffer the same forces that they need to compensate for.

The rule to finish a sprint and to follow through on a kick is to prevent explosive decelleration as the muscle eccentrically contracts. To finish a sprint is actually pretty easy to do in soccer as a good athlete will only hold on to the ball for a few seconds. If a defender has an attacker covered the movements of both players will not exceed basic speeds and explosive decelleration will not be necessary. Athletes cant sprint side to side no matter how tallented they are.

I would give the same recommendations to strengthen hipflexors that I give my skaters. First, ensure full dorsiflexion has been achieved. Then ballance lunges and single leg squats that minimize hamstring involvement. As I have said previously, a return to sport asap is important even if the activities have been limited according to the current state of the condition. Also, jogging is not a good indicator of a complete recovery. In fact, it goves the athlete confidence to hurt themselves again.

I hope this clears the air a little.
Adamo

[wutti]

hi i know this is a late reply but I think its important.
most groin injuries are based on either adductor strains (gracilis or add. longus) or tightness of the lower abs (external oblique, transversus abdominis). rest is the most important treatment. then start with easy isometric exercise to strenghten add. normal exercise for abductors. also easy exersise for abs but be really carefull, supervision by physio. core stability is very important.
slowly return to play, start with straight movements, no turns etc.
studies say return to play for male athletes up to 9 month, female 7 month. some cases could never return.
i am currently treating a patient since 6 month, hopfully return next season (after 10 month)
so please be carefull, this is on of the seriousest injury in athletes.
good luck