A complete treatment and management plan for groin strain
The following is a very comprehensive and detailed management plan for complete recovery and rehabilitation from a groin strain.
Considering that this management plan was written more than ten years ago, my only addition would be the reduction of ice therapy and the addition of massage and heat therapy during the second, third and fourth phases. Regardless of my suggestions, the following will be extremely helpful to anyone who has or has suffered a groin strain.
Injury situation:
A varsity basketball player had a history of stiff groin. During a game, he suddenly twisted his trunk as he stretched out to the right side. There was a sudden sharp pain and a sensation of “giving in” in the left side of the groin that caused the athlete to immediately stop play and limp towards the side lines.
Signs and symptoms:
As the athlete described to the physical trainer, there was severe pain when rotating the trunk to the right and flexing the left hip. The inspection revealed the following:
- There was a significant point of tenderness in the groin, especially in the adductor magnus region.
- There was no pain during passive hip movement, but severe pain did occur during active and resistive movement.
- When the groin and hip were examined for injury, the hip joint, iliopsoas, and rectus femoris muscle were ruled out; however, when the athlete adducted the hip from a stretching position, it caused extreme discomfort.
Management plan:
This detailed management plan comes from one of my old college textbooks, called Modern Principles of Athletic Training by Daniel D. Arnheim. It’s one of those 900-page doorstops, but it’s the book I refer to the most for information on sports injury prevention and rehabilitation. It is an extremely detailed and valuable resource for anyone who works in the health and fitness industry. Then …
Based on the physical trainer’s inspection, with findings confirmed by the physician, it was determined that the athlete had suffered a second degree strain in the groin, particularly in the adductor magnus muscle.
Phrase 1
Management phase: Goals: To control bleeding, pain and spasms. Estimated time duration (ELT): 2 to 3 days.
Therapy: Immediate care: ICE-R (20 min) intermittently, six to eight times a day. The athlete wears a 6-inch elastic hip spike.
Exercise rehabilitation: Without exercise: rest as complete as possible.
Phase 2
Management phase: Goals: To reduce pain, spasms and restore full ability to contract without stretching the muscle. ELT: 4 to 6 days.
Therapy: Follow-up care: Ice massage (1 min) three to four times a day. Bipolar muscle stimulation above and below the pain site (7 min).
Exercise rehabilitation: PNF for hip rehabilitation three to four times a day (starting approximately 6 days after injury)
Optional: Jogging in water at chest level (10 to 20 min) once or twice a day. It should be done within pain-free limits. General body maintenance exercises are performed three times a week as long as they do not aggravate the injury.
Phase 3
Management phase: Goals: To reduce inflammation and restore strength and flexibility.
Therapy: Muscle stimulation using the overcurrent at 7 or 8 o’clock, depending on the athlete’s tolerance, along with ultrasound once a day and cold therapy in the form of ice massage or ice packs (7 min) followed by light exercise, two or three times a day.
Exercise rehabilitation: PNF hip patterns two or three times a day after cold applications, progressing to progressive resistance exercise using pulley, isokinetic, or free weights (10 reps, 3 sets) once a day.
Optional: Flutter kick swimming once a day.
General body maintenance exercises are performed three times a week as long as they do not aggravate the injury.
Phase 4
Management phase: Goals: To restore maximum power, endurance, speed and extensibility.
Therapy: If you do not have symptoms, precede the exercise with an ice massage (7 min) or an ice pack.
Exercise rehabilitation: Added to the phase 3 program, jogging on a flat track slowly progressing to a 3 mile run once a day and then progressing to figure 8, starting with obstacles 10 feet apart and gradually shortening the distance to 5 feet, at full speed.
Phase 5
Management phase: Goals: To return to sports competition.
Exercise rehabilitation: Athlete gradually returns to pre-competition exercise and gradually returns to competition while wearing a herringbone-shaped 8-shaped elastic hip bandage for protection.
Criteria for returning to competitive basketball:
- Measured with an isokinetic dynamometer, the athlete’s injured hip and groin should have the same strength as the uninjured hip.
- The hip and groin have a full range of motion.
- The athlete can run figure-8s around obstacles placed 5 feet away at full speed.
