A groin pull is actually an injury to one of the hip-adductor muscles on the inside of the thigh, which help bring the legs together.
A groin pull can be quite painful, but it is not dangerous. It can be painful for older patients who already have difficulty walking. At any age, the injury may become irritated when people are carrying something and walking downstairs, when they have little control over the adductor muscles.
In most groin-pull injuries, some muscle fibers in the hip-adductor muscles have been overstretched, and some might even have ripped. This type of injury will respond fairly quickly to gentle stretching, and the patient should recover in about 2 weeks. But if the injury occurs in the upper part of one of the adductors, where the tendon attaches to the pelvic bone, the area beneath the tendon can become inflamed, and healing could take as long as 6 weeks.
If the pain is very intense, advise the patient to use crutches for 2–3 days. For older patients or those who have trouble with crutches, I recommend using a walker. Also, advise the patient to apply ice to the injured area for the first 2 days after the injury takes place, and then switch to a heating pad, which can be applied for 15–20 minutes.
Be sure to rule out a hernia, which requires a different treatment. You can feel a hernia and can feel it enlarge when the patient coughs. If there's no palpable protrusion when the patient coughs, the problem is most likely a groin pull, rather than a hernia. In contemporary medicine, most people leave a hernia alone, especially if it is not too bothersome to the patient. Not all hernia repairs are successful, and the surgery can bring its own set of complications.
For one of the exercises, I recommend using a beach ball, something approximately 16 inches in diameter. A larger fitness ball works, too, but a very large ball may be difficult for older or less flexible patients to use. However, I don't recommend anything much smaller than 16 inches.
These exercises should be done three times daily for the first few days; then the patient can drop back to twice daily until the pain subsides. The adductor is a fairly large muscle, so healing is relatively rapid.
These exercises are safe for all patients, even following hip replacement.
Next month, my column will discuss exercises to rehabilitate a rotator cuff injury.
Exercises for a Groin Pull
Side-lying adductor stretch. Lie on the uninjured side, with knees slightly bent (about 45 degrees), supporting your head on one hand, using the other arm for balance. Slide the heel of the injured leg up to the knee of the uninjured leg, and gently raise the knee, rotating the hip joint. The upper thigh should be about at a 90-degree angle to the torso during this exercise. Hold for 5 seconds, then relax to the starting position. Repeat five to six times.
Back-lying adductor stretch. Lie on your back with your legs bent and feet flat on the floor. Starting with the uninjured leg, hook the foot of the uninjured leg behind the heel of the injured leg. Let the uninjured leg fall gently toward the floor, with gravity doing the work. Hold for 15 seconds. Return to the starting position and relax, then repeat for the other side. Start with three repetitions on each side, add one each day, working up to five repetitions on each side.
Seated ball stretch. Sit in a straight-backed chair with feet flat on the floor. Place a fitness ball, or a soft beach ball (about 16 inches in diameter) if you are less flexible, between your knees. Compress the ball with your knees and hold for 5 seconds, then relax for 3 seconds, still holding the ball gently between the knees. Start with 3 repetitions, and work up to 12.
Back-lying ball stretch. Lie on your back with knees bent and feet flat on the floor. Place a rolled towel or a smaller ball (about 12 inches in diameter, such as a soccer ball, if you are more flexible) between your knees. Attempt to squeeze the knees together and hold for 12 seconds. Repeat six to eight times.