Your Training Can Become Your Rehab
Concepts and Drills for Prevention
I was always told in school that after not seeing a condition for years, everyone will seem to present to the clinic at the same time with the same issue. Well, the injury de-jour seems to be groin pulls/strain. It's especially important to get these taken care of correctly because these injuries will set you up for hernias and hip impingement problems which often need surgical correction.
Let’s first categorize “groin”, because this is a very broad term. Conventionally speaking the “groin” consists of 5 muscles: Adductor Magnus, Gracilis, Adductor Brevis, Adductor longus, and Pectineus.
The common thought is these muscles collectively only adduct the leg, or pull the thighs together, which isn’t the case. True, each of these muscles adduct the thight, but some in the group assists in hip flexion while others work more with hip extension. This is a very important key which will direct the approach to rehab and further injury resistance training.
The major culprits in groin pulls often are Pectineus and Adductor Brevis due to their hip flexion components. Think about a hockey player powerfully pushing off from a dead stop. The push off leg will be in extended behind them at about a 45 degree angle with the toe pointed out (see this vulnerable position in the pics below). In anatomical terms we would say this is hip extension, external rotation, and abducted position. What's important about this, is these are the exact opposite actions of the Pectineus and Adductor Brevis, so in this position these muscles are fully lengthened in this position and where tissue damage typically occurs.
Regardless of how it occurs, there are some keys to proper recovery.
First, if you have this injury, getting quality soft tissue therapy performed is essential for restoring proper blood flow and health to the tissues. The high groin muscles are often neglected, because let’s face it, it can be an uncomfortable place to treat. If there is one muscle that could get a manual therapist a lawsuit for treating without a thorough conversation preceding treatment, it would be the Pectineus. But that being said, this muscle will heal with haphazard scar tissue repair and won’t function properly without this manual therapy.
Second, a lack of active and passive hip extension and internal rotation will increase your susceptibility to this injury, so it’s important you have a mobility routine that aims at increasing these ranges. This mobility routine should include both a static and dynamic drills, being sure all hip ranges are similar from left to right, as asymmetrical ranges will make you susceptible to injury. My go to prep for loosening up the hips are the two drills described in the video below.
Third, there needs to be strengthening of both the torso rotators and hip flexor complex. For torso rotators I like anti-rotations drills first followed by dynamic drills such as chops and lifts as described in the video below.
The hip flexor complex should be trained at it's end ranges, as this is where the majority of injuries occur. As you will recall, since Pectinius and Adductor Brevis both assist in hip flexion, they can easily get over loaded if the rest of the muscles aren't pulling their weight in the movement chain. The video below covers two drills I use to train this end range strength and mobility. (It's the longest video because this subject requires more explanation due to it)
For injury prevention purposes we will stop here. If this were a rehab discussion there would be more discussion on easing into plyometrics and deceleration drills, so in the interest of time and what little attention span remains after reading this, let me leave you with one last thought.
What's the take away here? Simply resting a groin strain until the pain is gone is not an adequate recovery protocol. Without addressing the important factors described in this blog, you will likely suffer from future ailments, such as hip impingement or hernias, due to the poor hip mechanics adopted by the body during the healing process. Recovery from any injury should never be sit and wait game, it should always be an active process.
Don't Just Mend. Transcend.
For more information on Chiropractic treatment, education on Body Maintenance techniques, or coaching for sustainable exercise programs visit www.ChiroStrength.com or call the office 931-321-1414 to schedule your FREE consultation with Dr. Dunaway.