Groin prehab / rehab routine?

[Joss Delage]

All,

 

I'm looking for a good routine to rehab my groin. I'm a 43 year old newbie, with a few years of powerlifting behind me. I have injured my groin doing heavy (for me) squats. I'm currently doing high rep / lower weight squats, which seems to help. What hurts is anything that ressembles a piriformis stretch. So for example, just sitting in a chair and folding my left leg high over the right leg is agonizing (so I don't d it...)

 

I'd like to find a good movement-based routine to gently rehab the groin.

 

Thanks,

 

JD

[Andrew Graham]

It's very hard to give a beneficial program without knowing the background of the injury and how long you've had it and what stage you are in with it!

BUT!.....check out elasticsteel stuff on youtube...he has some great mobilisations and strengtheners! And quite frankly everyone can do with these!

https://www.youtube.com/results?search_query=elasticsteel+adductors

[Douglas Wadle]

I'm about your age and have been rehabbing this same injury myself. Is it in the muscle belly, or up higher near the bony attachment on the pelvis? If it's in the muscle belly, it will be much easier to treat. myofascial techniques with rolling, deep massage, contrast therapy (ice/heat, repeat), and the frequent low level strength exercises you mentioned should take care of it. You can also do your own ASTYM massage to the area by greasing it up with some cocoa butter and then using a flat plastic or wood spatula (not sharp!) and scraping the muscle up and down. it should leave some redness, but not be too overly traumatic.

If it's up against the bone it will take much longer to heal due to poor blood supply. Try contrast therapy, ASTYM, and isometric contractions (stick a ball between your legs and pull gentle pressure against it and hold for a period of time. It may be worth seeing a PT, as frequently these patients have their pelvis out of alignment (at the SI joint) and that puts extra strain on the adductor attachment. as it improves try carefully working active strength of those tendons. I use a furniture slider under each foot and use my arms to support my weight on a low chair. let your legs slowly slide to the side in a controlled slow fashion until you're feelilng a good stretch, hold for a few seconds, then use the legs (maybe a little assistance as needed from arms) to pull yourself back upright. this will be very hard at first, but will increase your strength at end range of motion (which works the tendinous attachments better) and your mobility of that area. According to the Cyriax principle, a load at the end ROM works the tendons more, a load in the mid ROM works the muscle more. Gradually increase your ROM as you are able and this should not only improve your flexibility but prehab you against further injury.

[Afiya Zia]

http://www.youtube.com/watch?v=tT1VF2w9tG0

 

also, try doing band isometric hip adductions. Pull the band as close to your midline as possible and squeeze the muscles hard. Hold for 10-60 seconds in prone, supine and upright positions.

[Wesley Tan]

Hey JDelage, I am an Osteopath and treat these kind of issues frequently. 

 

Firstly, if squatting with heavy weight brought on the problem in the first place, why would squatting low weight for high reps be a solution?

 

Stop squatting with weight! There is an issue obviously, somewhere(s) in your anatomy that is causing to much force to concentrate on the problem area, when you squat under load or perform any movement, ideally some forces are absorbed locally and the rest dissapated via myofascial, joint and bony connections to other areas.. The problem is how the parts relate, your lower limb to pelvis, pelvis to spine and ribcage etc. You will have some imbalance between left and right for sure, not easy of course to speculate but an anterior innominate (half pelvis) and shortened adductors, Psoas and quadratus lumbrum are common findings with the hip and lumbar spine being impacted also.

 

Definitely see about getting some professional help, with someone who can asses your overall balance and not just focus on where the pain is (PT's have a tendency to do this in the UK).

 

Take the time to compare left and right sides through the following ranges:

 

Knee hugs lying on your back, one leg at a time. Compare range, look for pinching in the groin ( having short and tight myofascia at the back of the hip can prevent free movement from the hip into flexion and cause pinching at the front) and if the opposite leg rises (sign of short iliopsoas and rectus femoris aka hip flexors)

 

Quad stretches one side per time, sitting one leg out in front with the other knee flexed, foot by bum and knee on floor. Slowly lean back. Compare range and feel each side

 

Kneeling lunge, make sure to PPT (posterior pelvic tilt) look for stretch in pocket area (groin and thigh)

 

Sit in straddle, lean toward each foot slowly. Compare range, adductor stretch, can you even sit straight comfortably? Pay attention to how the sides of your low back feel, one side tighter? Short QL/obliques/lats...

 

Compare hamstrings similarly, stand with right foot 3 feet in front of left and slowly forward bend. Reverse and compare.

 

You already know there is a difference with hip flexion and external rotation. Pay attention to the differences between the sides and slowly work toward lessening those differences. Better done when your hot, post workout, stretching the tighter ranges and sides more than the easier ones.

 

If you haven't purchased F1 already, do so. It will slowly but surely guide you back into balance. Don't rush your recovery either!! Hope that helps, Wes

[Joss Delage]

Thank you all - great info. I have F1, I'll keep working at it and incorporate some of the ideas above.  Thank you again.

[Joss Delage]

Went to a see a chiropractor today; it turns out I have a hip impingement. He'll be working with me on that for the next few weeks. He thinks I should be able to resolve this without surgery. Apparently, I have poor hip and thoracic mobility, partly compensaty by good lower back mobility...

[Alexander Egebak]

Went to a see a chiropractor today; it turns out I have a hip impingement. He'll be working with me on that for the next few weeks. He thinks I should be able to resolve this without surgery. Apparently, I have poor hip and thoracic mobility, partly compensaty by good lower back mobility...

I im in the same boat as you, gotta get those hip flexors loosened up!