Groin Pull

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When a Groin Pull Feel Better? continued... In the meantime, switch to a new activity that won't put too much stress on your groin muscles. For instance, runners could try swimming. Whatever you do, don't rush things. Don't try to return to your old level of physical activity until: y y y You can move your leg on the injured side as freely and as easily as your other leg. The leg on your injured side feels as strong as the leg on the uninjured side. You feel no pain when you walk, jog, sprint, or jump. If you start pushing yourself before your groin pull is healed, you could re-injure yourself. And if you get further groin pulls, they may be harder to treat and take longer to heal. They can even lead to permanent disability. How Can I Prevent Groin Pulls? Given that groin pulls can be painful and debilitating, the best advice is to prevent them. You should: y y y y y Always stretch your leg and groin muscles before physical activity. Wear shoes with good support that fit well. Always increase the intensity of your physical activity slowly -- no more than a 10% increase a week. Stop exercising if you feel pain or tightness in your groin or the inside of your thigh. Do regular strengthening exercises for your thigh muscles, especially if you've had a groin pull before.
Further Reading:

Preventing Exercise Sprains and Strains

There are many things people can do to help lower their risk of sprains and strains: y y y y Avoid exercising or playing sports when tired or in pain. Maintain a healthy, well-balanced diet to keep muscles strong. Maintain a healthy weight. Practice safety measures to help prevent falls (for example, keep stairways, walkways, yards, and driveways free of clutter; anchor scatter rugs; and salt or sand icy patches in the winter). Wear shoes that fit properly. Replace athletic shoes as soon as the tread wears out or the heel wears down on one side. Do stretching exercises daily. Be in proper physical condition to play a sport. Warm up and stretch before participating in any sports or exercise. Wear protective equipment when playing.

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Run on even surfaces. Pain and tenderness in the groin and the inside of the thigh. Pain when you bring your legs together. Pain when you raise your knee. A popping or snapping feeling during the injury, followed by severe pain. Groin pulls are often divided into three degrees of severity:

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1st degree: Pain, but little loss of strength or movement. 2nd degree: Pain and some tissue damage. 3rd degree: Pain, loss of function, and a complete tear of the muscle. To diagnose a groin pull, your doctor will give you a thorough physical exam. Tests like X-rays and MRIs (Magnetic Resonance Imaging) may be needed to rule out other problems. What's the Treatment for a Groin Pull? Happily, a groin pull will usually heal on its own. You just need to give it some time and rest. To speed the healing, you can:

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Ice the inside of your thigh to reduce pain and swelling. Experts recommend doing it for 20-30 minutes every three to four hours for two to three days, or until the pain is gone. Compress your thigh using an elastic bandage or tape. Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs(NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects. So they should be used only occasionally, unless your doctor specifically says otherwise. Practice stretching and strengthening exercises if your doctor recommends them. Most of the time, these conservative treatments will do the trick. But not always. If these techniques still haven't helped after six months, you may want to think about surgery. While surgery may give you relief, it's a last resort. Not everyone can return to their previous level of activity afterwards. So talk over the pros and cons of surgery with your doctor. You should also consider getting a second opinion. When a Groin Pull Feel Better? Everyone wants to know how quickly they can get back in the game after a groin pull -- and how soon the pain will go away. But there's no easy answer. Recovery time depends on how serious your groin pull is. It may take four to six weeks, but that's just a rough estimate. People heal at different rates.

Following a groin strain injury, the adductor muscles are greatly reduced in power and impede walking. To aid the healing process, rest is important. Only small steps should be taken, and twisting the body should be avoided to prevent putting extra strain on the torn muscle fibres. When the muscles are fully healed, normal exercise can be resumed.
y Grade I Groin Strain: Mild discomfort, often no disability. Usually does not limit activity. Grade II Groin Strain: Moderate discomfort, can limit ability to perform activities such as Grade

Hip Flexor (Iliopsoas) Pain Reduction Strategies

Back to Pain Free Body

If youre back to ice sports, cycling, are sitting or driving more, or have been hauling heavy packs, you may be at risk for hip flexor tightness and pain. The biggest and deepest of the hip flexors is the iliopsoas, which begins as one muscle and splits off into two, the psoas major and the iliacus. About 50% of the population also has a psoas minor muscle. Iliopsoas trigger points can cause pain in the most unusual places, including the mid and low back, upper buttocks, hips, groin, abdomen, and pelvic floor. Hip flexor pain can be so debilitating, you may back off from your favourite activities, have a hard time sleeping, and may not be able to stand straight without pain. Tight iliopsoas muscles can also increase scoliosis, misalign the hips, and put compression on the intervertebral disks. There are so many ways to go about releasing these deep muscles that its a shame for anyone to suffer because theyre tight.

Active Stretching. There are a number of good iliopsoas stretches out there, such as the Sphinx and the Psoas Stretches. The Sphinx: Lie on the floor on your belly, place your forearms flat on the floor with the elbows under the shoulders and the forearms on the floor in front. Allow your belly to press into the floor, while also keeping your shoulders pulled down away from your ears. Remain in this gentle stretch for a few minutes at a time. The Psoas Stretch. This one is by Stuart McGill of the book Low Back Disorders: Evidence-based Prevention and Rehabilitation: Stand in a wide stride step, with the right foot back and the left foot forward. The right back foot

must be pointed straight forward and back, heel raised slightly. Bend your left knee forward, keeping your right thigh where it is. Do a pelvic tuck by pulling your belly button towards your spine. Lift your right arm out to the side as if its a raised stop sign, secure your balance, and lean slightly from the waist to the left. You should feel a stretch in the low back and hip area. Hold for 10 to 30 seconds. Passive Stretching. Highly recommended, Egoscues Supine Groin Stretch can take some time at first, but its worth it. Because hip flexors are often tight for a long time, the nervous system sets that tightness as the normal default. With this stretch, youll be coaxing the muscles to release, while at the same time retraining the nervous system to recognize a new, less-tense default. Youll need a chair and a stack of books (or other suitable prop) for this stretch. Egoscues Supine Groin Stretch: Lie on your back on the floor, place your right calf and foot on the chair with the knee at about 90 degrees, arms out to the sides. The left leg lies straight out, with the toe pointed up. Youll need to place the stack of books or other prop on the outside edge of your foot to keep the toe pointed straight up. If it drops out to the side, the stretch wont work. Now all you do is lie there, allowing the tension and tightness in the back and hips to release. At first you may have to do this up to 45 minutes, until your body learns how to release. Once learned, youll find 5 or 10 minutes will often do the trick. Dont forget to do both sides. This and other great body release and alignment stretches can be found in Pete Egoscues bookPain Free: A Revolutionary Method for Stopping Chronic Pain. Positioning. If you sit a lot or sleep with your legs pulled up to your torso, your psoas muscles are spending a lot of time in a shortened position. When you stand and lengthen them, youll have issues. Try to reduce the amount of time you spend in these positions. But if its an inevitability, balance with the stretching exercises above. An interesting note about the sleep positions. Sometimes people sleep on their bellies with one leg pulled up towards their torsos. This creates shortness in one posas, compared to the other, which can lead to unbalanced and torqued pelvic positioning.

Trigger Point Release. When youre in a lot of pain, trigger point release of those naughty muscle knots can bring you fast relief. I highly recommend Clair Davies The Trigger Point Therapy Workbook, an excellent how-to guide that explains iliopsoas self-massage in depth. Pick up a copy of this book and familiarize yourself with the psoas method before giving it a try. When doing the trigger point self-massage, Davies says, You will recognize the exquisite tenderness of trigger points in the psoas when you touch it. When theyre bad, even light massage can be nearly

unbearable, but dont let the discomfort make you quit. Trigger points in psoas muscles must be dealt with and direct massage is the most effective way to handle them.
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Some Cautions: Its important not to put pressure on those deep blood vessels, so if you feel a pulse shift your finger position. Be cautious about working the psoas higher than the belly button to avoid putting pressure on the kidney ureters. Normal massage contraindications apply.

Soft Tissue Release (STR) or Active Release Technique (ART). STR was developed just before or around the same time as ART. The two techniques are very similar. The idea is to do tissue release while the muscle in question is moving through its full range of motion from flexed to extended (shortened to lengthened). STR and ART help release restricted and adhesed muscle tissue (including trigger points), in a very effective way that can prove more successful than trigger point release alone when done correctly. You can go to an STR or ART therapist to have the expert work on you, which is a good idea to get a handle on the process. To do it yourself, check out the YouTube Vid above. Acupuncture. Its actually quite amazing how well acupuncture can work for psoas pain and spasm. Many physios, chiropractors, and physicians are trained in Acupuncture, which is geared towards musculoskeletal issues. Physiotherapy/Physical Therapy. Make an appointment with your local physiotherapist to find out if you have any muscle imbalances, gait issues, or posture or joint problems that are leading to your psoas issues. They can set you up with a treatment program that progresses as you do. Even if youve suffered for years, youll be amazed at how effective these hip flexors strategies can be. And with less tightness and pain you can get back to doing what you love. Related Articles Excruciating Back Pain (not of disk or psoas origin) Groin and Low Back Pain - Iliopsoas the Hidden Prankster Breathe Deeply to Reduce Pain Reduce Sport Pain Exercise, Massage, and New Activity Cautions

Modified Thomas test: Pt supine, with hip joints at end of table (legs hanging off table). Pt pulls knee to chest, if other leg flexes at hip (i.e. if can t remain hanging in slightly extended position, c/w iliopsoas tightness, contracture

does not limit activity.

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Grade II Groin Strain: Moderate discomfort, can limit ability to perform activities such as running and jumping. May have moderate swelling and bruising associated. GrGrade I Groin Strain: Mild discomfort, often no disability. Usually does not limit activity. Grade II Groin Strain: Moderate discomfort, can limit ability to perform activities such as running and jumping. May have moderate swelling and bruising associated. Grade III Groin Strain: Severe injury that can cause pain with walking. Often people complain of muscle spasm, swelling, and significant bruising. KT tape application is an appropriate use for Grade I and II groin strains. Seek professional medical evaluation for grade III strains and use KT Tape as part of a larger treatment plan ade III Groin Strain: Severe injury that can cause pain with walking. Often people complain of muscle spasm, swelling, and significant bruising. KT tape application is an appropriate use for Grade I and II groin strains. Seek professional medical evaluation for grade III strains and use KT Tape as part of a larger treatment plan running and jumping. May have moderate swelling and bruising associated. Grade III Groin Strain: Severe injury that can cause pain with walking. Often people complain of muscle spasm, swelling, and significant bruising. KT tape application is an appropriate use for Grade I and II groin strains. Seek professional medical evalGrade I Groin Strain: Mild discomfort, often no disability. Usually does not limit activity. Grade II Groin Strain: Moderate discomfort, can limit ability to perform activities such as running and jumping. May have moderate swelling and bruising associated. Grade III Groin Strain: Severe injury that can cause pain with walking. Often people complain of muscle spasm, swelling, and significant bruising. KT tape application is an appropriate use for Grade I and II groin strains. Seek professional medical evaluation for grade III strains and use KT Tape as part of a larger treatment plan uation for grade III strains and use KT Tape as part of a larger treatment plan

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