How To Rehab An Adductor Strain

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Stretching, rest, and core strengthening exercise is not the answer for adductor strains. Unfortunately, this is the most common advice given to people trying to recover from groin strains. 

In this article, I’m going to go through the exact strategies that I take people through to improve their adductor symptoms and get them back to lifting, running, cycling, and other sports. 

I’ll also include a bit about my own rehabilitation when I injured my adductor back in physical therapy school. 

Table of contents:

• What are the best exercise progressions for an adductor strain?
• How do I know if I’m pushing too hard or not hard enough? How do I know how to progress?
• How long will it take to improve my symptoms?
• Can I exercise with an adductor strain?
• Should you stretch an adductor strain?

What are the best exercise progressions for an adductor strain?

Before we get into exercise progression first, I want to make sure you understand whether to know if you are pushing too hard or not hard enough. 

Pain levels. We want to make sure that one hour after an exercise session and 24 hours after that your symptoms have stayed at a tolerable level. This usually means between a 0 to 4 on the pain scale. 

If after 24 hours, your symptoms are beyond a 4, this means that you likely pushed too hard and for the next exercise session you should modify your workout further. Modifications, as discussed in this article about deadlifting and back pain. 

Modifications, briefly, include:

• Altering tempo of the exercise. Slowing down the movement significantly, to as slow as 8 seconds up and 8 seconds down. 
• Changing the intensity (weight)
• Reducing volume (how many sets and reps you are completing)
• Reducing frequency (giving yourself more time between workouts of the same muscle group)

Now that we have the information solidified, let’s get into the exercises. 

I like to show what the ultimate goal of a successful outcome is, and then work our way backward. 

So, in that spirit, I’m going to show you the exercises that are MOST challenging, first, to give you an idea of what you should be doing once you’re feeling a lot better. 

1. Single leg skier jumps
   1. These are great plyometric exercises as you are really challenging the adductors to propel yourself off the ground, side to side. 
2. Full Copenhagen planks
   1. These are now very popular as preventative exercises with soccer players as when practiced at least 2x/week, they significantly reduce the risk of adductor injuries. 
   2. E3 Rehab has a great video on this that you can watch, here. 
3. Running, cycling, sprinting.
   1. Generally, once you can do the single-leg skier jumps, other jumping variations, and full Copenhagens, you should be able to tolerate your normal activity/sport at the very least in a reduced intensity. 

Alright, so now that I’ve shown you what the goal exercise abilities are, let’s go into the first exercises you should be trialing. 

Disclaimer: If you try these and are not making any progress over the course of 2-4 weeks, please contact a professional to help you. If you specifically want help from me and my team, you can contact me at [email protected].

For each of these movements, we want to use the process of elimination to make sure that you are not doing too many or too little of each movement. 

Day 1-7

1. Sidelying adductor leg raises (every other day)- start by doing these for 3 sets of 10, track your symptoms over the next 24 hours and check-in to see if they are the same better or worse. Once these get easier you can even add resistance bands to them to increase the challenge.
2. Abdominal crunch (every other day) (sometimes there is abdominal pain in addition to adductor pain, indicating a potential diagnosis of athletic pubalgia.). I include abdominal work into the mix just in case there is some abdominal contribution.
3. My recommendation is to work your abs and adductors to a point of light exhaustion and/or burning. This keeps the intensity low to start with.

Day 7 – 14

4. Modified Copenhagen side plank (every other day)- this one is going to be a lot more challenging and will vary from person to person. Try to hold from 10-30 seconds. Complete this 3 times on each side. 
5. Adductor machine (every other day) – if you have access to this machine, this is great because you can easily change the weight. Complete these exercises slow and controlled with lighter weight to start with. Start with 3 sets of 10 reps. Number of reps and sets and change over the course of rehab. 
   • IF you do not have access to an adductor machine you can also do standing resisted adduction with a resistance band (amazon link) or with a cable column machine at the gym with ankle attachment.

Day 14 – 21

6. Split squats (every other day)
   1. Also, three sets of 10 on each side of these. Start with bodyweight, see how that feels, and as symptoms permit, increase weight and range motion as described below. 
   2. As these feel better, working through a larger range of motion by elevating your front and back leg off the ground by standing on books, or two short step stools would be the next progression. 

Day 21 – 28

By the end of week three or four, you should have a pretty good idea of how your body responds to these different exercises. 

My recommendation at this point is to select the two or three exercises that you can do, that don’t flare symptoms up past a tolerable level and then focus on those for the next 2-4 weeks, progressing weight, sets and reps. 

It’s impossible to give a specific time frame without asking follow-up questions to you, so if you need help with that, just shoot me an email to [email protected].

How long will it take for my symptoms to improve?

From what I’ve seen in the clinic, it can range anywhere from two weeks to 3 months to start to see improvement. If you are trying to get back to high-level sports that are explosive in nature I would wager to expect a longer time frame of 6 months or more. 

Of course, this is impossible to predict as each person is different and each strain is different (more severe or less severe). 

The thing that will absolutely increase how long you’re dealing with this is only doing stretching, ice, and rest. This won’t solve the problem and will just frustrate you further, so, please don’t do that. 

I’ve written another article about how long to expect healing to take that you can check out here.

Can I exercise with an adductor strain?

Yes. As discussed above, it’s perfectly fine, and actually encouraged to exercise with an adductor strain. 

Returning to your normal activities as soon as possible is recommended, granted you do not experience symptoms beyond 0 to 4 on the pain scale 24 hours after your activity. 

If you’re a lifter, hiker, cycling, hockey player, soccer player, or something else, it’s fine to participate in those activities as long as you adhere to the above guidelines. You likely won’t be able to cut and go all out though, which likely limits return to competition for the time being. 

Should you stretch an adductor strain?

It depends. There’s likely nothing wrong with including a groin stretch into the mix as long as it does not irritate symptoms. Ultimately every exercise, stretch, or activity selection is determined by how your body responds, i.e. your symptoms after activity. 

As an anecdote, most people I have worked with do not benefit from stretching and often times irritate symptoms further. Or, it feels good for about 15 minutes and then goes back to how it normally feels. 

I find that when my clients actually do a warm-up and strength training type exercises that it ends up feeling better, which, is aligned with the research in terms of tendon and muscle rehabilitation. I’d highly recommend this video by Dr. Jill Cook, a prolific tendinopathy researcher.

In Summary

• Pay attention to your symptoms during, one hour after, and 24 hours after exercise and activity. If it’s beyond the acceptable range of zero to four on the pain scale, you’ll likely want to modify your exercse as described above or in this article.

• A full recovery can take anywhere from 2 weeks to 6+ months depending on the severity of the strain, consistency, and iteration of a rehab plan,  and personal factors (genetics, etc.)

• Strength training and return to modified activity is a better approach than stretching, rest, and ice. 

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