“An ounce of prevention is worth a pound of cure” is a wise axiom with applications to all areas of life, and it’s especially true when it comes to groin injuries. Injuries to the groin are often the most difficult and frustrating to heal, and afterwards, some athletes become fearful of going all out and never regain their previous competitive level.
When I talk about groin injuries, I’m referring primarily to the adductors. The five major adductor (or groin) muscles are the gracilis, the pectineus, and the adductor longus, brevis and magnus. Their primary function is to pull the leg back to the midline of the body (think “ADDuctor”), but they work with other muscle groups (such as the abductors, hip flexors and hip extensors) to produce coordinated movements.
Rather than spending time on the numerous advances in sports medicine available for treating groin injuries, I’ll focus on five practical tips you can implement today to help prevent groin pulls.
1. Ensure structural balance in your training.
Adductor pulls often occur when there is an imbalance among the adductor muscles or the muscle groups they work with; in such cases the muscles cannot handle the stress of certain athletic movements. For example, if an athlete’s knees buckle inward as they run or land after a jump, this could suggest an imbalance between the adductors and abductors (or perhaps even a weakness in the vastus medialis oblique, a muscle that is essential for helping the kneecap to track properly. In my PICP Level II course, I teach my students numerous static and dynamic tests to determine exactly where these imbalances occur so that, as trainers, they can prescribe the appropriate corrective exercises to resolve them.
2. Perform a variety of exercises for the adductors.
Many fitness writers try to make a name for themselves by pushing just one type of exercise – this is tempting to do because headlines such as “The single best hamstring exercise for athletes!” tend to attract attention. The problem is that the idea is not true. Muscles respond best to a variety of exercises performed at a range of angles and with various types of resistance and tempo prescriptions. In the case of groin pulls, eccentric training is especially important to help athletes safely decelerate the limbs. Do I recommend walking lunges to prevent groin pulls? Sure. I also like 45-degree angle lunges and high step-ups and sumo-style deadlifts. Wide-stance squats (rotating the feet out to up to 50 degrees) are excellent to increase the work of the adductors. To put it another way, when I’m asked what I believe is the best adductor exercise, my answer is, “The one you are not doing!”
3. Avoid treadmills.
Running and skating treadmills can create faulty movement patterns. Because the surface moves underneath the athlete, there is a decrease in hamstring firing. Likewise, EMG-supported research shows that sideboard exercises are not biomechanically specific to skating – sideways sled dragging would be a much better way to train the adductors. Further, training on treadmills confuses the brain, leading to decreases in speed and power and an increased risk of injury.
4. Perform a variety of stretching methods.
Stretching is valuable in helping to ensure optimal range of motion and in reducing muscle tension. What many coaches and athletes don’t realize is that there is a poor correlation between dynamic flexibility and static flexibility, so being able to touch one’s toes does not necessarily mean that an individual will be able to express that same level of hamstring flexibility in a dynamic athletic movement. If adhesions in the muscles are limiting flexibility, I’ve found that the FAT tool (especially when combined with a NO2-increasing cream) is valuable, as is the soft-tissue treatment called Active Release Techniques®. Another great system to help improve joint range of motion is PIMST, or Poliquin Instant Muscle Strengthening Techniques. PIMST uses a myriad of bodywork techniques, including acupressure, that immediately increase flexibility and facilitate fascial release.
5. Use exercise machines sparingly.
Many adductor machines start in the weakest position of the strength curve. To use more weight, the tendency is often to start the motion by jerking the weight, which can cause injury. Further, machines only work the muscles in one fixed movement pattern and often in isolation. As a general rule, athletes should not perform more than 20 percent of their training on machines, and they must pay special attention to performing the exercises smoothly, especially during the first repetition.
Groin injuries account for up to 5 percent of all sports-related injuries, and the rates are much higher for sports such as soccer and hockey. However, if you follow my advice, the odds will be in your favor for having an injury-free athletic career.