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Groin
Strain - A 5 Phase Management Plan
The
following is a very thorough and detailed management plan for
the full recovery and rehabilitation of a groin strain. As mentioned
earlier, it's taken directly from "Modern Principles of
Athletic Training" by Daniel D. Arnheim.
Considering
this management plan was written over ten years ago, my only
addition would be the reduction of ice therapy and the addition
of massage and heat therapy during the 2nd, 3rd, and 4th phase.
Regardless of my suggestions, the following will be extremely
useful for anyone who is, or has suffered from a groin strain.
Groin
Strain Situation:
A women varsity basketball player had a history of tightness
in her groin. During a game she suddenly rotated her trunk while
also stretching to the right side. There was a sudden sharp
pain and a sense of "giving way" in the left side
of the groin that caused the athlete to immediately stop play
and limp to the sidelines.
Groin
Strain - Symptoms & Signs:
As the athlete described it to the athletic trainer, there was
severe pain when rotating her trunk to the right and flexing
her left hip. Inspection revealed the following:
There
was major point tenderness in the groin, especially in the region
of the adductor magnus muscle.
There
was no pain during passive movement of the hip, but severe pain
did occur during both active and resistive motion.
When
the groin and hip were tested for injury, the hip joint, illiopsoas,
and rectus femoris muscles were ruled out as having been injured;
however, when the athlete adducted the hip from a stretch position,
it caused here extreme discomfort.
Groin
Strain Management Plan
Based on the athletic trainer's inspection, with findings confirmed
by the physician, it was determined that the athlete had sustained
a second-degree strain of the groin, particularly to the adductor
magnus muscle.
Phase
1
Management
Phase
Goals: To control haemorrhage, pain and spasms.
Estimated Length of Time (ELT): 2 to 3 days.
Therapy
Immediate Care: ICE-R (20 min) intermittently, six to eight
times daily. The athlete wears a 6-inch elastic hip spica.
Exercise Rehabilitation
No Exercise - as complete rest as possible.
Phase
2
Management
Phase
Goals: To reduce pain, spasm and restore full ability to contract
without stretching the muscle.
ELT: 4 to 6 days.
Therapy
Follow up care: Ice massage (1 min) three to four times daily.
Bipolar muscle stimulation above and below pain site (7 min).
Exercise
Rehabilitation
PNF for hip rehabilitation three to four times daily (beginning
approx. 6 days after injury)
Optional: Jogging in chest level water (10 to 20 min) one or
two times daily. Must be done within pain free limits.
General
body maintenance exercises are conducted three times a week
as long as they do not aggravate the injury.
Phase
3
Management
Phase
Goals: To reduce inflammation and return strength and flexibility.
Therapy
Muscle stimulation using the surge current at 7 or 8, depending
on athlete's tolerance, together with ultrasound once daily
and cold therapy in the form of ice massage or ice packs (7
min) followed by light exercise, two to three times daily.
Exercise Rehabilitation
PNF hip patterns two to three times daily following cold applications,
progressing to progressive-resistance exercise using pulley,
isokinetic, or free weight (10 reps, 3 sets) once daily.
Optional: Flutter kick swimming once daily.
General body maintenance exercises are conducted three times
a week as long as they do not aggravate the injury.
Phase
4
Management
Phase
Goals: To restore full power, endurance, speed and extensibility.
Therapy
If symptom free, precede exercise with ice massage (7 min) or
ice pack.
Exercise Rehabilitation
Added to phase 3 program, jogging on flat course slowly progressing
to a 3-mile run once daily and then progressing to figure-8s,
starting with obstacles 10 feet apart and gradually shortening
distance to 5 feet, at full speed.
Phase
5
Management
Phase
Goals: To return to sport competition.
Exercise Rehabilitation
Athlete gradually returns to pre-cmpetition exercise and a gradual
return to competition while wearing a figure-8 elastic hip spica
bandage for protection.
Criteria
for Returning to Competitive Basketball:
As
measured by an isokinetic dynamometer, the athlete's injured
hip should have equal strength to that of the uninjured hip.
Hip
has full range of motion.
The
athlete is able to run figure-8s around obstacles set 5 feet
apart at full speed.
For
A Guide for the Treatment & Prevention of Groin Injury Click
Here
Article
by Brad Walker. Brad is a leading stretching and sports
injury
consultant with over 15 years experience in the health and
fitness industry. For more articles on the prevention & treatment
of sports injury, subscribe to The Stretching & Sports
Injury Newsletter by visiting http://www.thestretchinghandbook.com
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