Adductor Strain (Groin Strain): Evidence-Based Recovery, Rehabilitation, and Return to Sport

By Mark Jamantoc, PT, OCS, FDM-IC

Pulled Your Groin? Here's What You Need to Know About Adductor Strains

If you've ever felt a sudden sharp pain in your inner thigh while sprinting, cutting, kicking a soccer ball, skating, or changing direction, there's a good chance you've injured your adductor muscles, commonly called a groin strain.

At Praxis Physical Therapy, we work with runners, soccer players, rugby athletes, hockey players, CrossFit athletes, baseball players, and active adults recovering from adductor injuries. The good news?

Most groin strains recover very well with the right rehabilitation program.

The key is treating the injury correctly from the beginning instead of simply resting until the pain goes away.

What Is an Adductor Strain?

The adductor muscles are a group of muscles located along the inside of your thigh.

Their job is to:

• Pull the leg inward

• Stabilize the pelvis

• Generate force during sprinting

• Assist with cutting and changing direction

• Produce power during kicking

Among these muscles, the adductor longus is by far the most commonly injured.

How Common Are Groin Strains?

Adductor injuries are one of the most frequent muscle injuries in sports.

Research has shown:

• Approximately 11% of all sports injuries involve the hip or groin.

• About 6% of all athletic injuries are adductor strains.

• In professional soccer, groin injuries account for nearly one-quarter of all muscle injuries.

• NCAA football reports adductor strains as the most common hip injury.

At Praxis, we commonly see these injuries in:

• Soccer

• Rugby

• Hockey

• Baseball

• Football

• CrossFit

• Distance runners

• Pickleball athletes

What Causes an Adductor Strain?

Most adductor strains occur during explosive movements such as:

• Sprinting

• Cutting

• Sudden acceleration

• Deceleration

• Kicking

• Changing direction

• 

  
  

These movements require the adductors to absorb high forces while rapidly lengthening.

The injury often feels like:

• A sharp pull

• Sudden pain

• A tearing sensation

• Immediate difficulty sprinting or pushing off

Risk Factors

Some risk factors cannot be changed, including:

• Previous groin injury

• Male athletes

• Increasing age

Others can be improved through training:

• Weak adductor muscles

• Poor hip strength balance

• Reduced hip mobility

• Sudden increases in training volume

• Inadequate strength training

This is exactly why strengthening—not just stretching—is such an important part of rehabilitation.

Signs You May Have an Adductor Strain

Common symptoms include:

• Pain in the groin or inner thigh

• Pain when squeezing your knees together

• Pain while sprinting

• Pain with cutting or changing direction

• Tenderness along the inner thigh

• Pain when stretching the adductors

Severe injuries may also include bruising or a palpable defect.

How We Diagnose Groin Strains at Praxis

A thorough physical examination is often more valuable than immediately ordering an MRI.

Our evaluation includes:

History: Understanding exactly how the injury occurred.

Movement Assessment: Watching how you squat, lunge, run, and move.

Strength Testing: Evaluating:

• Hip adduction

• Hip abduction

• Core strength

• Single-leg stability

Provocation Tests: Evidence supports using a combination of:

• Resisted adduction testing

• Squeeze tests

• Passive stretching

These tests can accurately identify many adductor injuries without advanced imaging.

Do You Need an MRI?

Not always.

While MRI remains the gold standard for imaging, research suggests that a detailed clinical examination explains much of an athlete's recovery timeline, with MRI providing only modest additional information in many cases.

Imaging may be appropriate if:

• A complete tear is suspected

• Symptoms are severe

• Recovery is slower than expected

• Surgery is being considered

How Long Does Recovery Take?

Recovery depends on injury severity.

Grade I

Minor strain

Approximately 1–2 weeks

Grade II

Partial tear

Typically 3–7 weeks

Grade III

Complete tear

Often 8–14 weeks, depending on whether surgery is required.

Remember:

Healing times are averages.

Returning too early significantly increases the risk of reinjury.

Evidence-Based Rehabilitation

One of the biggest misconceptions is that groin strains simply need rest.

In reality:

Active rehabilitation consistently outperforms passive treatment.

Research has shown that supervised exercise programs lead to faster and more successful return-to-sport outcomes than passive approaches.

At Praxis, rehabilitation progresses through carefully planned phases.

Phase 1: Calm Things Down

Goals:

• Reduce pain

• Restore motion

• Begin gentle muscle activation

Typical exercises include:

• Pain-free adductor isometrics

• Bridges

• Core stability work

• Controlled squats

• Step-ups

Pain is monitored carefully rather than avoided entirely.

Phase 2: Build Strength

As symptoms improve, we begin restoring true strength.

Exercises may include:

• Cable adduction

• Split squats

• Reverse lunges

• Single-leg bridges

• Deadlifts

• Dynamic core exercises

Load is increased gradually while monitoring symptoms.

Phase 3: Return to Performance

This stage prepares athletes for sport—not just daily life.

Training often includes:

• Sprint progressions

• Cutting drills

• Direction changes

• Sport-specific movement

• Heavy resistance training

• Power development

The goal is confidence under game-speed conditions.

The Copenhagen Adductor Exercise

One of the most researched exercises for groin injury prevention is the Copenhagen Adductor Exercise.

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Research demonstrates improvements in:

• Adductor strength

• Hip stability

• Muscle size

• Flexibility

Teams using structured Copenhagen training programs have reported meaningful reductions in groin injuries over a season.

At Praxis, we modify this exercise to match each athlete's current capacity before progressing to more demanding variations.

Returning to Sport Safely

Pain-free movement alone is not enough.

Before returning to full sport, we look for:

• Full range of motion

• Restored adductor strength

• Sprint tolerance

• Cutting without symptoms

• Sport-specific skill progression

• Confidence during competition

This is where objective testing becomes valuable.

For competitive athletes, Praxis also utilizes VALD ForceDecks and VALD Dynamo strength testing to objectively measure lower extremity strength and performance when appropriate, helping guide return-to-sport decisions rather than relying on pain alone.

Why Athletes Choose Praxis

At Praxis Physical Therapy, we combine:

• One-on-one 60-minute treatment sessions

• Evidence-based rehabilitation

• Sports-specific strength programming

• Fascial Distortion Model (FDM) manual therapy when appropriate

• Individualized exercise prescription

• Return-to-sport testing

• Performance-focused rehabilitation

Whether you're trying to get back to soccer, rugby, CrossFit, hockey, baseball, running, or simply enjoying an active lifestyle, our goal is to help you return stronger and reduce your risk of future injury.

When Should You See a Physical Therapist?

Don't wait if you have:

• Groin pain that limits walking or running

• Pain with sprinting or cutting

• Recurrent groin injuries

• Pain that isn't improving after several days

• Difficulty returning to your sport

Early evaluation often leads to a faster recovery and reduces the risk of long-term problems.

Ready to Get Back to Sport?

If you're dealing with groin pain or an adductor strain, we're here to help.

Praxis Physical TherapyBellingham, Washington

Our evidence-based rehabilitation programs are designed to help athletes recover efficiently, rebuild confidence, and return to the activities they love.

Schedule your evaluation today and let's get you moving again.