What a groin strain is
The adductors are a group of muscles running from the pubic bone down the inner thigh. They pull the leg toward the midline and steady the pelvis every time you plant a foot, cut or strike a ball. Adductor longus takes the highest load and is the one injured in most cases.
An acute strain happens in one moment: a sharp pain high on the inner thigh during a kick, a stretch for the ball or a change of direction. Walking and getting out of a car hurt for the first few days.
Long-standing groin pain is the other pattern. An ache near the pubic bone that warms up during a game, is worse afterwards and stiff the next morning. It builds over weeks in footballers, hockey players and runners, and it often follows an acute strain that was played on.
Several other structures share the area: the hip flexor, the lower abdominal attachment, the pubic joint and the hip joint itself. Sorting out which one is the source is the main job of the assessment, because the treatment differs.
What causes it
The adductor tears when it has to brake a fast-moving leg at length, as in the wind-up of a kick or a wide lunge, with more force than it is conditioned for. The long-standing version comes from weeks of that load exceeding recovery.
The strongest risk factor is a previous groin injury. Low adductor strength comes next, and it is trainable.
Sport is behind most of it at working age. In UK clinic records we analysed for adults under 40 with hip and groin pain, about four in five named a sport or training as the trigger.
Risk factors
- A previous groin injury
- Adductors that are weak relative to the muscles on the outside of the hip
- Sports with kicking, skating or repeated cutting: football, futsal, hockey, rugby
- A sudden rise in matches or training, such as pre-season or a winter five-a-side league on top of gym work
- Reduced hip rotation
- Playing on with a mild strain
The adductor squeeze test is the most useful single check. Lying on your back with knees bent, squeeze a fist or a ball between your knees as hard as you can for five seconds and score the groin pain out of 10. A score of 0 to 2 is a green light for full training. A score of 3 to 5 means modify: train, with sprinting, kicking and cutting reduced. A score of 6 or more means stop and rehab. Used weekly through a season, it catches the problem a fortnight before it stops you.
What the evidence says
For long-standing adductor-related groin pain, active strengthening beats passive treatment by a wide margin. In the trial that set the standard, 79 per cent of athletes on an 8 to 12 week exercise programme returned to sport at their previous level without pain, against 14 per cent of those given passive treatment such as massage, stretching and electrotherapy.
The Copenhagen adduction exercise builds eccentric adductor strength quickly. A programme using it reduced the prevalence of groin problems in male footballers by 41 per cent across a season.
Acute adductor strains do well with early, graded loading. Most athletes with mild and moderate injuries return within two to four weeks when rehab is criteria-based.
Clinical examination identifies the source of groin pain reliably in most cases. Imaging is useful when the pattern is unclear or progress stalls.
Rest alone has poor results for long-standing groin pain. Symptoms settle, then return within days of resuming sport.
Recovery timeline
Mild acute strains take one to three weeks and moderate ones four to eight. A complete tear, or one where the tendon has pulled from the bone, takes three months or more.
Long-standing groin pain needs 8 to 12 weeks of structured loading, and often longer for a full return to match play. Progress is steady when the programme is followed three times a week.
| Stage | ✓ Do this | ✗ Avoid this |
|---|---|---|
| Days 1–5 | Walk normally. Start gentle adductor squeezes against a ball at a pain level of 3 out of 10 or under. Bike for fitness. | Stretching the groin hard, or testing it with a kick |
| Weeks 1–3 | Side-lying leg lifts, banded adduction, then short-lever Copenhagen holds. Straight-line running when the squeeze test scores 2 or under. | Cutting, kicking and sprinting before straight-line running is comfortable |
| Weeks 3–8 | Full Copenhagen adductions, lateral lunges, then cutting drills and passing, building to shooting and sprints. | Jumping from the gym straight into a match |
| Return to play | A full week of normal training first, with a squeeze test at 0 to 2 the morning after. Keep Copenhagens in twice a week. | Stopping the strength work once the season restarts |
How we treat it at Kingsway
Rehabbing a groin strain
The first session locates the source of the pain, measures adductor strength against the other side, and sets the criteria for each stage back to sport.
- Palpation and resisted tests to separate adductor, hip flexor, abdominal and hip joint sources
- Squeeze testing with a pain score, recorded as your baseline
- Hip range and strength testing, compared side to side
- Soft tissue work through the adductors, hip flexors and glutes to ease guarding
- A loading programme that builds toward the Copenhagen adduction exercise
- A staged return plan: straight-line running, then cutting, then kicking, with a test at each step
An acute strain usually needs three to five sessions. Long-standing groin pain is closer to six to ten across 8 to 12 weeks, with most of the work done by you between appointments. Where the pattern points to the hip joint or a hernia, you are referred to your GP or a sports doctor.
When to get it checked
Book an assessment if a groin strain has not improved after two weeks, if the pain has returned more than once this season, or if you have an ache that warms up and then punishes you the day after. Get seen promptly for groin pain with a lump, with clicking or locking in the hip, or with pain on every step.
See a doctor or go to A&E if
- A lump or bulge in the groin, especially one that appears on coughing or straining
- Pain or swelling in a testicle
- Groin pain on every step that is getting worse in a runner, which can indicate a stress fracture in the hip
- A pop with immediate bruising spreading down the inner thigh
- Locking, catching or giving way in the hip
- Groin pain with fever, or with burning or blood on passing urine
Common questions
How long does a groin strain take to heal?
A mild strain takes one to three weeks and a moderate one four to eight. Long-standing groin pain takes 8 to 12 weeks of structured strengthening.
Use the squeeze test as your guide. A score of 2 or under out of 10 the morning after full training means you are ready.
Should I stretch a groin strain?
Leave firm stretching alone for the first week. Gentle movement inside a comfortable range is fine.
Strength is what resolves a groin strain. Range returns as the muscle tolerates load again.
Can I keep playing with groin pain?
With a squeeze test of 0 to 2, yes. At 3 to 5, train with sprinting, kicking and cutting reduced and start strengthening that week. At 6 or more, stop and rehab.
Playing through a moderate score for weeks is the usual route to a problem that lasts the whole season.
What is the Copenhagen exercise?
A side plank with the top leg supported on a bench or held by a partner, so the adductors of that leg hold your body weight. You lower and raise the bottom leg, or simply hold.
Start with the knee on the bench for 10-second holds. Build to the ankle on the bench for 3 sets of 8 to 12, twice a week.