Groin Strain (Pulled Groin): Symptoms and Recovery

01Anatomy

The groin muscles

The adductors (adductor longus, brevis and magnus, gracilis and pectineus) run from the pubic bone down the inner thigh. They pull the legs together and stabilise the pelvis during running and kicking. The adductor longus is the muscle most commonly strained. Together with the hip flexors and abdominal muscles, the adductors form the “groin” region, where several conditions can cause similar pain.

02Symptoms

Symptoms

• Sudden pain in the groin or inner thigh, sometimes with a pulling sensation.
• Pain on squeezing the legs together, lifting the leg sideways, sprinting, kicking or changing direction.
• Tenderness, swelling and bruising on the inner thigh.
• Stiffness, weakness and difficulty walking quickly.
• Pain on stretching the inner thigh (for example the splits).

03Grades

Grades and recovery time

• Grade 1: mild, a few fibres; walking is comfortable; 2–4 weeks.
• Grade 2: partial tear; pain with walking, swelling and bruising; 4–8 weeks.
• Grade 3: complete tear or avulsion from the bone; severe pain, bruising and loss of function; 3 months or more, with surgery sometimes considered.
• Chronic or recurrent groin pain in athletes can last months if not properly rehabilitated.

04Causes

Causes and risk factors

• Sudden changes of direction, sprinting or kicking, common in football, hockey, rugby, skating and tennis.
• Overstretching, as in a slip or a tackle.
• Previous groin injury, the strongest risk factor.
• Weak adductors compared with abductors; poor core and hip control.
• Fatigue, inadequate warm-up and sudden increases in training.
• Reduced hip mobility.

05Other causes

When groin pain is not a strain

• Hip joint problems: femoroacetabular impingement, labral tears and osteoarthritis.
• Inguinal hernia or sports hernia (athletic pubalgia).
• Osteitis pubis or stress injury of the pubic bone.
• Stress fracture of the femoral neck or pelvis in runners.
• Nerve entrapment, lower back and urological or gynaecological conditions.
• In children and teenagers: hip conditions such as slipped capital femoral epiphysis, requiring prompt assessment.
• See also hip flexor strain.

06First days

First days: what to do

• Reduce activities that provoke pain (sprinting, kicking, sideways movements) for a few days.
• Walk with a shorter stride, and avoid wide steps and rapid direction changes.
• Use paracetamol for pain; avoid early anti-inflammatories and heat.
• Apply light compression, such as compression shorts, and elevate if swelling is present.
• Begin gentle pain-free adductor contractions (squeezing a pillow between the knees) after 2–3 days.

07Rehab

Rehabilitation exercises

• Phase 1: isometric adductor squeeze (ball or pillow between the knees, hold 5–10 seconds, 10 times), glute bridges.
• Phase 2: side-lying hip adduction 3 × 10–12, standing resistance-band adduction, lateral band walks, hip hinge and squats.
• Phase 3: Copenhagen plank (short lever first), cable or band adduction, lateral lunges, single-leg exercises.
• Phase 4: running, accelerations, side shuffles, kicking and cutting drills.
• Progress as pain allows (3/10 or less) and ensure strength of adductors is at least 80–90% of the other side before full sport.
• Include core and hip abductor strengthening.

08Return

Return to sport

Return when pain-free in daily life, with squeeze test strength near normal, and able to run, change direction, kick and train without pain, ideally after completing a full progressive programme. Mild strains often take 2–4 weeks, moderate 6–8. Chronic cases need longer, structured rehabilitation. Returning too soon leads to persistent groin problems and re-injury.

09Prevent

Prevention

• The Copenhagen adduction exercise performed regularly reduces groin injuries in team sport athletes.
• Warm up properly with dynamic hip movements.
• Build training load gradually.
• Maintain hip mobility and core stability.
• Treat early niggles instead of playing through pain.

11Cases

Three common situations

A footballer feels a pull in the groin during a sprint: reduce load, early isometrics and a progressive programme.

A runner with deep groin ache and clicking: consider a hip joint cause; see a clinician.

An athlete with groin pain that keeps returning: structured rehabilitation including Copenhagen exercises and load management.

12Load

Managing training load while you recover

Complete rest is rarely needed. Cycle, swim with a flutter kick or train the upper body while the groin recovers, and reintroduce running in straight lines before cutting and kicking. Keep a simple log of pain during and after exercise: if pain rises above 3/10 or is worse the next morning, drop back a step. Gradual, patient progression is the best insurance against chronic groin pain.

13Summary

Key points to remember

Groin strains respond to a short period of protection followed by structured strengthening. Distinguish them from hip and hernia problems if pain persists, avoid rushing back and include preventive adductor exercises. Our physical therapy team can assess and treat groin pain.

This guide is for general information and does not replace an assessment by your own doctor or physical therapist.