Exercises To Reduce Pain In Groin While Running

The Doha agreement classifies groin pain into four categories: psosas, adductor, inguinal and pubic related groin pain depending on the location as shown below (Weir et al., 2015). Pain in groin while running is likely caused by one of the above, once we have ruled out more urgent pathologies such as femoral neck stress facture, sacral stress fracture or pain referred from the visceral organs.

Image taken from Weir et al., (2015) pp 5

Most common cause of pain in groin while running

Adductor-related groin pain is the most common classification and is bought on via an acute adductor injury (strain) or through repetitive overuse over a period of time, and it has a high refractory rate with symptoms often lasting a number of months.

It is diagnosed clinically with a combination of pain around the adductor region, pain on palpation of the adductor tubercle region and pain on resisted adductor testing (Weir et al., 2015).

Progressive loading of the region is the current best practise for helping to relieve adductor-related groin pain and building back to running and sport pain free.

Exercise progressions for reducing groin whilst running

Phase 1

Focuses on calming the region down. This must involve a combination of stopping the aggravating activity to break the cycle of exercise-related irritation and inflammation, and light loading activities with isometric or isotonic exercise.

In my experience, I have found isometric exercise to the beneficial in this early stage and it can be progressed easily as seen below. You would look to complete 4-5 sets of 30 second holds 4-5 x weekly.

Phase 2

Once the region is calm and you are pain free at rest and can now load the region with isometric exercise, we would progress onto isotonic exercise. This usually works through Copenhagen exercise progressions.

I am a big advocate of progressive loading and ramping up intensity rather quickly in this phase week-on-week so progressions of 10-12, 6-8, 2-4 reps on a weekly basis to force continual loading of the region works well (provided you have calmed it down!).

In this stage I would look at a graded return to running (flat, concrete or track running... not trails!).

Phase 3

This stage looks at return to sport drills. This focuses on exposing the adductor complex to high rate of force development at varying lengths and positions.

Drills can last anywhere from 5 to 10 minutes and should be done 2 times weekly initially. Starting with non-reactive elements and progressing through to more chaotic drills that bring in decision making under pressure, multiple environmental variables and go-no-go scenarios.

If you want the full videos and exercise progressions, follow the links below to your Instagram channel.

https://www.instagram.com/reel/DeBeRCDIUSb/?utm_source=ig_web_copy_link&stkn=MzRlODBiNWFlZA==

https://www.instagram.com/reel/DeE_PdkMdOk/?utm_source=ig_web_copy_link&stkn=MzRlODBiNWFlZA==

References

Weir, A., Brukner, P., Delahunt, E., Ekstrand, J., Griffin, D., Khan, K. M., ... & Hölmich, P. (2015). Doha agreement meeting on terminology and definitions in groin pain in athletes. British journal of sports medicine, 49(12), 768-774.