Adductor Strain

A sharp pain in the groin when changing direction. This sudden sensation often signals a pulled adductor muscle, a common injury among soccer, hockey, and football players.

Adductor injuries account for 23% of muscle injuries in professional soccer players. The good news is that with the right treatment, most strains heal completely within 4 to 8 weeks.

This guide explains how to recognize an adductor strain, understand its severity, and heal properly.

What is an adductor strain?

An adductor strain partially or completely tears the muscle fibers in the inner thigh. This injury occurs during a violent contraction or excessive stretching of the groin muscles.

The adductors form a group of five muscles:

The adductor longus accounts for 62% of groin injuries in athletes. The musculotendinous junction near the pubis is the most vulnerable area.

Common synonyms: groin muscle tear, adductor strain, groin myofascial injury.

What causes adductor muscle strain?

A muscle strain occurs during an explosive contraction or sudden stretching. Risky movements include changes of direction, side kicks, sprints, and forced lunges.

The main mechanism involves eccentric contraction: the muscle contracts while lengthening. The adductors undergo this tension during changes of direction and cross kicks.

Typical injury situations:

• Quick changes of direction during sports (soccer, hockey, basketball)
• Side kick or cross kick in soccer
• Acceleration in sprints, especially during explosive starts
• Forced gap when the leg slips or gets stuck
• Falling with legs apart, especially during collisions

Sports activities cause 85% of adductor strains. Soccer presents the highest risk, with 8 to 18% of players suffering groin injuries each season.

Who is at risk of suffering an adductor strain?

Athletes who play sports involving rapid changes of direction are most at risk.

High-risk sports: soccer, ice hockey, football, basketball, tennis, and figure skating.

An adductor/abductor strength ratio of less than 80% increases the risk of injury fourfold. A preventive strengthening program reduces this risk by 41%.

How can you recognize the symptoms of a strained adductor muscle?

The main symptom: sudden, sharp pain in the groin or inner thigh, often described as a stabbing pain. A bruise may appear within 24 to 72 hours.

Typical signs:

• Sudden, localized pain in the groin at the time of injury
• Popping or tearing sensation in the groin
• Difficulty walking, especially with long strides
• Pain during specific movements: getting into the car, lifting the leg, squeezing the thighs
• Swelling and bruising on the inner thigh (appears within 24-72 hours)
• Tender spot near the groin or along the inner thigh

The pain often radiates toward the inside of the knee. It increases when squeezing the thighs together or lifting the leg to the side.

Important point: Pain that has developed gradually without a specific moment of injury probably indicates another condition, such as pubalgia or adductor tendinopathy.

What are the different degrees of severity of a muscle strain?

Clinicians classify muscle strains into three grades according to severity:

The majority of adductor strains (70-80%) are grade 1 or 2 and respond well to conservative treatment.

How does a physical therapist diagnose a strained adductor muscle?

The diagnosis is based on the history of the injury and clinical examination. The physical therapist assesses the mechanism of injury, locates the pain by palpation, and tests the strength of the adductors.

The evaluation includes:

• The story: precise mechanism of injury, sensation at the time, progression of symptoms
• Physical examination: palpation of the groin and inner thigh, observation of gait
• Strength tests: squeezing the thighs together against resistance (Copenhagen test)
• Stretch tests: pain when passively moving the leg apart

Clinical diagnosis is sufficient in the vast majority of cases. Ultrasound or MRI are only used for severe, atypical cases or those that do not progress as expected.

At Physioactif, our physical therapists accurately assess the severity of your injury in order to develop a treatment plan tailored to your specific situation.

When to consult a physiotherapist for an adductor strain?

Consult a physical therapist if you have the symptoms described above. You do not need to see a doctor before consulting a physical therapist.

Consult within 48-72 hours if:

• Sudden groin pain during sports
• Difficulty walking normally
• Visible bruise on the inner thigh

Seek emergency medical attention if:

• Severe pain with complete inability to walk
• Visible deformity in the groin area
• Associated urinary or testicular symptoms (could indicate a hernia)

Early consultation allows the diagnosis to be confirmed, other conditions to be ruled out, and rehabilitation to begin at the right time.

How to treat a strained adductor muscle?

Treatment follows the PEACE and LOVE protocol: initial protection followed by gradual reintroduction of load. Inflammation is part of the normal healing process.

Acute phase (0-72 hours): PEACE

Recovery phase: LOVE

Key principles: On the second day, begin light contractions if the pain remains below 4/10 and decreases within 30 minutes after exercise.

What is rehabilitation in physical therapy?

Your physical therapist will develop a multi-phase rehabilitation program to optimize healing and prevent relapse.

Phase 1: Protection and mobility (days 1-7)

• Walk with small steps, without limping if possible.
• Light isometric contractions of the adductors
• Gentle hip mobility within pain-free ranges of motion

Phase 2: Gradual strengthening (weeks 2-4)

• Isometric and then concentric strengthening exercises
• Modified Copenhagen Program (strengthening the adductors)
• Work to stabilize the pelvis and core
• Stationary bike, swimming

Phase 3: Functional return (weeks 4–8+)

• Eccentric adductor exercises
• Progressive straight-line race
• Low-speed steering changes
• Exercises specific to the sport practiced

Phase 4: Return to sports

• Functional tests: strength, speed, agility
• Complete training without restrictions
• Relapse prevention through maintenance programs

The Copenhagen program reduces adductor injuries by 41% in soccer players. Your physical therapist will teach you these exercises.

What to do at home for an adductor strain?

First days (48-72 hours)

• Walk with small steps to avoid straining your groin.
• Use compression shorts or an elastic bandage.
• Apply ice for 15-20 minutes several times a day if it provides relief.
• Avoid movements that reproduce the pain.

After 72 hours

Gentle contractions: Squeeze a pillow between your knees for 5-10 seconds, 10 repetitions, 2-3 times a day. The pain should remain below 4/10. Pain-free cardio: stationary bike or swimming to maintain physical fitness and promote blood circulation. Progression criteria: Increase the intensity if the pain subsides within 30 minutes after exercise and you can repeat the same exercise the next day. Consult if: no improvement after 10 days, or if the pain increases despite rest.

How long does it take for an adductor strain to heal?

The recurrence rate for adductor injuries reaches 18-32% if rehabilitation remains incomplete. A supervised gradual return significantly reduces this risk.

How can we prevent repeat offenses?

Prevention is based on specific strengthening and adequate warm-up.

Effective prevention program:

• Strengthening the adductors: Copenhagen exercises 2-3 times per week
• Muscular balance: maintain an adductor/abductor ratio greater than 80%.
• Dynamic warm-up: progressive movements before each sporting activity
• Load management: gradual increase in training intensity

The Copenhagen program, performed twice a week during the season, reduces adductor injuries by 41%.

Key points to remember

• Adductor strain causes sudden pain in the groin during explosive movement.
• Most muscle strains (grades 1-2) heal within 1 to 8 weeks with proper treatment.
• Complete rest does not speed up recovery. Gradual and controlled exercise promotes better recovery.
• Preventive strengthening significantly reduces the risk of injury and recurrence.
• Consult a physical therapist for an accurate diagnosis and a tailored program.

References

• Werner J, Hagglund M, Walden M, Ekstrand J. UEFA injury study: a prospective study of hip and groin injuries in professional soccer over seven consecutive seasons. Br J Sports Med. 2009;43(13):1036-1040.
• Serner A, et al. Study of acute groin injuries in male soccer players. Br J Sports Med. 2015;49(18):1165-1171.
• Tyler TF, Silvers HJ, Gerhardt MB, Nicholas SJ. Groin injuries in sports medicine. Sports Health. 2010;2(3):231-236.
• Hagglund M, Walden M, Ekstrand J. Risk factors for lower extremity muscle injury in professional soccer. American Journal of Sports Medicine. 2013;41(2):327-335.
• Kiel J, Kaiser K. Adductor Strain. StatPearls Publishing. 2023.
• Harøy J, et al. The Adductor Strengthening Program prevents groin problems among male soccer players. Br J Sports Med. 2019;53(3):150-157.
• Serner A, et al. Characteristics of acute groin injuries in the adductor muscles. Knee Surg Sports Traumatol Arthrosc. 2020;28(12):3808-3819.
• Thorborg K, et al. Clinical examination, diagnostic imaging, and testing of athletes with groin pain. J Orthop Sports Phys Ther. 2018;48(4):239-249.