Phase 1: Acute Phase (Pain and Inflammation Control)

Exercise

Instructions

Sets x Reps

Frequency

Rest

Avoid activities that exacerbate pain or discomfort.

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Ice Therapy

Apply an ice pack to the affected area for 15-20 minutes.

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3-4 times a day

Gentle Range of Motion

Perform pain-free range of motion exercises for the hip and groin area, such as gentle leg swings and hip circles.

2-3 sets

1-2 times a day

Phase 2: Isometric Exercises

Exercise

Instructions

Sets x Reps

Frequency

Isometric Adductor Contraction

Lie on your back with your knees bent. Place a ball or pillow between your knees. Squeeze the ball/pillow by contracting your inner thigh muscles without moving your legs. Hold the contraction for 5-10 seconds.

2-3 sets

10 reps

Isometric Abductor Contraction

Lie on your back with your knees bent. Place a ball or pillow between your knees. Push your knees outward, squeezing the ball/pillow using your outer hip muscles. Hold the contraction for 5-10 seconds.

2-3 sets

10 reps

Isometric Hip Flexion

Lie on your back with your legs straight. Lift your affected leg slightly off the ground by contracting your hip flexor muscles. Hold the contraction for 5-10 seconds.

2-3 sets

10 reps

Phase 3: Eccentric Strengthening

Exercise

Instructions

Sets x Reps

Frequency

Eccentric Adductor Slide

Sit on a stability ball or a chair with your feet on the ground and knees bent. Place a small towel or gliding disc under your affected foot. Slide your foot away from your midline, allowing your inner thigh muscles to lengthen. Slowly return to the starting position.

2-3 sets

10 reps

Eccentric Hip Abduction

Lie on your side with your affected leg on top. Lift your top leg as high as possible, then slowly lower it back down, focusing on controlling the movement.

2-3 sets

10 reps

Eccentric Squats

Stand with your feet shoulder-width apart. Slowly lower yourself into a squat position, focusing on controlling the movement and keeping your knees in line with your toes. Push back up to the starting position.

2-3 sets

10 reps

Phase 4: Functional Exercises and Return to Sport

Exercise

Instructions

Sets x Reps

Frequency

Lateral Lunges

Stand with your feet hip-width apart. Step to the side with your affected leg, keeping your toes pointed forward and your knee aligned over your toes. Lower yourself into a lunge position and then push back up to the starting position.

2-3 sets

10 reps

Single-Leg Squats

Stand on your affected leg with the opposite foot lifted off the ground. Slowly lower yourself into a squat position on the standing leg while keeping your knee aligned over your toes. Push back up to the starting position.

2-3 sets

10 reps

Sport-Specific Drills

Gradually incorporate sport-specific movements and drills, such as cutting, dribbling, and passing, into your training routine. Begin with low-intensity and progress as tolerated.

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3-4 times a week

Massage and Mobilizing Protocol:

1. Frog Stretch: Begin in a quadruped position with your hands and knees on the ground. Slowly widen your knees apart, allowing your hips to sink down towards the ground. You should feel a stretch in your groin area. Hold the stretch for 30-60 seconds, focusing on deep breathing and relaxing into the position.

2. Kneeling Groin Mobilization: Kneel on one knee and place the other foot out to the side, creating a 90-degree angle with your leg. Slowly shift your weight forward, allowing your knee to move out over your toes. You should feel a gentle stretch in your groin area. Hold the stretch for 30-60 seconds and repeat on the other side.

3. Adductor Release with Foam Roller: Sit on the ground with your legs extended in front of you. Place a foam roller perpendicular to your body and position one inner thigh on top of the foam roller. Apply pressure with your body weight and roll along the inner thigh, from just above the knee to the groin area. Spend extra time on any tight or tender spots. Perform the release for 1-2 minutes on each leg.

4. Psoas Release with Lacrosse Ball: Lie face down on the ground with a lacrosse ball positioned under your lower abdomen/pelvic area, just to the side of your belly button. Apply pressure with your body weight and move the ball around to release tension in the psoas muscle, which connects the hip to the lower spine. Spend 1-2 minutes on each side.

5. Adductor Massage with Manual Pressure: Sit on the ground with your legs spread out to the sides. Use your hands or fingertips to apply firm pressure along the inner thigh muscles (adductors). Begin at the knee and work your way up towards the groin area, applying pressure to any tight or tender areas. Hold the pressure for 30 seconds to 1 minute and release. Repeat as needed.

6. Hip Flexor Stretch: Kneel on one knee with the other leg forward, creating a lunge position. Tuck your pelvis under and gently lean forward, keeping your torso upright. You should feel a stretch in the front of your hip and groin area. Hold the stretch for 30-60 seconds and repeat on the other side.