How can I recover from a groin injury in one month?

author : AMSSM

comments : 2

From yoga to Crossfit, what strategies can be used to get a groin injury under control for racing?

Member Question from piyushdabomb

"About 4 weeks ago, my groin muscles started really acting up. They would hurt whenever I would run. I was supposed to run the Richmond marathon, but I didn't because of groin muscle pain leading up to the race. I have decided to run the half marathon instead of the full in Singapore because after resting for a couple weeks and trying to run 3 miles, the pain returned. After my race this Sunday, I plan to take a month off to really treat this annoying groin injury.

Here is my plan for the next month: Increase my swimming endurance and do a ton of Hot Yoga.

My questions:

1. Is Hot Yoga the right approach to treat my groin muscle problem? What else can I do (other than rest) to recover and strengthen my groin muscles in a month?
    
2. Are there any 'muscle' x-rays that I can get to look at my groin muscle to see if it's torn or something? I don't see any redness from the outside at all.
   
   
3. Do you recommend aqua running? If I aqua run and then swim, will my swim be impeded by fatigue from aqua running? What if I swim first and then run in the water?
   
   
4. What about cycling? It seems like Cycling also affects my groin muscles. What do I do? Help!
   
   
5. Will Crossfit help?

I've signed up for Ironman Canada and I'm hoping to use this month to build my swimming and flexibility levels."

Answer from Corey Ellis, MD
Member AMSSM

Adductor muscle or groin muscle strains are a common injury, usually seen with sports requiring quick or repetitive lateral movements. Running alone would not normally be considered high risk, but groin injuries can occur. In my experience, groin muscle injuries, similar to hamstring injuries, can be difficult to treat. They are often nagging injuries that take a long time to resolve, especially during training or competition.

Without a history and physical exam, it is difficult to clearly diagnosis the groin pain you are experiencing. Non-sport related injuries such as hernias and referred neurological pain should also be considered. Your groin pain seems to worsen with high impact activities such as running and be less intense with low impact activities such as swimming and aqua running. This would raise some concern for a stress fracture in the hip. I believe it would be prudent to see a sports medicine physician to discuss these possibilities. 

Let’s assume your pain is muscular in origin. My first goal in treatment is to get pain-free with daily activities. This often means brief periods of significant rest and light stretching. Once daily activities are pain-free, I recommend maintaining endurance with non-aggravating activities, increasing intensity of stretching, and introducing strengthening exercises. The progression to higher intensity and longer duration of exercise is the difficult part. Ideally you want to do enough to add strength and endurance, but not enough to re-injure the muscle. You may have occasional setbacks that require some adjustments in your rehab. If you prefer some advice, an experienced physical therapist or athletic trainer may be helpful on daily decisions.

In regard to your specific questions:

1. Hot Yoga would be a reasonable approach to maintaining flexibility. You may need to add a couple stretches specifically for your groin. Also, be careful not to be too aggressive too early with stretches involving your groin or hamstrings.
2. Traditional x-rays mostly visualize bone. An example of a “muscle x-ray” would be an MRI. An MRI visualizes soft tissue such as tendons and muscles as well as bone. I often order an MRI if an injury that I diagnosed is not responding to treatment as I would expect.
3. I feel aqua running and swimming would both be good options to maintain your endurance. Swimming involves more technique work. I would be hesitant to swim second if fatigue affects technique. If it doesn’t hurt your technique, go ahead and follow your normal order.
4. You will likely be able to cycle before you can begin running, but you still need to gradually increase duration and intensity after becoming pain-free with daily activities.
5. My recommendation would depend on the intensity of your particular workout. Generally, core strengthening programs are never a bad idea. With Crossfit, I would have some concern with overdoing it. I would probably start with something less intense and save Crossfit until your groin improves.

Corey Ellis, MD

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date: February 14, 2011