If you’re anything like me, you’re spending this week glued to social media, keeping track of what’s going on at Worlds (great photos and updates are coming out to daily, thank goodness). When you’re not doing that, you’re probably playing and training for ultimate. As the club season gets started, I’ve had the expected increase in the number of emails from ultimate athletes about nagging injuries and questions about rehab. Next to hamstring injuries, the injuries I get asked about most are those to the groin/adductor area. These injuries are often frustrating because they’re difficult to diagnose, difficult to recover from and difficult to prevent re-injury in a sport like ultimate. Why is that the case, and what can we do to change the odds?
Groin and adductor strains are very common in sports that have a lot of sprinting and change of direction. Sometimes they clear up quickly, in which case you can rock a lot of the info in this article, but it’s important that get a diagnosis if the pain persists! What you think is a groin strain could also be (or develop into) a sports hernia, which you definitely don’t want to mess with. If you’re not sure which you’re experiencing, consult a physician or physical therapist.
Groin and adductor strains happen when excess force is placed on that musculature and there are a few reasons why that might happen in ultimate. Check them out below the diagram.
- changing direction/cutting (especially on uncertain terrain or in late-game when you’re tired)
- lunging to throw (especially with exaggerated foot turn out on your forehand)
- poor pelvic stability (puts excess strain on adductors whenever you shift weight)
- poor hip mobility (something’s gotta move when you lunge/change direction!)
Do you have a groin or adductor strain? Here’s what you can do to get better:
Make sure you stick to this progression when you’re working on this issue during a session:
soft tissue -> mobility/flexibility -> activation -> activity.
In other words, unstick what’s stuck, move the areas involved, turn on the musculature you want to work, and train or play ultimate. If this doesn’t help and you aren’t getting better, go see a medical professional! I can’t say this enough.
Soft Tissue Work
The Voodoo X band can be helpful in unsticking the injured area from tissues surrounding it (here’s a DIY version of the band). Next, do some soft tissue work around the injury site (using a lacrosse ball and foam roller, you can do this movement with your leg up on a table if needed). Once it’s feeling better, you can start working on the site itself as long as it’s not too painful. One of the major causes of re-injury for a groin strain is scar tissue buildup due to a lack of soft tissue work – a lot of people just don’t feel comfortable massaging their groin, much less having a professional do it for them. But if you want to recover well, you’ve got to work the kinks out!
Mobility and Flexibility
Lower body mobility issues can crop up after a few days or weeks of hanging out and inactivity, even if you haven’t had them before. It’s just as important to restore good function with stretching, while getting back into the rhythm of playing. Frog Stretch and Frog Stretch (Groin/Adductor Focus) are great choices here, but make sure you focus on keeping a neutral spine while doing them. That means don’t round your butt underneath as you push back – think about your tailbone reaching behind you. This Standing Hamstring Stretch is also great for the adductor area, especially as you turn to open the hip. Additionally, this Psoas Stretch can help prepare your deeper core muscles to help support your pelvis and trunk.
When an area gets injured, it has a tendency to jump in and try to help whenever you’re moving – it pus the musculature on a kind of high alert. So it’s important to try to get your bigger and more supportive muscles on board before you start asking a lot of your body! Glutes are the most important area to enervate (my favorite exercises are Circle Band and Cook Hip Lift), but some Psoas Strengthening will help a lot as well! And my favorite team warm up for this purpose is the Hip Flexor Trio, since it helps turn on the glutes and the psoas, as well as priming the mid-back to do a lot of the work of throwing.
Let’s break this down into two pieces: warmup and strength and endurance.
The Lunge Matrix is starting exercise I use in all my classes to get functional movement patterns up and running in all three planes of movement (frontal, sagittal and transverse). When you do this one, work hard to keep your pelvis stable and don’t twist or displace your hips in order to get into a deeper lunge. Take it slow and find good depth in the stretch, and never push through pain. The Running Man is my favorite gym warm up (you’ll need a wall). It’s an awesome way to get ready for all staggered and single leg movement you’ll be doing. Again, watch your hips, and make sure you’re feeling it in your glutes!
Strength and Endurance
Emphasizing stable hips and using your glutes and hamstrings more than your inner thighs for balance is key. The Staggered Deadlift is a good way to load up your legs while noticing any differences between the injured and non-injured legs, and the Bench Hip Extension will let you focus on using your glutes instead of your adductors to extend your hip. Once the area at risk is feeling better, start working your adduction and abduction in a functional way with Weighted Lateral Lunges and Crossover Step Ups. If you have access to a slideboard, doing some skating can really help you learn to recruit your outer hip muscles when you’re cutting!
Also, take a look at the Sternum Turn for a simple adjustment you can make in your running and strength movements. It may take the strain off your adductors for good. Seriously!
Once you’re recovered from the initial injury, it’s important to ascertain if there are any movement pattern problems you need to address, otherwise the risk of re-injuring is high! Record yourself performing the 3-Hop Test wearing shorts with a visible waistband, then play it back in slow motion and look for sideways dips or twists in your pelvis when you land. If your pelvis changes position every time you put force into the ground, that means your groin musculature is really getting yanked around when you cut, lunge, and jump. You need to develop better pelvic stability.
The Dowel Twist is a great corrective for pelvic instability, and you can progress to the Loaded Hurdle Step, making sure you watch in the mirror for any settling or hiking up in the hip. Test yourself periodically with single leg hops and bounds (forward, lateral, vertical), watching those hips for deviation. Any other strength movements are great to perform if you have this issue, just make sure you’re prioritizing stable hips, and stop or decrease weight if you feel your adductor engaging too much!
Want to reduce the incidence of these injuries in your players (or yourself) with a couple good warm up moves in practice? I recommend the Frog Stretch, Hip Flexor Trio and Lunge Matrix for this task (all linked earlier), emphasizing neutral spine and stable hips.
You can definitely recover fully from one of these strains, but it also definitely will not happen by itself – you’ve gotta do the work! Good luck, and let me know if you have any questions! :)
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