Hip and Core Strength Prevent Groin Pain

An overly bold statement?

Not in light of experimental and “in the trenches” experience.  Research has shown that adductor (groin) strains result from a strength imbalance between the hip adductors and hip abductors (or the muscles that pull the leg toward the midline vs those that pull it away from the midline).  There is also research to support a lack of core strength relative to adductor strength as a risk factor for sports hernias, which can also be a source of groin pain.  How do you avoid these issues?  

Create a balanced muscular strength and endurance profile around the hip and core. 

Adequate range of motion is a piece of the puzzle, but ensuring balanced muscular strength and endurance across the hip and core musculature is paramount to preventing groin pain.  

If you think back to the analysis we went over a couple weeks ago, you should have some information on specific muscular weaknesses and imbalances.  The training to help alleviate these problems isn’t overly complex.

Core Stability

If your athlete has insufficient front plank endurance, add 3 sets of front planks to their training.  A progression might look like:

  1. Sets: I generally keep sets constant at 3, sometimes 4.
  2. Time: Start with 3-4 sets of 20s holds.  Progress your athlete to 30s holds, then 45 s holds.
  3. Exercise Complexity: Start with standard front planks.  Progress to single-leg holds, then marches (alternating which foot is on the ground in a controlled manner).
  4. Exercise Selection: Keep planks as part of a warm-up, but progress to more advanced linear core training exercises such as bar rollouts or bar rollout iso-holds.

Side planks would follow a similar progression.  The only difference is if you notice a side to side imbalance during the screening.  In this case, you’d want your athlete to perform their first set on their “good” side, then have them perform 3-4 sets on the other side.  Remember, if you add a balanced training program to an unbalanced athlete, you get an increasingly unbalanced athlete.  The key is to CREATE balance, but catering to your athletes needs.  If they have a lagging side, a program with 1 set on the good side and 3-4 sets on the lagging side will usually help create the balance that will keep them healthy.

Hip Strength

A lack of hip external rotation strength and hip abduction strength can be addressed using:

  1. Side-lying hip abduction w/ external rotation holds
  2. Glute Bridge with MiniBand (Shoulder width stance, hips abducted)
  3. Glute Bridge with MiniBand (Narrow hip width stance, hips externally rotated)
  4. Lateral MiniBand Walk
  5. Backward Monster Walk
  6. 1-Arm 1-Leg DB Stiff-Legged Deadlift (DB in hand opposite to foot on ground)
  7. All single-leg exercises

As mentioned above, if your athlete is noticeably weaker on one side, do NOT train both sides equally.  Have them do 1 set on their good side, and 3-4 sets on their weaker side.  Since some of the above exercises are bilateral by nature, an imbalance will dictate which exercises you include and which you don’t.  Or at least make sure you include one exercise that addresses the imbalance and any others to reinforce the strength bilaterally.

As for hip flexor and adductor strength, thing can get a little more complex there.  Luckily, I’ve already written in depth on this issue.  Rather than regurgitate everything I’ve already written, go ahead and check out my articles at SBCoachesCollege.com.  Part I has a lot of the hip mobility exercises I talked about last week, so it might be a good review.  Part II has the hip flexor and adductor strengthening exercises and progressions that are more relevant to this weeks topic.  I have to give Mike Boyle, Brijesh Patel, and Shirley Sahrmann most of the credit for the ideas and exercises that went into these articles and into my hip-specific analyses and programming.  They came up with most of this stuff, I just found a way to plug it all together into a system that works well for me.  Hopefully it’ll makes sense to you and you’ll have success implementing it with your athletes.

Keep working hard.

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