It's been sore high on the inside of your thigh for a while now. Maybe it started with one awkward stretch for a ball, maybe it just crept in over a season. It eases once you're warm, bites again the next morning, and it hurts to squeeze your knees together or swing the leg across your body. You've rested it twice. Both times it came back the week you started training properly again.
That pattern is typical of an adductor strain, and the reason rest keeps failing is simple: the muscles need to be rebuilt, and rest on its own doesn't do that.
Your adductors are a group of muscles that start on the pubic bone and run down the inside of your thigh. They pull your leg inwards and steady it when you plant, kick or change direction. A strain means part of that muscle-tendon unit has been loaded past what it could handle.
Most adductor strains happen where the muscle turns into tendon 1. The usual culprits are changes of direction, kicking, sprinting and jumping, and a previous groin injury is a known risk factor 1. Groin injuries make up around 4 to 19% of all injuries in men's football clubs and 2 to 14% in women's 6.
Physios grade the damage 1:
There's also a second version of this problem that doesn't look like an injury at all: adductor pain that has lingered for months. In the best-known trial of it, athletes had put up with their groin pain for a median of 40 weeks before treatment started 2. That's where a structured program matters most.
Groin pain is messy to label: one review found 33 different diagnostic terms in use 6. An international consensus meeting in Doha in 2014 cut through that by sorting groin pain according to where it's coming from 6:
More than one can be present at once. If you're not sure the adductors are the culprit, our groin strain page is the broader starting point.
An adductor strain is a hands-on diagnosis. Under the international consensus on groin pain in athletes, it takes two findings together: tenderness when the adductors are pressed, and pain when you squeeze against resistance 6. There's a catch. The pain the test produces has to be the pain you came in with, and a merely sore spot doesn't count 6. Before any testing, a clinician asks how it happened and what you've noticed since, then checks for swelling, bruising and muscle strength 4.
Scans take a back seat for a reason. Imaging findings are common in athletes with no symptoms at all, which makes scans a difficult way to diagnose groin pain 6. A clinician also stays alert to other causes, such as a hernia, a stress fracture or a trapped nerve 6.
Why lean on loading? In a randomised trial of 68 athletes with long-standing adductor-related groin pain, 23 of those given active strength and coordination training returned to sport without groin pain, against 4 of those given physiotherapy without active training 2.
We'd be doing you a disservice if we stopped there. A Cochrane review found only two eligible trials, 122 people in total, both at high risk of bias, and concluded the evidence was insufficient to recommend any one conservative treatment 3. The exercise advantage wasn't statistically significant on patients' own overall rating at 16 weeks, or on treatment success at 8 to 12 years 3. The fair summary: active loading is the best-supported first-line approach, but the evidence base is small and people respond differently. That's an argument for an individual assessment, not a program off the internet.
Not in the first few days 4. After that, manual therapy is a reasonable companion to loading. In the second Cochrane trial, a combined approach using heat, manual therapy and stretching did as well as exercise therapy alone, and got athletes back to full sport about 4.5 weeks sooner on average 3. Small trial, but a real one.
Gentle adductor stretching is a standard part of rehab 1. On their own, they fall short: a program built around stretching, electrotherapy and friction massage did worse than exercise therapy at 16 weeks 3.
Rarely needed. Ultrasound can show the damaged area if the diagnosis is unclear, and an X-ray may be used to rule out a fracture 4.
Rarely required for a strain 4.
In a trial of 35 semi-professional Norwegian men's football teams, one exercise (the Copenhagen adduction, done three times a week preseason and once a week in season) cut the risk of reporting groin problems by 41% 5. A prevention study, not a treatment trial, but a good reason to keep the exercise going once you're back.
An adductor strain is worked through The Well Motion Recovery Path™. What moves you up a phase is what the inner thigh can take, not the week count.
How long it usually takes. In a 2023 systematic review, athletes with partial adductor tears returned to play 1 to 7 weeks after injury with physiotherapy. Complete tears averaged 8.9 weeks without surgery and 14.2 weeks with it 11, a choice that rests with a specialist. Those figures come from low-level studies of athletes, so treat them as a guide.
Prevention has been trialled for groin injuries, so this list is firmer than most:
Most adductor strains are straightforward. Get it assessed properly if:
None of that is cause for alarm. It usually just means the right structure hasn't been identified or loaded yet, and that's fixable.
We start by listening: how it began, what makes it worse, and what it's stopping you from doing. Then we examine the area, explain what we find in plain English, and agree a plan with you. Your first visit is 40 minutes at Engadine and 30 minutes at our other clinics.
We see patients at Engadine, Mount Annan, Narellan and Appin, and at home through our mobile physiotherapy service. If you have private health cover, here's how health fund rebates work for physiotherapy.
It depends on the grade (little loss of strength at grade 1, a partial tear with weakness at grade 2, a complete tear at grade 3 1) and on how the rehab is progressed. We couldn't find good-quality research giving reliable timeframes for each grade of adductor strain, so we won't invent one. The bigger risk is leaving it: athletes in one trial had lived with it for a median of 40 weeks before treatment 2. Our groin strain page covers typical timeframes.
A sudden, severe pain in the groin or high on the inside of the thigh that gets worse with activity. Moderate to severe strains can bruise or swell. The spot is tender to press 1.
You lie on your back and squeeze your knees together against resistance 1, and one study found hips at 0° or 45° the best positions to test in 10. Pain on squeezing, together with tenderness over the adductors, is how adductor-related groin pain is identified 6. It's also used to track progress.
It depends on timing. On a fresh strain, don't: healthdirect advises against massage on a mild strain because it can increase swelling 4, whether it's your own hands or someone else's. Once the early phase has settled, gentle stretching 1 and hands-on treatment 3 are options. For pain that keeps coming back, a program built around stretching and massage did worse than exercise therapy in one trial 3.
A ball squeeze is the usual starting point 9, progressing through resistance bands to the Copenhagen adduction exercise, which cut groin problems by 41% in one football trial 5. Where you start depends on your grade and your pain: that's what an assessment sorts out.
Chronic pain at the front of the pelvis, most often in footballers and running athletes, that tends to get worse the longer it's played through.
Read morePregnancy-related pelvic joint pain, caused by increased ligament laxity and load through the pelvis.
Read moreA strain of the adductor muscles that pull the leg inward, common in sports with sudden changes of direction.
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