You changed direction chasing a ball, or stretched for one, and something pulled high on the inside of your thigh. Sharp enough that you stopped. By the next morning it's sore to bring your legs together, sore getting out of the car, and you're quietly trying to work out whether this is a two-week problem or a two-month one.
Or nothing dramatic happened at all. The inner thigh has just been tightening up for weeks, worse after every game, and it hasn't come good on its own.
Your adductors are a group of muscles running from the pubic bone down the inside of your thigh. Their job is to pull your leg towards the midline and help control it when you're changing direction. A strain means the muscle-tendon unit has been loaded past what it could tolerate, and the adductor longus takes the hit far more often than the rest 1,4.
What it looks like clinically is specific: tenderness over the adductor tendon or where it attaches to the pubic bone, plus groin pain when you squeeze your legs together against resistance 1. In an acute strain the pain comes on suddenly, often badly enough to take you out of the game 11, and swelling and bruising can follow 9.
Grades describe how much damage is there. A "tear" isn't a different injury from a "strain"; it's the same injury further along the spectrum.
| Grade | What's happened 1 | Typical return to full team training 4 |
|---|---|---|
| 1: mild | Pain, with minimal loss of strength or movement | Around 2 to 3 weeks |
| 2: partial tear | Tissue damage that reduces strength, without complete loss of function | Around 2 to 3 weeks |
| 3: complete tear | Complete disruption of the muscle-tendon unit, with loss of muscle function | Around 11 weeks |
Those figures come from male athletes following a supervised, criteria-based programme 4, so treat them as a guide, not a promise. Groin injuries are common in sport generally (in men's club football, groin injuries account for 4% to 19% of all injuries 8), and the single biggest risk factor for any soft-tissue injury is having had one before 3. A previous groin injury roughly doubles the risk of a new one 6.
Groin pain is hard to label. More than 30 different diagnostic terms have been used for it 8, which is why an international group of clinicians agreed on a simpler system: sort groin pain by where it's coming from 8.
| Where it's coming from 8 | What tends to point to it |
|---|---|
| Adductor-related (this page) | Tenderness over the adductor tendon, pain on squeezing the legs together |
| Pubic-related | Pain centred on the pubic bone itself at the front of the pelvis |
| Iliopsoas- or hip-related | Deeper pain, often with hip movement rather than adduction |
| Inguinal-related | Pain around the inguinal canal. A hernia can sit here |
| Other causes | Nerve irritation, pain referred from the lower back or pelvis, and non-musculoskeletal causes such as kidney stones or infection 8,2 |
Two of those overlap with conditions we cover separately. Persistent pain at the front of the pelvis, especially in footballers and runners, is worth reading about as osteitis pubis. Pelvic joint pain during pregnancy is a different thing again: see symphysis pubis dysfunction. If you already know the problem is specifically your inner-thigh muscles, our adductor strain page goes into that group in more detail.
Sorting this out is the first job of an assessment, and for most people it's done by examination rather than a scan 8.
Most groin strains are diagnosed without a scan. The international consensus on groin pain in athletes built its whole system on a thorough history and a physical examination 8. For the adductors, two findings together make the diagnosis: tenderness when the muscles are pressed, and pain when you bring your leg inwards against resistance 8. Your clinician will also ask how it happened and check for swelling, bruising, movement and muscle strength 9.
Sometimes an ultrasound is used to see the damaged area more clearly, and an X-ray can rule out a fracture 9. In the athlete study behind the timeframes on this page, every injury was also graded on MRI 4. That was research, and it isn't what a usual assessment involves.
Massage sits on the "not yet" list in the first 48 to 72 hours under standard Australian first-aid advice 3. Past that window, manual therapy is a reasonable adjunct alongside active rehabilitation, helpful for comfort and movement, never the whole plan.
Useful for discomfort and swelling early on 2,3. Worth knowing that the "no heat, no massage" convention comes from a first-aid guideline last reviewed some years ago, and current practice leans more on getting sensible load back in than on prolonged rest.
A real option, and one to discuss with your pharmacist or GP 2; Well Motion physiotherapists don't prescribe medication.
Occasionally helpful when the diagnosis is unclear 1, but it isn't routine 8. One reason to be cautious: scan findings are common in athletes who have no symptoms at all 8, so a scan finding has to be read next to your history and examination, not instead of them.
Rarely part of the picture for an acute strain. One systematic review of long-standing groin pain in athletes found return to play was no different between surgery and rehabilitation for adductor-related pain, and the studies behind it were poor quality with a high risk of bias 12. Conservative care is first-line, and that's a conversation for a specialist, not a physiotherapist, in any case.
A single-exercise adductor strengthening programme, run three times a week preseason and weekly in season, cut the proportion of players reporting groin problems by 41% in a cluster-randomised trial 5. An earlier and larger trial of a six-exercise programme found a 31% reduction that didn't reach statistical significance 6. And a follow-up study of the successful programme found only 46% of players actually did it as prescribed 7. So: low-cost, worth doing, still not settled, and the weak link is whether you keep it up, not the exercise itself.
A groin strain is worked through on The Well Motion Recovery Path™. How the adductor copes with load decides when you step up a phase. The diary doesn't.
How long it usually takes. For most people recovery is measured in weeks 2. In one cohort of male athletes on a supervised program, grade 1 to 2 strains were back in full team training at a median of 18 days and complete tears at 78 days 4. That is one study of athletes, so read it as a guide.
The strengthening trials are covered above. Here's what else the research says about staying uninjured:
Some groin symptoms aren't a muscle problem at all. Call triple zero (000) or go to an emergency department if 2:
Book a proper assessment with us if:
Most groin strains are none of that. With sensible rehabilitation, recovery is usually measured in weeks 2, though a complete tear can take around three months, and sometimes much longer 4.
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.
In one study of athletes on a supervised, criteria-based programme, grade 1 to 2 injuries were clinically pain-free at a median of 13 days and back to full team training at 18 days; complete tears took a median of 55 days to become pain-free and 78 days to full team training 4. For most people, recovery is measured in weeks 2, and after a complete tear the range ran from five weeks to more than seven months 4. The date matters less than the milestones: returning only after reaching the pain-free criterion was linked to a reinjury rate of 5% rather than 21% 4.
They're the same injury at different severities. A grade 1 strain leaves your function and strength essentially intact; a grade 2 is a partial tear with obvious weakness; a grade 3 is a complete tear with full loss of function 1. The practical difference is time: grades 1 to 2 tend to run about two to three weeks to full training, a complete tear around 11 weeks 4. An examination usually settles which one it is, with a scan reserved for when the diagnosis is genuinely unclear 1.
Often, yes: a grade 1 strain doesn't take your strength away, and a grade 2 leaves you weaker rather than unable 1. Walking usually hurts on push-off, bringing your legs together, or changing direction. Being unable to take weight through the leg is different, and that one is worth getting looked at promptly.
There isn't a single best one, and we'd be wary of any page that names one for an injury nobody has examined. The exercise with the strongest trial evidence behind it is a progressive adductor strengthening exercise, which cut reported groin problems by 41% in one cluster-randomised trial 5, though a larger earlier trial of a fuller programme didn't reach significance 6, and adherence is the real weak point 7. In rehabilitation, the sequence matters more than the exercise: pain-limited isometrics first, then strength and endurance, then control and running 1,4.
There's no good evidence on sleeping position for a groin strain; nothing we could find addresses it. What is supported is general comfort: avoid the positions and movements that provoke the pain, skip tight clothing, and use an ice pack for discomfort or swelling early on 2. Beyond that, whatever lets you sleep is fine.
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 inner-thigh muscles, closely related to a groin strain but specific to the adductor group.
Read more
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