Groin Injury Prevention and Rehab

The following post is one that I originally wrote for the Mega Goaltending blog on different ways to keep your groin muscles healthy. However, skaters can take the same advice from this blog, as goalie is not the only position that is prone to groin injuries. Hockey players, in general, have a higher risk of sustaining a groin injury than other sports simply because of the lateral forces required in a skating stride. With hockey season in full swing, and some leagues quickly nearing the halfway point, I thought this would be a timely post for everyone. After reading, take a few minutes and devise a plan to keep your groins healthy.

The muscles of the groin are a goalie’s best friends. They allow a goalie to snap down into a butterfly, close up the five-hole, and are pretty much involved in every movement a goalie makes. However, just like best friends, they can be a thorn in a goalie’s side. Groins are strong and powerful, yes, but they are often overused and become injured as a result. Taking care of the groin muscles is an important part of a goalie’s rehab and training regimen.

The groins are a group of muscles on the inner thigh. They consist of five muscles (adductor brevis, adductor longus, adductor magnus, gracilis, pectinius) whose primary job is to adduct the leg, meaning bring the leg closer to the midrange of the body. Like most muscles in the body, the groin muscles serve a secondary purpose as well. These actions include hip flexion and extension, internal and external rotation of the thigh, and even flexion of the knee. This long list of secondary actions causes the groin muscles to be constantly innervated during lower body exercise.

The constant use of the groin muscles during any lateral or up/down movement is going to fatigue the groin quicker than a forward/back movement. Then there is the dynamic nature of the movements a goalie must make. Quick, aggressive lateral movements, both standing or kneeling, are going to utilize the groin in a stabilizing role. The primary movers of a lateral movement are the hip abductors (located on the outside of the hip), which are responsible for pushing the goalie from side to side. During a quick lateral push, the groin muscles must stabilize the thigh from rotation, as well as control the push through controlled lengthening, otherwise known as an eccentric contraction. This eccentric contraction requires a much higher force production than the concentric contraction (the “pushing”) and thus the chance of injury is much greater during an eccentric contraction. Taking into account these demands of the groin muscles and it’s easy to see why groin injuries are prevalent in goalies.

Rehabbing and performing general maintenance on the hip region is important to keep the groin muscles healthy and lower the chance of injury. Proper groin rehab is a multi-faceted approach that involves the groin muscles as well as the surrounding musculature of the hip (abductors, flexors, extensors). Most importantly, the groin muscles must be strong enough to endure the high force values asked of them during competition. Groin strengthening exercises such as the Groin Ball Squeeze, the Band Hip Adduction, and the Bench Hip Adduction train the groin in their primary concentric movement. Additionally, the Band Hip Adduction and Bench Hip Adduction can, and should, be trained in an eccentric motion as well. To avoid any strength imbalances, the hip abductors should also be trained. The Triangle Terror, Band Hip Abduction, Bench Hip Abduction, Quad Out Hip Lift, and Clamshell are all good exercises to train the hip abductors.

Groin smashApart from being strong, the groin muscles need to be flexible as well. Regular mobilization exercises are important in maintaining normal resting length of the groin muscles. The mobilization exercises can be mild stretches such as a Wide Knee Child’s Pose, or a Frog Pose, or they can be more aggressive like the Band Supported Splits. Working to mobilize the hip flexors through the Couch Stretch, or the glutes and abductors through a Pigeon pose or Elevated Pigeon will also aid in mobilizing the groins.

Finally, proper tissue care is imperative for proper functioning of the groin muscles. Tissue care refers to working through the muscle tissue through different massaging modalities, and ensuring proper activation of the musculature. Foam rolling the groins with a traditional foam roller is a good start to keeping them healthy. Sometimes a more invasive approach, such as utilizing a barbell and weight plates, is needed to work the tissues with enough force to cause a change in the deeper or stiffer muscles. Applying these techniques to the hip abductors, flexors and extensors is also important to reduce the strain on the groin muscles. Making sure the surrounding musculature is activating correctly is also needed to reduce the stress on the groin muscles. If the muscles around the hip do not activate when needed, the load on the groin muscles increases, as they must pick up the slack of the non-functioning muscles. Activation exercises for the hip abductors, flexors, and extensors, such as the Cook Hip Lift, Quad Out Hip Lift, Hip Flexor Band Pull and the Clamshell will help to keep the hip muscles firing and reduce the load on the groin muscles.

Goalies need to be aware of their groin muscles, and apply these techniques as needed to their training program. Doing so will decrease a goalie’s chance of injury and help keep them out on the ice.

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