By Carl Valle
Groin injuries are ugly injuries, mainly because they are difficult to manage and require a lot of attention to detail to reduce and fix a tear if it does happen. I am seeing more and more injuries to adductors now, and much of it is due to lack of recovery time after a long season and, ironically, too much work on trying to prevent injuries causing the process to backfire. In my earlier article on groin injuries, I covered mistakes in approaches. Now I will get into the weeds and share actual changes to a training program that make a difference.I see more injuries to adductors now—due to short recovery times and injury prevention backfiring. Click To Tweet
While this article includes an exercise list, I made sure I wrote enough on the whys so it’s not just a video channel and some casual technique advice. Many mistakes in training come from including the wrong exercises at the wrong time, as well as general progressions and loading errors. Finally, I include a few exercises that I shared in past articles and expand on their use.
How Groin Muscle Groups Are Different Than Hamstring Muscles
SimpliFaster is a massive resource for information, and if you need to find the right exercises for developing specific muscles, several articles include electromyography charts and data. While EMG is important, selecting exercises and training protocols isn’t just about mean and peak outputs. Additionally, the groin isn’t like the hamstring group, as the muscles around the hip are different than the three hamstring muscles that wrap the posterior thigh. The adductor magnus does share duties for hip extension, but it’s unique enough to be treated as a hip adductor due to training and rehabilitation design.Adductor training relies on the patient, gradual, and controlled progression of the athlete. Click To Tweet
You can use many of the principles of training and rehabilitation with adductor training, as they are pretty much universal, but the key difference is patiently progressing. It’s not that we should treat the adductor system as something that is fragile, but many athletes are either simply not experienced with the exercises or injured when they first try them. Like any new exercise, anything foreign will feel strange and sometimes recruitment will not be as “clean,” meaning ideal for that movement. Another factor to consider is that many athletes who are prone to tightness in the adductor area will not respond to self-massage as well as they will to strength training, but only if it’s gradual and controlled.
What I Don’t Consider Groin Injury
As I mentioned earlier, the groin is a little on the congested side anatomically, meaning a lot of muscles and other tissues surround a small piece of real estate on the body. Due to the muscle attachments, the pelvis is more complicated than the knee flexors and hip extensors. I prefer not to include the hip socket, or acetabulum, as a groin injury.Lower ab & quad muscle injuries are medically part of the groin area, but need a different approach. Click To Tweet
Technically, the hip flexor, hip joint, lower abdominals, and adductor muscle all count as the groin, but most mechanisms that cause issues to the labrum are unique enough to place them into a different category for practical training and rehabilitation purposes. Usually, avoiding contraindicated options and clinical reasoning is the right path for handling joint issues, but I think of a groin injury as involving anything that attaches to the femur and is a strong contributor to adduction. Lower abdominal and quadriceps muscle injuries are part of the groin region medically, but from a coaching perspective, they involve a different strategic approach.
If the athlete has issues with the labrum, tendons of the rectus femoris or iliopsoas, or a less commonly injured muscle like the sartorius or gracilis, then this article isn’t a good fit. Those issues deserve a much different plan of action, as they are very specific and require expertise that I simply don’t have. I have had a few athletes come to me with labral issues that seem to resolve with managed workloads and good training, but flare up when they run out of capacity to handle stress to the system, such as inflammation patterns or extreme fatigue.
Coordination – Why Hip Flexion Dissociation Is Essential and Powerful
Finally, movements that are natural patterns of adductor silence or high activity of muscles that are flexors or extensors of the hip should be considered part of a comprehensive training program. My primary question with Shirley Sahrmann’s work on movement impairments is that, while I loved most of the biomechanical theories at first glance, much of what she shared was not clinically strong enough for me to put much stock into her methodology after doing my homework. What I soon saw as her seminal work took off was a gluttonous gorging on corrective exercises that simply didn’t do much but unload an athlete from overtraining. Neurologically, I saw the logic, but the mechanisms and causation for change did not make an airtight case for keeping her suggestions in my program.
Too many corrective exercises usually lead to problems with athlete dependence and nocebos, and fail to expose athletes to ballistic work that is necessary to handle sporting actions. Low load movements are teaching opportunities, not solutions to remodel tissue or prepare the neuromuscular system for stresses seen in etiological activities. Still, some home therapy has value, so throwing away all mobility and corrective work is just as bad as overdosing on it, but minimalism is the goal.
Biomechanically, every athlete has slightly different recruitment strategies due to expressions of motion, anatomical influences, and development history. Some noted scientists questioned ideal models of locomotion and sporting action, but I have yet to see those same critics of conventional biomechanics share alternative concepts that are repeatable outside of an editorial-style article. If you notice a theme for the exercises below, it is that all but one is on the feet and include flexing or hinge patterns at the hip joint.Removing all mobility and corrective work is as bad as overdosing on it; minimalism is the goal. Click To Tweet
A few dissections show that while muscles act like individual notes in concert with each other in movement, sometimes tissues are connected indirectly from fascia and other biomaterials. I am not saying that Anatomy Trains is a valid roadmap, but lower abdominal injuries usually occur from tissues that are simply contracted and I believe this is from poor coordination and major weakness. I have included some of the exercises because they may—and I repeat, may—improve lengthening of the fascicles of the adductors. Eccentric lengthening under load may help with coordination from a tissue perspective, even if the muscle is not firing differently.
The Exercises – Key Movements to Consider
Based on the research and common training programming of leading coaches, the exercises below will likely be a good fit for your program. Even if the exercises don’t make sense at first glance, think big picture of how they help solve the entire program, not just EMG readings or if an athlete feels the burn. Most of the exercises do get high EMG readings, but some of the patterns are more about improving the capacity of the groin in multiple planes and load vectors.
Mach and Pasienta Drills
Most coaches will be familiar with the drills from Gerard Mach, as nearly every conventional track and field program does marching drills during the warm-up. Some coaches will know the rationale behind the drills, as they had ulterior motives besides teaching fundamental movements—they were great winter conditioning drills to prepare for outdoor track when facilities and warm weather training camp were limited.
The 1950s and 1960s were a different era, and at that time getting the job done in elite sport meant finding a way or making one. Implementing Mach drills with purpose and focus works, but only if you stay vigilant and don’t let technique become an example of going through the motions. Sometimes I program different drills that have little carryover or use to preserve the value of Mach’s exercises.
The French coach Jacques Pasienta is less known, but I recommended his book last year and hope readers picked it up. With his foundation in physical education, Pasienta’s expansive exercise list can drown an experienced coach, but his options include jumping and ballistic motions that are just challenging enough to help with groin strength without chancing injury.
Some of his options may be too risky, so I recommend experimenting cautiously. Remember that most drills are there to prepare for the physical demands of landing, recovering, and propulsive actions in sprinting. Even if the drills are great conditioning and teaching options, actual running and sprinting are needed to prepare the thigh.
Heavy Romanian Deadlifts
At first glance, I thought EMG readings would be similar for the use of a single leg versus bilateral, but there is enough of a difference to leave the single leg options for those that simply want variation with a purpose. On paper, a single-leg-supported Romanian deadlift (RDL) would have higher readings because the adductor would act as a stabilizer in addition to other duties, but my own EMG findings show that theory isn’t true. Several coaches swear by the value of single leg options, but from secondhand EMG readings it seems a difference exists between bilateral and unilateral deadlifting.
While I see a case for abduction recruitment with single leg training, the step-up and single leg squats are enough for me not to worry, and sprinting and plyos are enough to cover the bases as well. Everyone that talks about single leg training seems to be stuck in the view of the weight room and speaks through the barbell hole of a bumper plate.
We need more research on the adductor system in weight training to see how RDLs help or hinder it. Click To Tweet
Another reason I don’t do too many single leg RDLs is that fatigue of the low back needs to be considered, as well as time constraints. If I do three sets of heavy RDLs and use typical rest periods, it’s far more efficient than doing six sets to ensure both legs are trained with the same approximate load. While a fresh leg might be ready to go after the other leg is completed, the lower back is still used and needs a break. Pat Davidson has a modified version of the RDL that I am experimenting with, but it will take me a year before I know anything worth sharing.
Single leg training has a lot of value, but due to sports already getting enough stimulation, it’s redundant to make the weight room functional by trying to replicate what is visible. Sometimes the EMG readings can be surprising, and it’s up to coaches to find the truth even if the research is not available. If you want to do single leg RDLs, think about using a flywheel system as Shane did when he did a great job reviewing how and when to do this movement.
I don’t know if the team at Queensland University of Technology is doing anything innovative or progressive with the adductor system, as they are hamstring researchers. Some consider the adductor magnus the “fourth hamstring” as hip extension is connected to that muscle, but I view them as part of the system for recovery and stance support in sprinting. I don’t think training them will make an average athlete into a great one, but RDLs tend to empirically result in a lot of muscle soreness during the first few sessions. We need a lot more research on the adductor system in weight training to know how they help or how they may hinder development of this system.
Hurdle mobility may be the perfect solution for many athletes who need to get out of the comfort zone of the weight room and add some rhythm into their program. My biggest complaint is that the competition track hurdle is either too low or too high for athletes. Hurdles tend to be too tall to step over without excessive compensation, or too low to go under without cheating with spinal flexion.
If done with PVC hurdles, classic hurdle mobility with Physiclo pants is just the right challenge to the hip flexors without the complaints of insertion discomfort or pinching sensations we tend to see with band or cable flexion exercises. Going under the hurdle laterally is a great mobility and general preparation exercise, as it’s like a deep lateral squat. I love using weight vests or sand bags with this movement.Hurdle mobility may be a perfect solution for athletes needing to add some rhythm to their program. Click To Tweet
Challenging hurdles can be creative without placing “randomness without reason.” Coaches can add small loads to the equation so the athlete needs to stay alert, like using a sandbag or medicine ball so the movements are more hip-driven. Tempo or speed of the movements can be challenged, such as going very slow or very fast, or a combination of the two.
Athletes can work the concentric or eccentric tension, but keep in mind that this will not create any fascicle lengthening. Aggressive eccentrics to adductors or hip flexors will not come from hurdle mobility routines. Soccer athletes and running backs tend to do poorly with hurdle mobility; hence the reason I make them do hurdle exercises until mobility is polished.
Heavy and High Step-Ups
An entire article on step-ups was popular a year ago, but if I wrote it again I would share the value of groin muscle recruitment. About a year later, high step-ups with heavy loads have made a difference for those with prior adductor injuries. I believe the exercise is successful because it teaches the athlete to load the support leg aggressively, and doing so concentrically challenges the adductor system. Lateral step-ups are okay if you have a very wide box, as are fine exercises during most stages of training or rehab, but the athlete needs to be aware of each and not fall asleep.High step-ups with heavy loads make a difference for those with prior adductor injuries. Click To Tweet
There is not much concrete EMG research (or impressive readings) on adductors with step-ups, but I am not looking for maximal recruitment—I am looking for intelligent coordinated recruitment under heavy load. I can do isolation band work and other exercises such as machines or even high-rep ThighMaster work, but sometimes middle-ground exercises are options that give the adductors a bit of a break. Going too heavy on single leg training can overload stabilizers that need rest, especially during the competitive season.
As I mentioned in the step-up article, eccentric lowering is where most of the opportunities are lost with this great single leg exercise. Lowering with control and a complete range of motion is challenging and sometimes bruises the ego, but the step-up is worth including as it’s between a dissociation exercise and a high recruitment movement. Again, the step-up and other exercises are not targets to increase adductor usage; they’re just a way to recruit lightly to balance training.
Copenhagen Adduction Exercise
Kristian Thorborg does great work in the area of athlete injuries, and the groin is his specialty. Like the Nordic hamstring exercise, the Copenhagen adduction exercise (CAE) has its fair share of critics because it’s simple and isolates the muscle group. Fortunately, the research shows it has great value, and an athlete can do it without equipment if they have a partner, or with very little equipment if they do it solo.
I think progressing to the exercise is necessary, even for those with a great background in adductor strength. Very few exercises have similar carryover to the Copenhagen adduction exercise, unlike the Nordic hamstring exercise. With Nordics, athletes can use heavy Romanian deadlifts and back hypers and have some general hamstring strength, but the CAE is a rare breed and athletes don’t do much that can replace it. It’s the only exercise I have used that I feel a little uncomfortable with, as it’s not something with related exercises.
After a few weeks progressing to options that are similar to the CAE, one or two sets of four to five reps is enough to get comfortable with the exercise without getting too sore. Some athletes use ankle weights, but that’s not necessary if you rely on a wide range of exercises to prepare the body.
Bionic Resistance Slide Board
Slide board training is a great option for many athletes, but you first need to find out if the athlete has a history of sports hernias and poor tissue quality. I know evaluating muscle status is tricky, but SimpliFaster created an entire buyer’s guide just to explain the options in quantifying the transient patterns of muscle and other tissues.
If an athlete is over-recruiting the area to protect it, the use of a slide board may, ironically, be an overdose. I prefer that athletes prone to pulls don’t avoid slide boards, but only use them when linear sprinting is sufficient and the area has calmed down. Those with a lot of external rotation of the femur during running tend to use adductors too much with flexion of the hip, but again, this an observation and not true with every athlete. If an athlete lacks deceleration and lateral movement proficiency, I put them on the slide board and do a lot of power work. Sometimes I will use a slide board for conditioning, but now I think it’s more of a strength tool.
Video 1. Several companies now provide smooth resistance for slide board work, and I like the adduction and abduction recruitment and stretching of this exercise for athletes. Not only is it great for strength, it can reinforce movements that are useful for other exercises.
This space will grow in the future and evolve past just accommodating resistance and oversized elastic bands. Due to the deep lateral squatting pattern and range of motion of the push-off leg, I really like slide boards for all field sport athletes, but only use them if athletes are ready for them. Due to the rise in applied research in the clinical setting, I think we will see more rehabilitation programs include the slide board as part of the process in getting athletes back on the field.I think we’ll see more rehab programs include the slide board as part of the return-to-play process. Click To Tweet
Why no supine exercises or ball squeezes, you ask? I am not in favor of isolated hip flexor exercises and isometric exercises for groin strength unless the movements are prescribed by a therapist. My reasoning is simple: Many athletes do a lot of hip flexor movements already with core training, and while ball squeezes are great tests, exercises with low feedback don’t motivate athletes.
While isometric testing is useful, isometric training is more limited with athlete compliance due to the static nature of the muscle contraction. I know that bridge motions recruit the adductor system, but I prefer most of my exercises with athletes on their feet, as I can load the movements incrementally. I do sometimes employ standing adductor pulls, as it works the foot intrinsics after ankle injuries; however, those are early-stage options for the most part, not primary tools in my environment.
If you are going to do adduction work with bands or other equipment, make sure you know the true loading so you can progress incrementally. Getting on your feet encourages elastic or slow eccentric responses naturally, and the remodeling is usually more complete when looking at the sonography later.
Program with More Precision
Of course, there are other exercises that you could easily exchange for those on my list, but the goal is to make sure the movements really get to the heart and soul of groin strengthening. I hope that the list can evolve and be tinkered with so that outcomes in either rehabilitation research or internal injury rate analysis improve.
The inclusion or abandonment of an exercise isn’t the only decision to make with groin muscle training—you should consider overload in practice or sporting technique as well. Finally, when injuries continue, step outside the problem and think about factors such as neurological pathologies and podiatric care, as barbells and dumbbells solve most of the problems, but not all of them.