Groin Health, Speed, Conditioning, and Monitoring Progress

 

Ryan Cotter is a Strength and Conditioning Coach with the New York Red Bulls. He previously worked at the University of Maryland as a Strength and Conditioning Coach for the men’s soccer, men’s lacrosse, and women’s gymnastics teams. Before Maryland, Ryan worked as an Assistant Strength and Conditioning Coach at Northern Arizona University. He has an MS in Exercise Physiology from the University of Utah and a BA in Exercise Science from Hope College.

FreelapUSA: The NordBord created some buzz on hamstring strength and symmetry, but the muscles around the groin, lower abdominal area, and hip are a little more complicated. What do you do to prepare to reduce groin injuries and, if one does occur, what is a good R2P strategy?

Ryan Cotter: First, I agree wholeheartedly that the groin, lower abdominal area, and hip are much more complex than the hamstrings. More muscles crossing more joints and attaching to more areas means exponentially more things that could go wrong. We attack the groin with a three-pronged approach focusing on muscular strength, pelvic posture and positioning, and reducing the overall load on the groin.

1. Groin Strength—We address groin strength by first measuring isometric hip ab/adduction strength with handheld dynamometry. This gives us a baseline for each player’s ab/adduction relative strength and the ratio between the two, which some research indicates is important when managing groin pain and injuries (6). We re-evaluate these strength levels periodically throughout the year and anytime someone complains of groin pain and tightness.

Vald Performance recently released a product called the Groin Bar which makes this testing procedure much faster and more convenient. A baseline strength value to compare is important information to have for a return to play protocol following a groin injury.

In an attempt to keep both hip ab/adduction levels high throughout the year (we’re concerned mostly with adduction strength), we program one dynamic hip abduction exercise, one dynamic hip adduction exercise, and one isometric hip adduction exercise during the week.

Typical examples of these exercises are miniband shuffles, slideboard lateral lunges, and soccer ball squeezes, respectively. We also use many basic single leg exercises that force the groin to act as a synergistic stabilizer (pistol squats, skater squats, lunges, etc.).

2. Neutral Pelvic Posture—We attempt to promote neutral pelvic posture with core exercises inspired by the Postural Restoration Institute (PRI). Mike Robertson’s Complete Core Training (4) is an excellent resource for these core activities that are easy to perform in a team environment. I’m not a PRI expert by any stretch of the imagination, but I like the idea of athletes having the ability to perform activities with a neutral pelvis and ribcage; it makes sense regarding functional anatomy.

3. Reducing Load on the Groin—Reducing global load on the groin is probably the most challenging of the three interventions. The very act of passing and shooting a soccer ball with the inside of the foot, possibly a soccer player’s most universal maneuver, forces the groin’s musculature to absorb high levels of torque. This is compounded by the ever more prominent tactical approach of soccer coaches having their athletes play small sided games. This results in more interactions with the ball, more passes, more shots, and quicker, aggressive changes of direction—meaning more stress on the groin.

Even on light or regen days, one of the universal drills of choice is boxes (also called 5v2 or rondos), a game that involves almost exclusively inside of the foot passing and quick changes of direction. Even the most open-minded coaching staffs might have a hard time parting ways with a drill that is so embedded in the soccer culture.

To curb the load on the groin, we do as much as we can on regen days to get the athletes doing things that don’t stress the musculature the same way they do on normal training days. This usually means bike, elliptical, etc. instead of running and passing.

From a return to play perspective following a groin injury, the range of motion and strength levels should be restored to pre-injury levels. Next, we gradually reintroduce dynamic activities such as cutting, passing, pivoting, and kicking until the athlete feels fully comfortable returning to normal training.

Qualitative measurements of these high-velocity actions are not possible without high-tech 3D motion capture, something we don’t have here in New York. Programs such as DARI or Kitman Labs could be beneficial in these situations.

FreelapUSA: Player speed is paramount but so is the ability to play more than ninety minutes. Can you explain how you maintain speed and conditioning outside of practice? Is their room to improve over the season in underdeveloped players or is it, at best, a slow death?

Ryan Cotter: We use a weekly physical periodization plan that allows us to get most of our conditioning work done during normal training. We’ve used GPS data to code all of our drills, which allows us to look at the physical demands of any drill on a per minute basis. We then compare that data to the per minute data from matches and see which drills are overloading which physical variables/metrics.

For example, playing 4v4+3 to small goals on a 24×16-yard field will elicit more high-intensity decelerations per minute compared to an 11v11 match. Therefore, we would likely include that drill on a day when we are trying to overload decelerations and tax the hip flexors.

 

I do believe that strict running drills still have a place in this system; we include traditional sprinting drills in the middle of training on our high-speed running days. I don’t believe, however, that you need to spend much time outside of regular training doing conditioning drills if your training sessions are appropriately planned.

On the flip side of the coin, high- and max-velocity training need to be addressed on a regular basis outside of normal soccer drills. If you look at the match and training GPS data, athletes rarely, if ever, spend any time at >90% of their maximum sprint speed. We don’t need to address this variable separately if we keep athletes prepared for situations when they have to reach these velocities and we improve their maximum velocity capacity.

High- and max-velocity training need to be addressed regularly outside of normal soccer drills. Share on X

We typically train max-velocity sprinting on Wednesdays (our high-speed running days) by microdosing (1) some alactic sprint work at the end of the warmup, as well as some slightly lactic speed work with a short repeat sprint session (2 to 4 minutes total) in the middle of the training session.

A typical repeat sprint session could be 4 to 60-yard sprints (end line to midfield) every 30 seconds (roughly 1:3 work:rest). This distance is long enough for the athletes to accumulate some distance at very high- and max- velocity, the work:rest ratio keeps the session short, and subsequent sprint efforts don’t deteriorate too much in quality.

In addition to sprinting, we attempt to improve max-velocity abilities through weekly strength training sessions (Tuesday) and plyometrics (Wednesdays and Fridays). The strength session is performed post-training, and the plyometrics are at the end of the warmup.

Regularly assessing max sprint speed is easy to do with GPS data. Regular measurement of acceleration abilities with shorter sprints is a little more labor intensive and requires the right equipment (convenient and reliable timing gates) and a coach willing to spend the time.

FreelapUSA: Some have dismissed the torso and core, and some still train it like it’s sacred ground. Do you assess this area, and do you treat it differently with training or keep it similar to other muscle groups?

Ryan Cotter: In general, the majority of our core work is accomplished simultaneously during our multi-joint, ground-based lifts. Literature reviews on core training (2, 4, 7) corroborate this thought process.

As I mentioned, we do use PRI style core exercises that emphasize neutral and sometimes flexed postures. While heavy weight training can sometimes be a hard sell with soccer players, if you put a core workout up on the board, enthusiasm for the weight room suddenly spikes. The athletes would do core work on their own regardless of whether it’s programmed, so we provide exercises that might have more benefit and carryover than a few hundred crunches.

If you put a core workout up on the board, enthusiasm for the weight room suddenly spikes. Share on X

If I’m honest, I cannot say with full confidence that even this style of core work has much benefit in a team or non-individualized setting. However, I could be wrong on this topic, as other authors would suggest (3).

FreelapUSA: Many coaches are talking about very complicated and specific monitoring strategies. What do you do that is extremely simple but consistent and will help high school programs make progress?

Ryan Cotter: I’m a big fan of Rate of Perceived Exertion (RPE) based training load (training load = RPE x session duration). If you can’t objectively collect external load variables outside the weight room, I believe RPE, while subjective, is a good indicator of the overall stress placed on an athlete during the training session.

RPE provides a versatile data point that takes into account athlete readiness, well-being, and the intensity of the session. While its biggest strength is that it’s fairly all-encompassing, its biggest weakness is its inability to tease out specifics about why the score is what it is.

RPE is a good indicator of the overall stress placed on an athlete during a training session. Share on X

While GPS technology is not affordable for many high school programs, the coach can still plan practice with physical emphasis similar to what I’ve described. GPS data allows specific numbers to be collected (and the results can occasionally be surprising for some drills), but the majority of drills, especially in soccer, can be “coded” with the naked eye.

Smaller pitch sizes and numbers overload high-intensity decelerations, while larger spaces demand high-speed running. Inside the weight room, volume load (sets x reps x percent) is an easy calculation that helps manage and periodize training programs.

FreelapUSA: Practice loads using GPS is standard with clubs. How do you help coaches understand the need for daily, weekly, and seasonal loading patterns? How do you educate without sounding rude but remaining firm on player health and performance?

Ryan Cotter: First, I think it’s important that coaches have a basic understanding of the physical demands of the game. Once they have a reference point in their head, daily and weekly workloads start to make more sense. For example, 600m of high-speed running in a training session is about 60% of the game load for a winger.

Next, I think it’s very important to meet coaches where they are and only offer data they can digest or understand. If they’ve never worked with GPS, giving them ten variables might be too much at the beginning. Start with the basics of volume (total distance) and intensity (high-speed running, accelerations, and decelerations). Once they become comfortable with these metrics, we can start to go into more detail (high-speed running vs. very high-speed running, total distance vs. meters/min, acute:chronic ratios of all the relevant metrics, etc.)

At the end of the day, it’s important, especially early on, to recognize that the coaches ultimately make the training decisions. We can present our opinion and the metrics and rationale that support the suggestions, but we must concede the ultimate decision making to them; at least until we build up a level of trust where they will have a lot of faith in our suggestions.

It’s also important for fitness coaches to realize that the data only provides information on relative risks and trends about injury and performance. There is no way to know for sure how a player is going to respond to any given load.

Being rigorous with the consistency of data collection is extremely important. It’s better to consistently collect, analyze, and report three metrics than to be even slightly inconsistent with ten metrics. I suggest following the adage, “collect a lot, report a little,” meaning the daily and weekly reports to coaches need to include only the basics. More detailed complex reporting and metrics, while always collected and analyzed, only need to be brought to the coaches’ attention when action (deviation from normal training) might be required.

Short reports that coaches understand tend to get looked at and considered while lengthy reports often go unread.

References

1. Hansen, D. M. “Micro-Dosing with Speed and Tempo Sessions for Performance Gains and Injury Prevention.” Strength Power Speed. October 26, 2015.
2. Lederman, E. (2010). “The Myth of Core Stability.” Journal of Bodywork & Movement Therapies, 14(1), 84-98. doi:10.1016/j.jbmt.2009.08.001.
3. McGill, S. (2010). “Core Training: Evidence Translating to Better Performance and Injury Prevention.” Strength and Conditioning Journal, 32(3), 33-46. doi: 10.1519/SSC.0b013e3181df4521.
4. Reed, C. A., Ford, K. R., Meyer, G. D., & Hewett, T. E. (2012). “The Effects of Isolated and Integrated ‘Core Stability’ Training on Athletic Performance Measures: A Systematic Review.” Journal of Sports Medicine, 42(8), 697-706.
5. Robertson, Mike. Complete Core Training. (Indianapolis, IN: Robertson Training Systems, 2016), DVD.
6. Tyler, T. F., Nicholas, S. J., Campbell, R. J., & McHugh, M. P. (2001). “The Association of Hip Strength and Flexibility With the Incidence of Adductor Muscle Strains in Professional Ice Hockey Players.” American Journal of Sports Medicine, 29(2), 124-128.
7. Wirth, K., Hartmann, H., Mickel, C., Szilvas, E., Keiner, M., & Sander, A. (2017). “Core Stability: A Critical Analysis of Current Guidelines.” Journal of Sports Medicine, 47(3), 401-414. doi:10.1007/s40279-016-0597-7.