Groin/High Adductor Strain: Causes, Symptoms and Treatment

A groin or adductor strain is a common cause of medial leg and groin pain, especially among athletes. In this video, Travis Owens, DC discusses the causes of groin pain. He also explains signs or symptoms that may indicate you have a muscle strain, or an injury to any of the adductor muscles (the muscles on the inner side of the thigh). Additionally, he explains the way traditional health care approaches these injuries and ways Airrosti is different. Click here to learn more about what to expect at your first visit to Airrosti.


A groin strain, also referred to as a pulled groin muscle, is an acute injury to the muscles on the inside of the thigh, known as the adductor muscles. These muscles help to stabilize the trunk and move the legs inward. A strain typically occurs as a result of an athletic injury or awkward movement of the hip joint, which leads to stretching or tearing of the inner thigh muscles.

The adductor longus, running from the pubic region of the pelvis down the inner thigh, is the most commonly injured structure. Other muscles that are commonly injured include the medius, magnus and the gracilis.

A strain injury is graded I-III based upon its severity. Mild strains involve overstretching of the muscle, whereas more severe strains can involve extensive tearing of the muscle fibers. Grade I involves a mild strain with some injury, bruising, and tenderness, but no significant fiber disruption. A Grade II injury involves injury to the muscle-tendon fibers, but the overall integrity of the muscle-tendon unit is preserved. A Grade III injury is one that results in a loss of overall tendon integrity. Most injuries to the adductor muscles are Grades I or II.


Most commonly, strains in the groin muscles occur during acute muscle contraction, such as when kicking, pivoting, or skating.

Groin pulls are common in people who play sports that require a lot of running and jumping. In particular, suddenly jumping or changing direction is a likely cause. These pulls often appear in people who play soccer and football, and they make up about 10% of all injuries in professional hockey players.


Adductor strain is a common injury among those who engage in specific physical activity involving sudden acceleration or changing direction, including: soccer, hockey, football, basketball, tennis, figure skating, gymnastics, baseball, softball, sprinting, and martial arts. Failing to properly warm up, stretch, or be properly conditioned can increase your risk of injury.

Other risk factors include:

  • Previous groin or hip injury
  • Weak thigh or hip adductor muscles
  • Muscle fatigue from repetitive stress/overuse
  • Intense training over a brief period of time
  • Increasing age
  • Reduced flexibility or range of motion


Depending on the underlying cause, pain can be mild or severe, come on gradually or suddenly, and vary in quality (dull, sharp, throbbing, or even burning). Common symptoms include:

  • Pain and tenderness in the groin and the inside of the thigh
  • Sudden onset of pain sometimes accompanied by the sensation of a pop in the inner thigh
  • Inability to continue activity after initial onset of pain
  • Pain when you bring your legs together or when you raise your knee
  • Bruising may develop, and limping may also be a symptom


Most adductor muscle injuries respond to conservative treatment. Initial treatment includes activity modification, which may temporarily include crutches, ice and anti-inflammatory medication, and physical therapy as symptoms improve.

Surgery may be needed for patients with chronic pain whose symptoms do not respond to conservative treatment.

The most important part of recovery in traditional care and sports medicine is rest. Time out of activity varies greatly with the extent of the injury. Most strains and tendon injuries start to improve within 10-14 days and continue to improve over many months. A severe strain may require crutches for several weeks and take a longer recovery period. Some patients will continue to struggle with mild chronic symptoms of pain for more than 6 months.


While most injuries respond well to conservative care, recovery time can be long and frustrating. Further, lengthy recover timelines can severely hinder an athlete’s ability to train, compete, and participate in sports and physical activity. In fact, as many as 42% of athletes with muscle-tendon groin injuries are not able to return to physical activity for more than 20 weeks after the initial injury.

However, Airrosti has demonstrated a proven ability to rapidly resolve the source of most injuries in as few as three visits (based on patient-reported outcomes). We help athletes and other active individuals avoid long recovery times and periods of inactivity. Highly targeted manual therapy and an active training program directed at strength and conditioning of the muscles helps speed recovery and provide lasting results.

Call Airrosti at (800) 404-6050 to see how we can help you get better faster, or click here to schedule your risk-free first appointment now.


Reviewed by Casey Crisp, Doctor of Chiropractic

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