Groin Strain: who to see and what helps

Groin Strain · Kitchener, Waterloo & Cambridge

A groin strain is a pulled or torn muscle on the inner thigh, usually from a sprint, a kick or a sudden change of direction. In one study of supervised rehabilitation, male athletes with less than a complete tear were back in full team training in about three weeks, and for pain that has lasted two months or more the trial evidence favours active strengthening over passive treatment. At CARESPACE the first visit is with a physiotherapist, who assesses and treats that day.

What a groin strain is

The groin muscles are the adductors, the inner-thigh muscles you use to squeeze your legs together. A strain is an overstretch or tear of one of them, most often the adductor longus. Strains are graded 1 to 3: pain with little loss of strength or movement, a partial tear with lost strength, and a complete tear or a tendon pulled away from the bone.

Longer-standing pain in the same place is often called adductor tendinopathy. An international agreement on groin pain in athletes chose not to recommend that term and uses adductor-related groin pain: tender adductors, and the familiar pain when the legs are squeezed together against resistance. This page covers both.

Symptoms

• Sudden pain in the groin or inner thigh during a sprint, a kick or a change of direction
• Pain and tenderness that are worse when you squeeze your legs together
• Swelling or bruising in the groin or inner thigh
• A limp, with a bad strain
• In the long-standing form, groin pain with sport that has gone on for two months or more

What causes it

A sudden change of direction is the typical mechanism, most often while accelerating into a sprint. Soccer and hockey produce the most adductor injuries, and in ice hockey they account for 10% of all injuries. In Waterloo Region that is a long season, from minor and adult league hockey to indoor soccer through the winter.

A previous hip or groin injury is the most significant risk factor. Weak adductors are another: in a study of National Hockey League players, those whose adductors were less than 80% as strong as the muscles that move the leg outward were 17 times more likely to strain one.

How it is diagnosed

From the story and an examination. Squeezing the knees together against resistance is the most sensitive test, and when pressing along the muscle does not hurt, an adductor injury is unlikely: in one study of 81 athletes, the chance that an MRI would show one fell from 57% to 9% (low-quality evidence). X-rays are usually normal in a simple strain but can show a piece of bone pulled away with the tendon.

Groin pain is sorted by where the tenderness is: the adductors (this page); the front of the hip (Hip Flexor Strain); the inguinal canal low on the abdomen, with no hernia to feel (Sports Hernia); and the pubic joint in the midline (Pubic Pain & Osteitis Pubis). An athlete can have more than one at once, and the hip joint should always be considered as a possible cause.

When groin pain is an emergency

Nobody at CARESPACE can rule out an emergency. These signs come from the NHS (the UK’s health service), Alberta’s and British Columbia’s health services and the US National Institutes of Health, in Ontario terms; where they differ, the more cautious instruction is used.

A hernia that changes suddenly. Call 911 or go to an emergency department right away if you have a hernia, or a lump in your groin or at your belly button, and any of these: the lump is suddenly larger than before; the area over it has turned red or become tender to touch, or the skin around it has changed colour; it no longer goes back in, or you cannot push it back with gentle pressure while lying down; sudden or severe pain around it, or very bad belly pain that does not go away; feeling sick, vomiting (including blood, or vomit that looks like coffee grounds) or being unable to keep food down; a bloated belly, or being unable to pass stool or gas; a fever or high temperature, or feeling hot, cold or shivery; or sudden confusion. Do not drive yourself. A trapped hernia can lose its blood supply (a strangulated hernia), which is life-threatening and needs surgery right away.

Sudden testicle pain. Call 911 or go to an emergency department right away if you have sudden, severe pain in a testicle, testicle pain together with feeling sick, vomiting or belly pain, or testicle pain that has lasted more than an hour or continues when you are resting. Do not drive yourself: ask someone to drive you or call 911 for an ambulance, and bring any medicines you take. It can mean a twisted testicle (testicular torsion), and the testicle can be lost if this is not treated quickly.

After a fall or injury. Call 911 or go to an emergency department if you have severe hip or groin pain, you cannot move your leg, walk or put weight on it, or you have tingling, numbness, weakness or loss of feeling in your groin, hip or leg. Do not drive yourself.

The same day, with a hernia or a change in a testicle. Go to an urgent care clinic or an emergency department the same day if you have a hernia and pain in or around it, or belly pain, that is new or getting worse but is not sudden or severe (a hernia that has turned red or become tender to touch is on the emergency list above); a hernia and constipation (being unable to pass stool or gas is on the emergency list above); a lump or swelling in a testicle or anywhere in your scrotum; a change in the shape or feel of a testicle; one testicle that has become bigger than the other; or an ache or discomfort in your testicles that worries you.

The same day, for the hip or groin. Go to an urgent care clinic or an emergency department the same day if you have severe hip or groin pain that started suddenly without a fall or injury; new or severe pain or swelling in the groin while a strain is healing; a hip or groin that is swollen and feels hot; a groin, hip or upper thigh that is cool or pale or has changed colour; or pain together with feeling generally unwell and a high temperature (or feeling hot, cold or shivery).

Hip or groin pain that came on with running or hard training, and did not start with a sudden sprint, kick, twist or change of direction, needs medical assessment the same day, at an urgent care clinic or emergency department if you cannot reach a physician or nurse practitioner. It can be a stress fracture in the neck of the thigh bone, which can shift out of place and then needs surgery, and X-rays alone cannot rule one out. Protect the leg with crutches until the diagnosis is confirmed. Stress Fractures has more.

The emergency departments in Waterloo Region are:

• WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
• WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
• Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge

If you cannot get there safely, call 911.

See a physician or nurse practitioner if you have a lump or bulge in your groin or at your belly button with none of the signs above, even one that disappears when you lie down, or if groin pain is increasing or is not getting better as expected.

What the evidence says about treating a groin strain

• The trial evidence is thin. A Cochrane review found two randomized trials: 122 athletes, all but one of them men, with adductor-related groin pain that had lasted at least two months. It rated the evidence low quality and not enough to advise any specific treatment. A Danish sports physiotherapy statement found no study of treatment for a fresh adductor strain.
• Active exercise beat passive treatment. One trial compared hip and abdominal strengthening and coordination training with stretching, electrotherapy and friction massage. At 16 weeks, 23 of 29 athletes in the exercise group were back at the same level of sport without groin pain, against 4 of 30.
• A hands-on package did as well as exercise. The other trial (54 athletes) compared heat, manual therapy and stretching with exercise therapy. About half of each group was treated successfully (14 of 26 against 12 of 22), and of those who got back to full sport (13 of 26 against 12 of 22), the hands-on group did so about four and a half weeks sooner. No side effects were reported.
• Return by criteria. In 81 male athletes on a supervised program with criteria for each stage, strains short of a complete tear were pain-free on examination after a median of 13 days and in full team training after 18; complete tears took 55 and 78 days. Athletes who reached the pain-free stage had fewer reinjuries in the next year (5% against 21%).
• Prevention has the strongest evidence. In research done mostly in soccer players, one study of a strengthening program built on the Copenhagen adduction exercise found 41% fewer groin problems than with usual care (moderate-quality evidence). It counted every kind of groin problem, so its effect on sudden strains alone is uncertain.

What a doctor may offer

These are not CARESPACE services. A pharmacist, physician or nurse practitioner can advise on acetaminophen and anti-inflammatory medicines for the early phase. Injections are listed as options, and surgery is considered for a tendon pulled off the pubic bone or when rehabilitation has failed.

How each CARESPACE service treats a groin strain

Physiotherapy

A physiotherapist can judge how severe the strain is and set the first week: what to rest from, and how to keep the leg moving without pain. From there the work is strengthening for the adductors, hips and abdominal muscles with coordination training, progressed to running, cutting and kicking as you meet the criteria for each stage. For pain that has lasted months, the same exercise-led program is where the trial evidence points.

See our physiotherapy team →

Chiropractic

A chiropractor can provide manual therapy and stretching alongside a strengthening program, and can examine the hip, pelvis and lower back to check whether the pain is coming from the adductors or the hip joint. For long-standing groin pain, a hands-on package of this kind did as well as exercise therapy in the one trial that compared them.

See our chiropractic team →

Kinesiology

A kinesiologist can run the strengthening and return-to-sport stages: adductor, hip and trunk strength, then sprinting, cutting and kicking at rising intensity, and afterward the Copenhagen adduction exercise used in the prevention research.

See our kinesiology team →

Other services people ask about

Massage therapy. Friction massage was part of the passive treatment that did far worse than exercise, and none of the sources below tested massage on its own.

Where most people start

With a physiotherapist, who assesses and treats at the first visit. The exception is hip or groin pain that came on with running or hard training and did not start with a sudden sprint, kick, twist or change of direction: that needs the medical assessment in the warning signs above first.

How your team works together

One practitioner can look after a groin strain from start to finish. Where more are involved, a physiotherapist can set the criteria for each stage, a chiropractor may add manual therapy and stretching, and a kinesiologist can run the sprinting, cutting and kicking progression toward those criteria.

Browse by service: physiotherapists, chiropractors and kinesiologists.

What to expect at your first visit

1. How it happened: the movement, whether you could carry on, and any earlier hip or groin injury.
2. The examination: pressing along the inner-thigh muscles, squeezing your knees together against resistance, and checks of the hip, lower abdomen and pubic joint.
3. How severe it looks, and whether a physician should see it.
4. Treatment at that visit and a plan to leave with: what to rest from this week, the first exercises, and the criteria for running again.

What you can do at home

• Rest and protect the groin for one to two weeks, and do nothing intense while you still have pain.
• Use ice or a cold pack for 10 to 20 minutes at a time, every one to two hours while you are awake, for three days, with a thin cloth between the ice and your skin.
• After two or three days, if the swelling has gone, use heat. Do not go to sleep on a heating pad.
• Wear snug shorts or underwear that support the area.
• Ask a pharmacist or physician about over-the-counter pain medicine.
• When the pain has eased, start gentle range-of-movement and stretching, and add strengthening once flexibility has improved.

How long it takes, and whether it comes back

It depends on the grade. Alberta’s health service says healing can take up to three weeks or more, and four to six weeks or longer in its general advice on groin injuries. Complete tears took a median of 78 days to reach full team training in the study of 81 athletes, and long-standing strains may take many months. About 20% of athletes have a recurrence.

Groin strain treatment in Kitchener, Waterloo and Cambridge

Kitchener. Physiotherapy in Kitchener, Chiropractic in Kitchener and Kinesiology in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.

Waterloo. Physiotherapy in Waterloo, Chiropractic in Waterloo and Kinesiology in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.

Cambridge. Physiotherapy in Cambridge. Location: Hespeler Road.

The city pages linked above show the locations and practitioners for each service, with their next availability.

Common questions

How long does a groin strain take to heal?

Up to three weeks or more, according to Alberta’s health service. Athletes on a supervised program reached full team training in a median of 18 days, or 78 after a complete tear.

Is it a groin strain or a hernia?

A hernia usually shows as a lump in the groin or scrotum; a strain is tender along the inner-thigh muscle. British Columbia’s health service says that if you are not sure which you have, one to two weeks of home treatment is okay to try. A lump in the groin needs a physician or nurse practitioner, a lump or swelling in the scrotum needs care the same day, and the warning signs above come first. See Hernia Rehab Before & After Surgery.

Should I stretch a pulled groin?

Gently, starting with range-of-movement exercises once the pain has eased. Stretching is not the main treatment: for long-standing groin pain, a program built on stretching and other passive treatment did far worse than strengthening.

When can I skate or play soccer again?

When you meet the criteria, not on a set date. The stages are pain-free on examination, then controlled sports training, then full team training.

Where can I get treatment for a groin strain in Cambridge?

Start with Physiotherapy in Cambridge; our location there is on Hespeler Road. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.

Do I need a referral?

No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →

Sources

• Almeida MO, Silva BNG, Andriolo RB, Atallah ÁN, Peccin MS. Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain. Cochrane Database of Systematic Reviews, 2013 (searches to December 2011).
• Weir A, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. British Journal of Sports Medicine, 2015.
• Ishøi L, Krommes K, Husted RS, Juhl CB, Thorborg K. Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport: grading the evidence. A statement paper commissioned by the Danish Society of Sports Physical Therapy. British Journal of Sports Medicine, 2020.
• Serner A, Weir A, Tol JL, Thorborg K, Lanzinger S, Otten R, Hölmich P. Return to sport after criteria-based rehabilitation of acute adductor injuries in male athletes: a prospective cohort study. Orthopaedic Journal of Sports Medicine, 2020 (abstract).
• Opara K, Pinkerman S, Kaiser K. Adductor Strain. StatPearls, updated December 2025.
• Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. American Journal of Sports Medicine, 2001 (abstract).
• MyHealth Alberta. Groin Strain: Care Instructions. Current as of July 2024.
• MyHealth Alberta. Groin Problems and Injuries. Current as of July 2024.
• HealthLink BC. Inguinal Hernia. Current as of March 2023.
• MyHealth Alberta. Inguinal Hernia: Care Instructions. Current as of October 2024.
• National Institute of Diabetes and Digestive and Kidney Diseases (US National Institutes of Health). Inguinal Hernia. Reviewed September 2019.
• NHS. Umbilical hernia. Reviewed November 2025.
• NHS. Hernia. Reviewed May 2026.
• NHS. Femoral hernia. Reviewed October 2026.
• NHS. Testicle pain. Reviewed June 2025.
• NHS. Hip pain in adults. Reviewed November 2025.
• Robinson PG, Campbell VBD, Murray AD, Nicol A, Robson J. Stress fractures: diagnosis and management in the primary care setting. British Journal of General Practice, 2019.

Related conditions

Hip Flexor Strain
Sports Hernia
Pubic Pain & Osteitis Pubis
Muscle Strains & Bruises
Hip Pain

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