How to avoid groin injuries in soccer

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A GUEST CONTRIBUTION FROM OUR EXPERT LASSE AHL

Disclaimer: The following text and its contents are not a medical indication. If you suffer from an injury, please contact a healthcare professional first before you perform the exercises mentioned above.

The in soccer playerInner circles an almost mystical muscle group of the adductors throws proven expertsQuestions have been raised within not just since BVB superstar Erling Haaland's recent injury. It is therefore no wonder that players who suffer from groin area complaints often lose track of things.

In the book “Return to Play in Football,” a scientific summary of the most common injuries in soccer and their rehabilitation, an entire sub-chapter is dedicated to the groin area.

“Return to Play in Non-Operative Hip/Groin Pain” is divided even more finely. As with many pathologies, this is due to the fact that groin injuries can be promoted by a variety of partly interrelated (multifactorial) risk factors.

Why an athlete now “Problems” Gets in the groin area is often diffuse and highly individual. Two famous examples may be mentioned for illustrative purposes. Jerome Boateng and Marco Reus, absolute exceptional athletes, have had an almost endless list of injuries over the course of their careers.

This list is dominated by “muscular problems in the adductor area”.

When we look at both players, we notice that their body geometry is fundamentally different. On one side is Jerome Boateng, 10 cm taller than the Bundesliga average and weighs just under 90 kg. On the other hand, the almost 20kg lighter Marco Reus (1.80m & 71kg).

Without wanting to go into too much anatomical depth, you can already see from the two players that the solution to “groin problems” cannot be summarized in a simple causal chain.

As already mentioned above, “non-surgical hip and groin pain” are subdivided once again. Since the anatomical complexity of the hip and groin areas may be the reason for the frequent occurrence of interrelated maladaptations, we limit this blog entry to a specific subgroup: the adductors.

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GROIN - RISK FACTORS

The adductors are involved in all important movements in soccer, whether running, sprinting, jumping, changing direction or shooting.

Since soccer depends primarily on sprinting, changing direction and abrupt U-turns, the demands placed on these relatively long, thin muscles are varied. The forces that act on them are often many times higher than their own body weight.

According to a 7-year prospective survey by UEFA, adductor-related injuries account for approx. 64% of total hip and groin injuries off.

Within adductor pathologies, we can distinguish three categories:

• hip adductor strains
• hip adductor tendinopathies
• Hip adductor demolitions

Anyone who has read this far could come to the conclusion that the adductors are a very fragile and fragile construct that should best be wrapped in “cotton wool.”

That is not the case.

Like the entire human body, the adductors also adapt to stress. So the real question is:

How much of what is too much?

In fact, the risk factors of adductor pathologies are quite diverse:

• Anatomical requirements (size, joint positions (alignment), abnormalities)
• preponderance
• age
• gender
• Previous adductor injuries
• Force differences from L to R
• Multiple overload, load tolerance (e.g. load management, especially eccentric overload)
• Torso and lower body strength deficit

Now for the good news: Many of the risk factors are controllable.

Ekstrand et al (2011) identified reduced strength and mobility in the hip complex, together with the prevalence of previous adductor injuries, as “THE” risk factors of a (recent) adductor injury.

Why is this good news now?

Reduced strength and mobility usually means that these are so-called conditional deficits and can therefore be changed. If we look at the risk factors mentioned above again, it is noticeable that 3 of the 4 modifiable (overweight would be #4) risk factors could be remedied through specific training.

REHABILITATION & PREVENTION

From the three categories, we will now only treat strains and, in small parts, tendinopathy.

Anyone who suffers from an acute adductor strain falls on average between 4 — 6 weeks off. However, the downtime here only describes the absence in team training and gaming operations.

Anyone who works on one of the adductor tendons under tendinopathy even falls approx. 9 months off.

Basically, both injuries differ not only in the type of tissue affected (muscle abdomen vs. muscle-tendon transition), but also in the type of treatment time. In addition, tendinopathy can develop as a result of an untreated adductor strain.

As with many muscular injuries, the advice is “Take a break” Exactly the wrong person in his generality.

Yes, loads that exert a strong mechanical stimulus on the already injured structure should be limited. In other words, running, sprinting, jumping, shooting and changing direction, i.e. everything that commonly happens in a soccer game.

In general, based on the evidence, it is possible to deduce that that those athletes who start active rehabilitation earlier return to the grass.

However, it is important to know what you can and cannot do in the specific phases.

Other rehab blog entries (Achilles tendon injury & shin splints) already know the terms of “Load Management” and the”Pain monitoring”. Both control units are also used in active hip adductor rehabilitation.

STRESS MANAGEMENT FOR GROIN INJURIES

In the best case, stress management should be carried out with trained specialists. Although there is often talk of load management in soccer, it is usually not entirely clear to the layman what is behind it.

In short, it is the planning of training and break times depending on factors such as load volume, intensity, frequency and individual work capacity.

In addition, in the event of a structural injury, there is also the fact that we should comply with the tissue healing phases.

Nevertheless, we can do more than you would think if you have a groin sprained in the early stages of the injury.

As already mentioned, high mechanical stimuli should be avoided in the acute phase. In this early phase of injury (here: strain), easy, cyclical movements are recommended, which cause little stress to the tissue and promote blood circulation.

You can approximately 2-7 days after the injury occurs Start active rehabilitation (depending on how you feel the pain). Should the sensation of pain permit, you can also start isometric (spirch “holding) exercises during this period of time in order to maintain or even increase the strength level of the affected muscles. Isometric exercises can also reduce pain for some people.

From the second week The dynamic exercises can be implemented, of course in consultation with the specialist staff and your own perception of pain. If the movements still cause significant pain in the second week, or persist after training (up to approximately 48 hours later), then leave Ego outside the door and take a step back again. Rehab is a marathon, not a sprint.

It is estimated From 3 weeks You can usually start with easy running training. The next steps, such as jump, sprint, change of direction and team training, should be accompanied by experts. A “return to play” test would be described as the gold standard.

Disclaimer about this article

At this point, we would like to leave another final disclaimer. All explanations at specific times and exercise implications have been compiled by us on the basis of research and experience.

They are neither fixed nor beyond reproach. There are playersinside who can start running and sprint training again after 7 days of post-strain. It becomes playerThey can only dive back into such speed spectra after 4-5 weeks.