| The following is a very thorough and detailed | | | | Phase 2 |
| management plan for the full recovery and | | | | Management Phase: Goals: To reduce pain, spasm |
| rehabilitation of a groin strain. | | | | and restore full ability to contract without stretching the |
| Considering this management plan was written over | | | | muscle. ELT: 4 to 6 days. |
| ten years ago, my only addition would be the reduction | | | | Therapy: Follow up care: Ice massage (1 min) three to |
| of ice therapy and the addition of massage and heat | | | | four times daily. Bipolar muscle stimulation above and |
| therapy during the 2nd, 3rd, and 4th phase. Regardless | | | | below pain site (7 min). |
| of my suggestions, the following will be extremely | | | | Exercise Rehabilitation: PNF for hip rehabilitation three |
| useful for anyone who is, or has suffered from a groin | | | | to four times daily (beginning approx. 6 days after |
| strain. | | | | injury) |
| Injury Situation: | | | | Optional: Jogging in chest level water (10 to 20 min) |
| A women varsity basketball player had a history of | | | | one or two times daily. Must be done within pain free |
| tightness in her groin. During a game she suddenly | | | | limits. General body maintenance exercises are |
| rotated her trunk while also stretching to the right side. | | | | conducted three times a week as long as they do not |
| There was a sudden sharp pain and a sense of "giving | | | | aggravate the injury. |
| way" in the left side of the groin that caused the | | | | Phase 3 |
| athlete to immediately stop play and limp to the | | | | Management Phase: Goals: To reduce inflammation |
| sidelines. | | | | and return strength and flexibility. |
| Symptoms & Signs: | | | | Therapy: Muscle stimulation using the surge current at |
| As the athlete described it to the athletic trainer, there | | | | 7 or 8, depending on athlete's tolerance, together with |
| was severe pain when rotating her trunk to the right | | | | ultrasound once daily and cold therapy in the form of |
| and flexing her left hip. Inspection revealed the | | | | ice massage or ice packs (7 min) followed by light |
| following: | | | | exercise, two to three times daily. |
| - There was major point tenderness in the groin, | | | | Exercise Rehabilitation: PNF hip patterns two to three |
| especially in the region of the adductor magnus | | | | times daily following cold applications, progressing to |
| muscle. | | | | progressive-resistance exercise using pulley, isokinetic, |
| - There was no pain during passive movement of the | | | | or free weight (10 reps, 3 sets) once daily. |
| hip, but severe pain did occur during both active and | | | | Optional: Flutter kick swimming once daily. |
| resistive motion. | | | | General body maintenance exercises are conducted |
| - When the groin and hip were tested for injury, the hip | | | | three times a week as long as they do not aggravate |
| joint, illiopsoas, and rectus femoris muscles were ruled | | | | the injury. |
| out as having been injured; however, when the athlete | | | | Phase 4 |
| adducted the hip from a stretch position, it caused here | | | | Management Phase: Goals: To restore full power, |
| extreme discomfort. | | | | endurance, speed and extensibility. |
| | | | Therapy: If symptom free, precede exercise with ice |
| Management Plan: | | | | massage (7 min) or ice pack. |
| This detailed management plan comes from one of | | | | Exercise Rehabilitation: Added to phase 3 program, |
| my old university text books, called Modern Principles | | | | jogging on flat course slowly progressing to a 3-mile |
| of Athletic Training by Daniel D. Arnheim. It's one of | | | | run once daily and then progressing to figure-8s, |
| those 900 page door-stoppers, but it's the book I refer | | | | starting with obstacles 10 feet apart and gradually |
| to most for information on sports injury prevention and | | | | shortening distance to 5 feet, at full speed. |
| rehabilitation. It's extremely detailed and a valuable | | | | Phase 5 |
| resource for anyone who works in the health and | | | | Management Phase: Goals: To return to sport |
| fitness industry. So... | | | | competition. |
| Based on the athletic trainer's inspection, with findings | | | | Exercise Rehabilitation: Athlete gradually returns to |
| confirmed by the physician, it was determined that the | | | | pre-competition exercise and a gradual return to |
| athlete had sustained a second-degree strain of the | | | | competition while wearing a figure-8 elastic hip spica |
| groin, particularly to the adductor magnus muscle. | | | | bandage for protection. |
| Phase 1 | | | | Criteria for Returning to Competitive Basketball: |
| Management Phase: Goals: To control haemorrhage, | | | | |
| pain and spasms. Estimated Length of Time (ELT): 2 | | | | 1. As measured by an isokinetic dynamometer, the |
| to 3 days. | | | | athlete's injured hip and groin should have equal |
| Therapy: Immediate Care: ICE-R (20 min) intermittently, | | | | strength to that of the uninjured hip. |
| six to eight times daily. The athlete wears a 6-inch | | | | 2. Hip and groin has full range of motion. |
| elastic hip spica. | | | | 3. The athlete is able to run figure-8s around obstacles |
| Exercise Rehabilitation: No Exercise - as complete rest | | | | set 5 feet apart at full speed. |
| as possible. | | | | |