RICE & MICE: Adductor strains

Jaromir Jagr is out for 7-10 days with what Paul Holmgren says is a left groin strain. My guess is that he felt a bit of a pull when splitting the defense in the 1st period of the Winter Classic on Monday.  He left the 3rd period early, maybe to see if taping it would give him some support, took a couple of shifts after that and decided to shut it down and remain on the bench for the remainder of the game. Jagr missed a few games in November with a right groin strain. I know I can only speculate on what exactly is going on with Jagr’s groin, but it’s possible that the strained groin is one of his adductor muscles.

An adductor strain is one of the issues that can cause groin pain and common in football, soccer, hockey and pretty much any other sport that relies on side to side movement. A sudden change of direction, forced abduction that puts an unusual stretch on the tendon (possibly due to collisions or falls), and sudden acceleration are the most common ways that the adductor is strained.

Strains are tears or stretching of the muscle fibers usually where the muscle fibers meat the tendon. Adductor strains cause pain with adduction of the thigh on the affected side. Remember adduction is when the legs are brought toward each other. Generally, symptoms are more diffuse, with typical complaints of pain and stiffness in the groin region in the morning and at the beginning of athletic activity. Initial intense pain lasts less than a second, sometimes described as a “twinge” in the muscle. This initial pain usually progresses into an intense dull ache. With a new sudden injury, there will likely be sharper pain felt accompanied by swelling, warmth and possibly some bruising. Sometimes a lump can be felt along the muscle in the area of the pain.

Adductor strains are common in hockey due to the nearly constant side to side motion of skating. Skating requires strong movements around the hip, including extension at the hip, abduction, and external rotation.  These movements build strong abductor muscles and strong gluteal muscles, so much so that there is sometimes a muscle imbalance between the abductor muscles and the adductor muscles.  The weaker adductors are left prone to injuries.

Of course, Protection, Rest, Ice, Compression and Elevation are the treatment of choice for the initial injury. More chronic injuries may benefit from Rest as well as massage. Protection of the injured area comes in the form of avoiding the activities that caused pain. Steroid injections are usually avoided for chronic issues, due to the risk of tendon rupture that they bring to the table.

Physical therapy for a mild adductor strain starts with hip stretching exercises as long as the stretches do not cause pain. Strengthening exercises may also be done immediately as long as they do not cause pain. Therapy will usually advance to include plyometrics, slide board and more sports specific drills. With mild strains the athlete may miss minimal to no competition time.

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