Physical Therapy for Inguinal Ligament Strain

The inguinal ligament is a tough fibrous band that supports the groin region and helps to prevent the intestines from protruding into the groin. An injury to the inguinal ligament is called a strain and is most commonly experienced by people who participate in certain sports: ice hockey, fencing, cross-country skiing, soccer, handball, high-jumping and hurdling.

A man working with his physical therapist. (Image: AndreyPopov/iStock/Getty Images)

Level 1 Therapy

Rehabilitation for a groin strain or inguinal strain varies depending on the time elapsed since the injury. For the first 24 to 48 hours, the area should be iced and exercised gently. A compression wrap may be used. Nonsteroidal anti-inflammatory drugs, or NSAIDs, may be prescribed to reduce swelling and pain. Light exercise such as using a stationary bicycle with the seat as low as possible and resistance set at a low to moderate intensity is recommended, as tolerated. Finally, static groin stretches, such as the sit-and-reach stretch, the supine groin stretch, the sitting groin stretch, the lunge stretch and the wall stretch, should be performed five times daily, with each stretch being held for 15 to 30 seconds. Avoid bouncing during the stretch as this can cause further injury.

Level 2 Therapy

Once the initial 24- to 48-hour phase has passed, moist heat therapy may be applied. The therapist or physician may perform ultrasound therapy as well. NSAIDs should be continued if prescribed. The groin stretches mentioned above should be continued, and a strengthening program should be undertaken. Examples of groin strengthening exercises include: straight-leg raises prone, supine, adduction – where you bring your leg toward the midline of the body -- and abduction – where you pull your leg away from the midline of the body; hip flexion; hip internal/external rotation; ball squeeze; front step-ups; and slide board. The compression wrap should be worn during these exercises. Perform the exercises every other day, leaving a day's rest in between each workout day.

Level 3 Therapy

After approximately one week, the next level of rehab may begin. Continue all of the activities mentioned in Level 2 and continue to increase the number of sets and/or reps performed of the strengthening exercises. Functional activities such as high-knee running, backward running, vertical leaps, horizontal leaps, bounding drills and sprinting exercises may be performed as tolerated. When both sides of the groin are equal in strength and there is little to no discomfort in the affected area, a return to full activities should be permitted as tolerated.

Caution

These exercises are no substitute for seeing a physician or physical therapist if you suspect you have suffered an inguinal strain. See a doctor to diagnose your condition and to prescribe physical therapy and any drugs as needed. Follow the advice of your physical therapist in order to return to complete function as soon as possible.

REFERENCES & RESOURCES
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