Hockey season is on!!!
Groin pain is a common complaint for soccer players and gollies. Excessive straining of the adductor muscles with repetitive leg swings and kneeling can cause pain and discomfort at the inner leg muscles, its attachment at the pubic bone and groin line.
The Holmich Protocol was initially developed to tackle ‘Sports hernia’ injuries, which can be applied to multiple sports rehab. Some of their exercises are depicted below. They have been specifically developed to strengthen the adductor and abductor muscles of the femur, both eccentrically and concentrically.
The stretching exercise for the iliopsoas (number 6) was included, as pain and tightness of this muscle is often a significant problem. The programme is designed so as to not to require any additional equipment, to be fast to carry out, and to be incorporated within the regular football warm-up. The exercises are:
- Isometric adduction against a football placed between the feet when lying supine, the first toe pointed straight forward and pressure being applied against the ball as hard as possible; each adduction ten seconds, five repetitions (stimulating the adductor muscle group and the torso-to-pelvis stability).
- Isometric adduction against a football placed between the knees when lying supine with flexed hips and knees and feet flat on the surface, the first toe pointed straight forward and pressure being applied against the ball as hard as possible; each adduction ten seconds, five repetitions (stimulating the adductor muscle group and the torso-to-pelvis stability).
- Combined abdominal sit-up and hip flexion, starting from the supine position and with a football placed between the knees (“folding knife exercise”); two series of 20 repetitions performed rhythmically at a slow pace (stimulating the coordination of both the eccentric and concentric work of the torso muscles and the hip- and pelvis-related muscles).
- One-leg coordination exercise flexing and extending the knee and swinging the arms in the same rhythm (“cross-country skiing on one leg”); one minute twice for each leg (stimulating the neuromuscular coordination, utilising the principles of core stability including the muscles of the torso as well as of the lower extremities).
- Hip adduction against a partner‘s hip abduction. In the sitting position, supported by the hands placed on the ground behind the trunk, one player places his straight leg with the feet and lower shin on the outside of his partner‘s feet and lower shin. He adducts as the partner abducts eccentrically and slowly gets his feet pressed together. He then abducts concentrically as the partner adducts eccentrically and is slowly brought into abduction. They work like this for one minute and then shift positions; two sets of one minute in both positions (stimulating the concentric and eccentric strength of both the adductor and the abductor muscles).
- Stretching of the iliopsoas muscle with a standardized technique; 20 seconds stretch for each leg repeated twice (start from the easiest version of this exercise 😊).
Engage glutes muscles + foot on the floor
Engage glutes muscles + Knee flexion
Engage glutes + knee flexion + hip forward
The duration of the exercise program was approximately 10 min and the exercises were used as an integrated part of the warm-up exercises before every regular football / soccer/ hockey practice.
Reference: Hölmich P., Larsen K., Krogsgaard K., Gluud C. Exercise program for prevention of groin pain in football players: A cluster-randomized trial. Scand J Med Sci Sports. 2010;20(6):814-821