Adductor strain exercises: a phase-based rehab handout

Key Takeaways

Adductor strains are common groin injuries affecting the inner-thigh muscles, graded by severity (Grade I: mild; Grade II: moderate; Grade III: severe tear).

Rehabilitation follows a progressive three-phase protocol, moving from low-intensity isometric holds to high-intensity eccentric work such as the Copenhagen adduction exercise, with clear dosage (sets, reps, frequency) per phase.

Return to sport is criterion-based: hip adduction strength within 10% of the uninvolved side and symptom-free sport-specific testing, not a fixed calendar date.

Practice management software like Pabau lets you deliver this handout digitally, track patient progress, and automate exercise-compliance reminders.

Adductor strain exercises rebuild strength in the inner-thigh muscles after a groin pull, progressing from gentle isometric holds to high-load eccentric work before an athlete returns to sport. This downloadable physical therapy handout gives physical therapists and sports medicine clinicians a structured, evidence-based program to hand a patient immediately after assessment.

Adductor strains are among the most common groin injuries in cutting and pivoting sports. One review of 25 college sports recorded the highest rates in men’s soccer and men’s ice hockey, with re-injury rates of 18% in professional soccer and 24% in professional hockey. A clear, dosed home program is what keeps those recurrences down.

The handout connects clinical guidance with home-exercise compliance, using phase-based progressions, dosage tables, and printable formats you can brand with your logo. Practice management software like Pabau lets you deliver and track it digitally, so exercise adherence lands in the patient record automatically.

What’s in the adductor strain exercises handout?

The handout is a patient-education document that turns adductor rehabilitation science into a practical home program for groin injuries affecting the inner-thigh muscles (the adductors: longus, brevis, magnus, gracilis, and pectineus).

It includes injury grading, timeline estimates per grade, exercise progressions with sets, reps, and frequency, stretching techniques, and clearance criteria for return to running or sport. Grading follows three levels:

• Grade I: mild strain with minimal pain and no meaningful strength loss.
• Grade II: moderate strain with functional loss and pain on resisted adduction.
• Grade III: severe tear with significant disability, often needing surgical consultation.

Clinicians typically confirm the diagnosis with a focused assessment such as the adductor squeeze test before assigning the handout, and document the injury with an appropriate code such as ICD-10 code S76.202D (adductor muscle strain, subsequent encounter), adjusting laterality and encounter type to the case.

According to evidence-based sports medicine literature, structured return-to-running protocols with clear progression thresholds are associated with faster recovery and lower re-injury rates than generic advice.

Adductor strain exercises by phase

The exercises progress along a strength continuum: from low-intensity isometric work at a short muscle length to high-intensity eccentric work at a lengthened position. Patients advance when they can complete the current phase pain-free, not on a fixed schedule. Dosages below are common starting points; set the exact prescription to the individual.

Phase 1 (early): isometric adduction

Low-intensity isometric holds (under 30% of maximum effort) activate the adductors without lengthening them. For a Grade I strain, these can often start within a few pain-free days.

• Isometric ball squeeze: lie on your back, knees bent, feet flat, and squeeze a ball or pillow between the knees. Hold submaximally and pain-free. A common starting dose is 5 holds of 20–30 seconds, once or twice daily.
• Short-lever progression: repeat the squeeze with the hips at a wider angle as tolerance improves, keeping every rep pain-free.

Phase 2 (intermediate): concentric strengthening

Moderate-intensity isotonic work (roughly 30–60% of maximum) moves the muscle through range under load and adds pelvic and core control.

• Side-lying hip adduction: lie on the injured side, top leg supported forward, and lift the bottom (injured) leg toward the ceiling. Aim for 3 sets of 10–15 reps.
• Standing band or cable adduction: pull the injured leg across the midline against light resistance, 3 sets of 12–15.
• Core and pelvis: add side planks and glute bridges to stabilize the pelvis, which shares load with the adductors during cutting.

Phase 3 (advanced): eccentric strengthening

High-intensity eccentric work (above 60% of maximum, at a lengthened muscle position) produces the highest adductor forces and best prepares the muscle for sport. The Copenhagen adduction exercise is the standout here: strong evidence supports it for building eccentric hip-adduction strength and preventing groin problems in athletes, so it is best introduced in late-stage rehab and carried into ongoing prevention.

• Copenhagen adduction exercise: in a side plank with the top foot supported on a bench or by a partner, lower and raise the hips under control. Start short-lever (support at the knee) and progress to long-lever (support at the foot). In a trial of male footballers, a three-level Copenhagen program cut the risk of groin problems by about 41%.
• Sliding leg adduction: with a towel or slider under the injured foot, let the leg slide out, then draw it back in against resistance.
• Loaded standing cable adduction: increase resistance through the full range as strength returns.

One evidence-based detail sets this program apart from the stretch-first handouts athletes usually find: the classic Hölmich active-training protocol for adductor-related groin pain deliberately omits passive adductor stretching in favor of progressive strengthening. Lead with the isometric and eccentric work, and treat stretching as optional comfort rather than the core of recovery.

How to use the adductor strain exercises handout

Deliver this handout within the first session after assessment and grading. The five steps below outline how clinicians fold it into their workflow.

1. Assess and grade the injury: Perform manual muscle testing (for example, using the MRC scale for muscle strength), palpation, and functional testing (hop test, squeeze test, pain on resisted adduction). Record Grade I, II, or III on the handout cover. This sets the phase the patient starts in.
2. Review the phases with the patient: Walk through the three phases during the appointment. Explain that progression depends on pain-free completion of the current phase, not calendar time. Have the patient demonstrate one exercise from each phase to confirm competency.
3. Provide phase-specific instructions: Highlight the active phase and the next one. If starting Phase 1, also show the Phase 2 exercises. Circle the dosage: sets, reps, hold times, and weekly frequency. Sticking to those dosages accelerates recovery more than random exercising.
4. Document the plan: Record exercise tolerance, pain response, and readiness to progress in each note. Practices using clinical documentation software can pull these fields straight from the handout’s dosage tables, cutting manual entry. This supports clinical safety and evidence of medical necessity for insurance.
5. Schedule progression reviews: Book the next session 1–2 weeks out to reassess. Distribute the handout digitally through the patient portal and ask for photos or short videos of home exercises to track compliance between visits.

This framework gives patients a signed reference guide, gives clinicians documented compliance, and keeps progression decisions criterion-based (pain-free strength, range of motion, functional milestones) rather than time-based.

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Who is the adductor strain exercises handout helpful for?

Physical therapists are the primary users. The handout supports groin strain rehabilitation across private practices, hospital outpatient rehab, and sports medicine teams. Clinicians working with soccer players, ice hockey athletes, rugby players, and runners benefit most, since adductor strains are especially common in these populations.

Compliance requirements differ between private practice and hospital settings. Therapists working across both may want to review compliance requirements for physical therapy practices when building handout distribution into their documentation workflow.

Many physical therapists run their practice on dedicated physical therapy practice management software that stores the handout in the patient’s chart alongside intake forms and progress notes.

Sports medicine doctors and athletic trainers use the handout to communicate nonoperative management to patients after a groin injury. Personal trainers and strength and conditioning coaches working within a supervised clinical pathway (not independent diagnosis) use it to guide return-to-training exercises.

Sports medicine practitioners in multi-disciplinary practices combine physical therapy, osteopathy, and strength training. Distributing the same graded handout keeps exercise progression consistent across the team. Many also use a sports physical form to document baseline clearance before returning athletes to training.

Benefits of using the adductor strain exercises handout

Compliance and adherence: A written, signed handout increases home-exercise adherence compared with verbal instruction alone. Patients refer to it between sessions and are more likely to complete the prescribed dosage, a pattern reflected in broader patient compliance research.

Criterion-based progression: Clear thresholds (“advance to Phase 2 when you can complete Phase 1 pain-free”) replace guesswork, reducing delayed recovery and re-injury. Patients understand the logic instead of feeling stuck.

Medicolegal documentation: A signed, dated handout demonstrates informed patient education and treatment planning. Notes referencing the handout dosage support medical necessity for billing and insurance review, which protects the practice during audits.

Practice efficiency: Less time repeating exercise instructions. Using structured patient intake forms and digital distribution through the client portal removes printing and mailing, so patients get instant access from any device.

Many practices pair this with a physical therapy intake form, so intake and exercise handout become part of the same digital packet.

Return to sport after an adductor strain

Returning to sport takes more than finishing the exercises. Progress through criterion-based milestones: pain-free hopping on the injured leg, single-leg stance stability with no trunk shift, sport-specific agility drills (cutting, pivoting), and sport-matched endurance.

The strength benchmark is specific. Measured unilaterally with a handheld dynamometer, hip adduction strength on the injured side should reach within 10% of the uninvolved side and within 10% of the same-side hip abductors. A squeeze test alone can miss these deficits, so measure each leg separately before clearance.

Grade I strains typically return to sport around 3–6 weeks post-injury, Grade II around 6–12 weeks, and Grade III (severe tears) 3–6 months or longer if surgery is needed. These are estimates only; timelines depend on training compliance, age, and injury history.

• Confirm hip adduction strength within 10% of the uninvolved side.
• Perform sport-specific movements without reproducing symptoms.
• Document that criteria are met before clearance.
• Communicate clearance to the patient and, if relevant, coaching staff or employer.

Conclusion

A phased, dosed, criterion-based adductor strain exercises handout turns rehabilitation science into something a patient can actually follow at home, so recovery is faster, adherence is higher, and outcomes are documented. Book a demo with Pabau to see how digital forms and patient portals streamline handout delivery and exercise tracking in your workflow.

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