Groin/adductor pain, slightly unstable leg

31yo Male, 235lbs, 6'2" Linear progression

Three or four months ago I pulled something in my groin while I was simply walking around in the house. I felt a sudden sharp pain and it froze up, making me stagger and hop in order not to fall over. The pain quickly dulled and I could move on with my day without any issue, however I felt like I was moving around being more careful with the way I moved the leg.

In training this caused squatting to be virtually impossible. Squatting down unloaded caused significant pain, and I was not able to hit depth. The Deadlift was not impacted a lot. For about four sessions after that I squatted the empty bar in an attempt to rehab. (side-note: I'm able to train only two days a week, so four sessions makes two weeks) The sessions after that I raised the weight around 45lbs every session to get back to what should be a 3x5 of 300lbs. This worked fine with some discomfort. The pain is far less and seems localized to my adductor. In deadlifting I don't feel any pain anymore.

However I seem to have gotten stuck squatting 225lbs. Not because of the weight, but because of the injured leg. It seems twitchy in the sense that it's very hard to keep the knee out and it feels like it is constantly changing it's position or activation. My form feels 'unstable'. I did not have this problem with 225lbs before. The only way I can keep the form acceptable is by slowing the reps down a lot. Going faster for a proper stretch reflex gives a sharp pain at the bottom (tried with lighter weighst).

My patience is wearing thin and I would like to get back to be able to use some speed and stretch reflex, and do the reps without instability. Get back on LP. I feel the progress of my deadlift (405lbs next session) is also starting to slow down because the squat is not being trained properly.

What could be the cause? At first I figured a simple muscle tear in the adductor, but that now seems to be taking too long to heal..
Bonus question: what's with not feeling the pain during deadlift? I would think the deadlift should activate the injured area as well.

Thank you,

Sir G,

Muscle belly tears tend to be very cinematic in appearance. They bleed a lot, and as such, muscle belly tears almost always show the appearance of trauma. Tendon injuries, including partial tears of tendons aren't as overtly demonstrative. This isn't the case with full ruptures, as full ruptures tend to demonstrate deformity in the muscle.....but, partial tears do not. Muscle belly tears tend to resolve very well on their own within a period of about 6 weeks, though training intelligently through a muscle belly tear can significantly shorten the return to function rate and also greatly reduce the re-injury rate (reinjury rate goes from 80+% down to about 10-13%).

Adductor tendon injuries are notoriously difficult to manage, however, tempo work is the mainstay rehab technique. What tends to work really well is using tempo work (3-1-2 tempo seems to be the right speed), but doing regular speed squats during your warm-ups up to the point where pain interferes with your technique. At that point, switch to tempo work. Over time, you will be able to handle heavier and heavier warm-ups at normal speed. This issue normally rectifies itself over the course of about 2-3 months of this training.

It doesn't hurt during the deadlift, because you aren't placing a lot of strain on the proximal insertion of the adductor tendon during a deadlift. Switch to a sumo stance, and you will immediately regret this decision.

Hi, I have aggravated an old groin tear injury about two months ago while squatting 330lbs. Now I can't get past 300lbs. without discomfort while squatting. Will the tempo work you mentioned alleviate this problem? Also, does 3-1-2 speed mean to count 3 sec. going down pause 1 sec. and 2 sec. coming up?
Thank you

Quote:

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Originally Posted by Will Morris

Sir G,

Muscle belly tears tend to be very cinematic in appearance. They bleed a lot, and as such, muscle belly tears almost always show the appearance of trauma. Tendon injuries, including partial tears of tendons aren't as overtly demonstrative. This isn't the case with full ruptures, as full ruptures tend to demonstrate deformity in the muscle.....but, partial tears do not. Muscle belly tears tend to resolve very well on their own within a period of about 6 weeks, though training intelligently through a muscle belly tear can significantly shorten the return to function rate and also greatly reduce the re-injury rate (reinjury rate goes from 80+% down to about 10-13%).

Adductor tendon injuries are notoriously difficult to manage, however, tempo work is the mainstay rehab technique. What tends to work really well is using tempo work (3-1-2 tempo seems to be the right speed), but doing regular speed squats during your warm-ups up to the point where pain interferes with your technique. At that point, switch to tempo work. Over time, you will be able to handle heavier and heavier warm-ups at normal speed. This issue normally rectifies itself over the course of about 2-3 months of this training.

It doesn't hurt during the deadlift, because you aren't placing a lot of strain on the proximal insertion of the adductor tendon during a deadlift. Switch to a sumo stance, and you will immediately regret this decision.

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Quote:

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Originally Posted by bobbymarley

Hi, I have aggravated an old groin tear injury about two months ago while squatting 330lbs. Now I can't get past 300lbs. without discomfort while squatting. Will the tempo work you mentioned alleviate this problem? Also, does 3-1-2 speed mean to count 3 sec. going down pause 1 sec. and 2 sec. coming up?
Thank you

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Will it alleviate the problem? That's a bit of a loaded question since the pain experience is far more complicated than just tissue damage. But, in my clinical practice, I have had success after success using this method and I think the literature is very supportive of the use of heavy, slow resistance training for tendon injuries.

Yes, 3 seconds down, 1 second pause, 2 second up.

Quote:

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Originally Posted by Will Morris

It doesn't hurt during the deadlift, because you aren't placing a lot of strain on the proximal insertion of the adductor tendon during a deadlift. Switch to a sumo stance, and you will immediately regret this decision.

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You were spot on about the sumo stance. That definitely hurts a lot.

Now to what it is.. I don't think it's muscle belly as there was no discoloration. I also have done rehab work for other muscle tears in the past, and this definitely behaves differently. It doesn't really go away. I fear it could be tendon. Is your advise for tendon inflammation? What if it is a partial tendon tear? I thought these don't heal on their own. My mother had a partial tear at the shoulder and she had to get it reattached.

Thanks

Quote:

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Originally Posted by Sir G.

You were spot on about the sumo stance. That definitely hurts a lot.

Now to what it is.. I don't think it's muscle belly as there was no discoloration. I also have done rehab work for other muscle tears in the past, and this definitely behaves differently. It doesn't really go away. I fear it could be tendon. Is your advise for tendon inflammation? What if it is a partial tendon tear?My usage of the term tendon injuries applies to both situations. I thought these don't heal on their own. They do not. They require stress being applied in a consistent, graded manner to facilitate the remodeling of the injured tissue. Rest + tendon injuries = bad outcomes. My mother had a partial tear at the shoulder and she had to get it reattached.Was she over 40-50 years old when this was found?

Thanks

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As above in bold type.

I find that I have to stretch my adductor/groin muscles before squatting or I'll tweak myself in this way, too. I don't think it's a tear, I think it's a cramp and stretching it seems to prevent that. And, yes, I feel a bit of pain in the deadlift after a tweak.

Quote:

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Originally Posted by Dust Devil

I find that I have to stretch my adductor/groin muscles before squatting or I'll tweak myself in this way, too. I don't think it's a tear, I think it's a cramp and stretching it seems to prevent that. And, yes, I feel a bit of pain in the deadlift after a tweak.

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Why is stretching effective for your situation? Just posing the question as an academic exercise.

Quote:

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Originally Posted by Will Morris

Why is stretching effective for your situation? Just posing the question as an academic exercise.

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My understanding of stretching is that you're trying to overcome the contraction reflex of the muscle. My mental model of what causes an adductor/groin tweak is that one of the muscles contracts too aggressively during the eccentric phase (that's when mine occur). I'm usually OK by the next workout, although there's a lingering soreness.

Quote:

---

Originally Posted by Will Morris

Sir G,

Muscle belly tears tend to be very cinematic in appearance. They bleed a lot, and as such, muscle belly tears almost always show the appearance of trauma. Tendon injuries, including partial tears of tendons aren't as overtly demonstrative. This isn't the case with full ruptures, as full ruptures tend to demonstrate deformity in the muscle.....but, partial tears do not. Muscle belly tears tend to resolve very well on their own within a period of about 6 weeks, though training intelligently through a muscle belly tear can significantly shorten the return to function rate and also greatly reduce the re-injury rate (reinjury rate goes from 80+% down to about 10-13%).

Adductor tendon injuries are notoriously difficult to manage, however, tempo work is the mainstay rehab technique. What tends to work really well is using tempo work (3-1-2 tempo seems to be the right speed), but doing regular speed squats during your warm-ups up to the point where pain interferes with your technique. At that point, switch to tempo work. Over time, you will be able to handle heavier and heavier warm-ups at normal speed. This issue normally rectifies itself over the course of about 2-3 months of this training.

It doesn't hurt during the deadlift, because you aren't placing a lot of strain on the proximal insertion of the adductor tendon during a deadlift. Switch to a sumo stance, and you will immediately regret this decision.

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Hi Mr. Morris. I'm dealing with a complete rupture of the Adductor Longus proximal tendon and have been looking through this forum for pre-existing discussions around that. Your comments have been incredibly useful. What has been your experience in the cases of complete tendon ruptures?

The orthopedic surgeon I went to said it's a pretty rare injury and there isn't consensus in the medical community yet due to a lack of a large sample size in pre-existing literature. It's possible to go either the surgical or non-surgical route. There is more strength lost w/o surgery, but surgery has more risk and recovery.

I am currently scheduled for surgery Monday and want to see what the Starting Strength community thinks, since I owe a lot to you guys.