Groin pain in active Johor athletes is one of the most common presentations in our clinic - and one of the most commonly mismanaged.
Around half the cases are adductor-related (pain in the adductor longus or brevis near the pubic bone), and the rest are a mix of inguinal-related, iliopsoas-related, pubic-related (athletic pubalgia), and hip joint related.
Lumping them together as "groin strain" leads to the wrong treatment.
For adductor-related groin pain specifically - the pattern we see most in Mount Austin football, Iskandar Puteri futsal, and the hockey circle in JB - conservative care with a well-evidenced protocol (Copenhagen programme) resolves the majority of cases with a predictable timeline.
How adductor-related groin pain presents
- Pain at the origin of the adductor longus - the tender spot is at the top of the inner thigh, just below the pubic bone.
- Pain with resisted hip adduction (squeezing a ball between the knees reproduces it).
- Pain with kicking, especially cross-body kicks or sudden changes of direction.
- Worse after training, better with rest, but returns when training resumes.
- Acute versus chronic matters - acute adductor strains (< 6 weeks) behave differently from chronic adductor-related groin pain (> 6 weeks).
The Copenhagen adduction programme
Evidence-based, progressive loading of the adductor complex. Three exercises form the core:
Copenhagen plank
Side-lying, with the top leg supported on a bench and the body held in a side plank position with the bottom leg raised off the floor.
Isometric hold, then progressed to dynamic up-and-down movement.
Progression:
- Week 1–2: short-lever (bent knee) static holds, 3 × 10 seconds each side, every other day.
- Week 3–4: long-lever (straight leg) static holds, 3 × 10 seconds.
- Week 5–6: long-lever dynamic (raise and lower), 3 × 6–8 reps.
- Week 7+: single-leg long-lever dynamic, 3 × 6–8 reps.
This is the most studied and effective adductor rehab exercise - in RCTs, 70–85% of players return to sport within 8 weeks.
Adductor squeeze
Lying on the back, knees bent, squeezing a ball or foam block between the knees. Progressively increases load.
Ball squeeze walk-out
From a push-up position with a ball between the thighs, walk hands forward and back.
Integrates adductor strength with core.
The staged return-to-sport
Weeks 1–3: symptom control
Relative rest from sport. Pain-free cross-training (swimming, stationary cycling).
Light Copenhagen work starts only when isometric squeeze is pain-free.
Weeks 4–7: progressive loading
Full Copenhagen protocol progression. Cross-training continues.
Jogging reintroduced at about week 4 if adductor squeeze is pain-free at 50% maximum effort.
Weeks 8–10: sport-specific drills
Sprinting, cutting drills, kicking at increasing intensity. No match play.
Weeks 11–12: return to full training and competition
Progressive return. First match usually 10–12 weeks from start for chronic cases, 6–8 for acute.
Return-to-play criteria
Before returning to match play:
- Pain-free full-effort adductor squeeze.
- Symmetrical strength on adductor strength testing (with handheld dynamometer, within 10% of uninvolved side).
- Pain-free completion of sport-specific drills at full intensity.
- No pain the morning after a full training session.
Returning before these criteria is how re-injuries happen.
Prevention - keep it once it's resolved
Twice-weekly Copenhagen programme, even after full return, reduces recurrence significantly.
Clubs and teams that adopt this as part of their weekly training see lower groin injury incidence across the squad.
When it isn't adductor pain
Distinguish from:
- Inguinal-related groin pain - deeper, often a lump, worse with Valsalva. Needs surgical assessment for possible sports hernia.
- Pubic-related groin pain - central, right at the pubic symphysis. Often combined with adductor issues.
- Hip joint / FAI - anterior groin, deep, worse with deep flexion. See our FAI and hip labral pieces.
- Iliopsoas-related - anterior hip pain, worse with resisted hip flexion.
A proper first-session assessment differentiates these. Correct diagnosis dictates correct treatment.
Typical Johor costs
- Physio course: 10–14 sessions at RM120-250.
- Handheld dynamometer strength testing (not all clinics have this; we do): included in session.
How PhysioJohor matches groin pain athletes
WhatsApp us with: sport, symptoms location and timing, any imaging done, how long symptoms have persisted, and return-to-sport target.
We match to a physio with groin-specific experience - the differential matters and the protocol differs substantially by subtype.
Related guide: Physiotherapy in Johor - complete guide