Part of Ice hockey and skiing injuries: ski boots, skates and what each sport does to a body
Hockey groin injury: why skating loads the inner thigh, and what to do about it
Warning signs, and when to get help
Why do hockey players get groin injuries?
The adductors run from the pubic bone down the inside of the thigh. Their job is to bring the thigh in toward the other leg, and to control it when something pulls it the other way. A skating stride does the opposite movement first, pushing the leg out and back, and then asks the adductors to bring it home under the body. Do that stride over and over for a whole session, on a surface that offers nothing to grip, and you have a muscle group working long and working often. That description is the movement itself rather than a research finding, and the causal weight on this page sits on the surveillance data below.
The data backs the training half of that story, not the collision half. Across 2014-15 to 2018-19 in college men's ice hockey in the United States, 19.72 percent of all practice injuries were to the hip or groin, more than any other region in practice, against 8.77 percent of injuries in competition, and practice injuries as a whole were 24.65 percent non-contact and 10.36 percent overuse against 7.51 percent and 2.16 percent in games (Boltz and colleagues, 2021). Across the whole dataset the hip or groin sat third among body parts at 12.10 percent, behind the shoulder and the head or face.
It is common, and more common than the time-loss numbers suggest. In 329 Swedish professional men, 175 players, 53.2 percent, reported a hip or groin problem during the previous season (Wörner, Thorborg and Eek, 2020). Twenty-six of them, 7.9 percent, had already had surgery on a hip or groin at some point. That is a level III study using players' recall of a season, which is worth knowing before you quote it, but the direction is not in doubt.
Women's hockey has one prospective season behind it, not a body of work. Among 129 players from the Swedish Women's Hockey League followed over 28 weeks, the hip or groin was the most reported region for overuse problems at 35 percent and the most burdensome at 49 percent of the total severity score, while acute injuries were most often the shoulder at 15 percent, the head at 13 percent and the knee at 11 percent (Wörner and Eek, 2025). The authors call for prevention strategies to be developed and tested, which is a fair reading of where that evidence stands.
Is it the skating or the shooting?
Nothing readable separates those two, and anyone who tells you otherwise has gone past the evidence. What the surveillance can separate is contact from non-contact and games from practice, and on both of those this injury lands squarely in the training week and not in the moments when somebody hits you (Boltz and colleagues, 2021).
The nearest thing to a movement-level answer comes from goaltending, and it is a survey of opinion, not a measurement. When 132 goaltenders and 43 coaches in Sweden rated goaltending movements for how demanding they are on the hip and groin, the stances most often rated very or extremely demanding were reverse vertical horizontal post-play at 40 percent and the butterfly save at 25 percent, and coaches rated techniques as more demanding than the goaltenders themselves did (Wörner and colleagues, 2021). That tells you what players and coaches believe is hard. It does not tell you what hurts people.
So the useful framing is not which action did it. It is how much of that action you did, how fast you added it, and what state the muscle was in when you started the week.
When in the week does it happen?
On training days, mostly. The groin's share of injuries more than halves when you move from practice to competition, while the shoulder and the head or face roughly double in the other direction (Boltz and colleagues, 2021). Games carry the higher rate overall, where the competition rate ran at 6.54 times the practice rate with a 95 percent confidence interval of 6.08 to 7.04, which is exactly why the groin standing out in practice says something.
So look at the shape of your week, not the roughness of the game. Back-to-back heavy skating days, a sudden jump in volume at the start of a season or after a break, and the first week back on the ice after time off are where this one is built.
Do goalies get more groin injuries?
The question is asked constantly and the honest answer is that it is unsettled. In that Swedish professional cohort of 92 goalkeepers, 93 defensemen and 144 forwards, there were no significant differences between playing positions in hip and groin problems (Wörner, Thorborg and Eek, 2020). The authors do not read that as a clean negative. They write that their results should not be taken to show either a lower or a higher prevalence among goalkeepers, because the goalkeepers were recruited separately from the other positions and fewer defensemen and forwards responded, and they note that goalkeepers are on the ice longer than anyone else and may well be at higher risk once exposure is accounted for. Earlier work had pointed the same way.
What the study does settle is the other half of the question. A forward or a defenseman who assumed this was a goaltender's problem has no grounds for it: just over half of every position in that cohort had a hip or groin problem in a single season, so nobody gets to skip the same rehabilitation.
What the famous strength test actually measured
There is a figure in circulation that a hockey player is 17 times more likely to strain the adductor, and it is real, but it travels without the part that makes it usable. The study tested 81 professionals before two seasons and followed 47 of them, during which 8 players sustained 11 adductor strains. Preseason hip adduction strength was 18 percent lower in the players who went on to strain the muscle. Adduction strength was 95 percent of abduction strength in the uninjured players and 78 percent in the injured ones, and the 17 times figure applies to players whose adduction strength was under 80 percent of their abduction strength (Tyler and colleagues, 2001).
The ratio is the actionable part and the multiplier is the headline. The population is one professional squad over two seasons with 11 strains in it, which is a small number of events for a large relative risk. And it is a measurement, not a home test, so the version to act on is a physiotherapist putting numbers on both directions, not a self-assessment on the dressing room floor.
The study that followed from the same group is the only hockey-specific prevention evidence we could find. Of 58 players on one team, the 33 identified as at risk on preseason strength did a 6 week functional strengthening program, and adductor strains fell from 11 across the two preceding seasons to 3 across the two following ones (Tyler and colleagues, 2002). No randomization, no control team, one squad. A clinical commentary on physical therapy management of hockey players sets out the broader prevention thinking for clinicians, including position and age effects (Wolfinger and Davenport, 2016).
Can you keep playing with a strained groin?
Plenty of players do, and that is the problem, not the solution. In the Swedish cohort, 158 players, 48 percent, had hip and groin problems that never cost them a day, with a median duration of 3 weeks; 97 players, 29.5 percent with a 95 percent confidence interval of 25 to 35, had problems that did cost time, and those ran to a median of 2 weeks with the middle half between 1 and 4 (Wörner, Thorborg and Eek, 2020).
The sting is in what happened next season. Players who had reported hip and groin problems started the following season with significantly worse self-reported hip and groin function, and the longer the symptoms had lasted the more disability they reported, at a p value of 0.002 or lower. So the question is not whether you can finish the shift. It is whether a problem you are managing week to week is quietly setting up a worse version of itself.
An international expert group agreed a shared vocabulary for this area in Doha, and the term for the pattern on this page is adductor-related groin pain: the adductors are tender to press and it hurts to squeeze the legs together against resistance (Weir and colleagues, 2015). That group also recommended dropping labels such as sports hernia and osteitis pubis, so if an old diagnosis of that kind is following you around, it is reasonable to ask what it means now.
Where to go next
The program is not on this page, on purpose. For the strain itself, the staged rehabilitation, the dose and the return criteria are on groin strain, and that page carries the trial evidence for adductor loading. If this has been grumbling for months instead of weeks, hip adductor tendinopathy is the better fit. If nothing has been named yet and you are not sure the inner thigh is even the problem, start at groin pain, which sorts the causes.
Pain felt deep in the front of the hip, with clicking, catching or a hip that feels stuck at the end of range, is a different conversation: hip impingement and hip labral tear cover it, and both carry the sections for readers who have had or are considering hip arthroscopy. If you have had an operation on the hip or the groin, your own surgeon's plan comes before anything written here, and those two pages are where the post-operative detail lives.
When the question becomes whether you are ready for a full session, the return to sport test battery sets out the tests clinicians use for that decision. The sport as a whole, and how it compares with skiing, is on the ice hockey and skiing injuries hub.
When to see a physio
Earlier than most players do. The reasonable triggers are a strain that has not clearly improved in a week or so of sensible self-management, a groin that has been strained before, or a complaint that keeps coming back every time the training week gets heavier. Add one more: if you have quietly changed how you skate or how you push off to keep away from it, that is worth an appointment even if you are still playing.
Expect the assessment to be hands and history, not a scan. Where exactly it is tender, what resisted squeezing does, what your adduction measures against your abduction, how your week has been built, and what else in the hip and the lower back might be contributing. Ask for the criteria for going back rather than a date, because the criteria are what stop this becoming the same fortnight three times in one season. The warning signs below come first, at whatever speed each line sets.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: sudden, severe pain in a testicle, testicle pain that comes with feeling sick, being sick or pain in your tummy, or testicle pain that has lasted more than an hour or carries on while you rest. Go to an emergency department straight away or call emergency services, and do not drive yourself. The testicle may have twisted (testicular torsion), which needs treatment quickly.
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: tingling or loss of feeling in the hip or leg after a fall or injury. Call emergency services or go to an emergency department.
- Emergency: pain, tingling, numbness or weakness in both legs, numbness or altered feeling around your genitals or bottom, or new trouble peeing or controlling your bladder or bowels. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away, and do not drive yourself. These can be signs of pressure on the nerves at the base of the spine (cauda equina syndrome).
Get help today
- Same day: a lump or bulge in your groin or upper thigh has become painful or tender, or you have a groin lump and a bloated tummy, you feel or are being sick, you are constipated, or you have a high temperature or feel hot, cold or shivery. This can be a hernia that has become trapped. Get medical help straight away, the same day, for example at urgent care or an emergency department. If the pain is severe or came on suddenly, you cannot poo or pass wind at all, you are vomiting blood or your vomit looks like coffee grounds, or you have suddenly become confused, call emergency services or go to an emergency department straight away.
- Same day: aching or discomfort in a testicle that worries you, a lump or swelling in a testicle, a change in its shape or in how it feels, or one testicle that has become bigger than the other. Get an urgent appointment with your doctor the same day.
- Same day: you felt a pop or snap in the groin or inner thigh and now have large bruising spreading down the inner thigh, a dip or gap you can feel in the muscle, or you cannot squeeze your knees together at all. Get assessed the same day, for example at an urgent care center, and ask whether you need a scan. The muscle may be badly torn or pulled away from the bone, which takes much longer to recover and needs its own plan.
- Same day: the groin or inner thigh is very painful or the pain is getting worse, the bruising or swelling is large or growing, you cannot walk more than a few steps, or the leg feels very stiff and hard to move. Get medical advice the same day.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: groin pain that built up with running, marching or jumping, often after you increased your training, and now hurts when you walk, makes you limp, or aches at rest or at night. Stop running and jumping and keep walking to a minimum until it has been checked. Get medical advice the same day and mention your training. If you cannot put weight on the leg, go to an emergency department. This can be a stress fracture in the neck of the thighbone (femoral neck stress fracture), which is easy to miss at first and can become a full break if you keep loading it.
- Same day: the hip or groin is hot and swollen, the skin around it has changed color, or you have groin pain with a high temperature or feel hot, cold or shivery. Get medical help the same day, and go to an emergency department if you feel very unwell. An infection in the joint or bone needs treatment quickly. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: a child or teenager has sudden pain in the hip, thigh or knee, is limping, or cannot put weight on one leg. Get an urgent appointment with a doctor the same day. If they have a high temperature or seem very unwell, go to an emergency department. This page is for adults, and hip pain in children has different causes.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new hip or groin pain after a fall, even a small one, if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time, even if you can still walk. Get medical advice the same day, and say that you fell and that your bones are thin. Until it has been checked, stop the exercises and keep as much weight off that leg as you can, using your stick, frame or crutches if you have them and asking someone for help to move about, because a crack in the hip that has not slipped yet can slip when you walk on it, and a hip that has slipped usually needs a bigger operation than one that has not. A broken hip is not always obvious at first, and a first X-ray does not always show it, so if you have been checked and sent home and you still cannot walk on that leg, or the pain is getting worse, go back and say so.
- Same day: hip or groin pain that is worse at night or does not ease with rest, and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.
Book an appointment
- Within a day or two: hip or groin pain that is worse at night or does not ease with rest, and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
- Within a few days: hip or groin pain that is worse at night or does not ease with rest, and keeps getting worse. See your doctor within a few days.
- Within a few days: new groin or hip pain and you take steroid tablets long term, or have in the past, or you regularly drink a lot of alcohol. This can be a sign of a problem with the blood supply to the top of the thighbone (avascular necrosis). Book an appointment with your doctor within a few days and mention the steroids or alcohol.
- Within a few days: the strain is not getting any better after a week or so of looking after it yourself, or your groin keeps getting strained again. Book an assessment with a physio or doctor in the next few days.
- Within 2 weeks: a lump in your groin or upper thigh that is not painful, especially one that gets bigger when you cough or sneeze and smaller when you lie down. This can be a hernia. Book an appointment with your doctor.
- Within 2 weeks: a lump in your groin or upper thigh that does not hurt and does not behave like a hernia, meaning it does not get bigger when you cough or sneeze, it does not get smaller when you lie down, it feels hard or fixed in place, or it is slowly growing. A painless groin lump is not always a hernia, and a swollen gland with no explanation needs looking at in its own right. Book an appointment with your doctor and ask for the lump itself to be examined rather than treated as a hernia on the history alone. Say when you book if you also have night sweats, an unexplained fever, itching, shortness of breath or weight loss you did not intend, because those change how quickly it should be looked at.
- Within 2 weeks: pain that spreads down the leg below the knee, especially with numbness or tingling in the leg or foot. The pain may be coming from your lower back rather than the groin. Book an appointment with a doctor or physio.
- Within 2 weeks: groin pain that came on slowly without a clear injury, or sits deep in the groin with clicking, catching or locking of the hip. Book an appointment with a physio or doctor. Groin pain has several possible causes, including the hip joint itself.
Common questions
How long does a hockey groin injury keep you out?
The best figure for professional men is a median of 2 weeks, with the middle half of players between 1 and 4 weeks, among the 97 of 329 Swedish professionals whose hip or groin problem cost them any time at all in the previous season (Wörner, Thorborg and Eek, 2020). That is self-reported recall over a season, not a day count kept by a medical team, so treat it as the shape of the thing. The figure that deserves equal weight is the other one in the same study: 158 players, 48 percent of those followed, had hip and groin problems that cost them no time off the ice, and those lasted a median of 3 weeks. So most of this injury is measured in weeks and not months, and a lot of it never produces a date to count from because the player never stops.
Do goalies get more groin injuries than forwards or defensemen?
Nobody can say yet, and the study usually quoted for an answer says so itself. Among 329 Swedish professional men split as 92 goalkeepers, 93 defensemen and 144 forwards, 53.2 percent reported a hip or groin problem in the previous season and there were no significant differences between playing positions (Wörner, Thorborg and Eek, 2020). Its authors then write that their result should not be taken to show either a lower or a higher prevalence among goalkeepers, because the goalkeepers were recruited separately and fewer defensemen and forwards answered, and they add that goalkeepers spend longer on the ice than any other position and may be at higher risk once that is allowed for. So the position question is open, and a goaltender should not read this as a reason to do less of the adductor work. What does exist for goaltenders is a perception survey: 132 goaltenders and 43 coaches in Sweden rated goaltending movements, and the stances most often called very or extremely demanding on the hip and groin were reverse vertical horizontal post-play at 40 percent and the butterfly save at 25 percent, with coaches rating techniques as more demanding than goaltenders did (Wörner and colleagues, 2021). How demanding a movement feels is not a measure of how often it hurts anybody.
Should I test my own adductor strength?
Not at home, no. The test behind the 17 times figure was done with equipment and a protocol in a professional preseason, comparing how hard you can pull your legs together with how hard you can push them apart, and the threshold that mattered was adduction below 80 percent of abduction (Tyler and colleagues, 2001). You cannot reproduce that by squeezing a ball between your knees and guessing. A physiotherapist can measure it properly, and the measurement is worth having if you have strained this muscle before, because that is the group the research was looking at. What the number is not is a license: a ratio above the threshold was not a guarantee in that study, which followed 47 players and recorded 11 strains in 8 of them.
What stops it coming back next season?
The one piece of hockey-specific evidence is not a randomized trial. On one National Hockey League team, 33 of 58 players whose preseason adductor strength marked them as at risk did a 6 week functional strengthening program, and the team recorded 3 adductor strains across the two following seasons against 11 in the two before, which the authors give as 0.71 against 3.2 per 1000 player-game exposures (Tyler and colleagues, 2002); all three later strains were first degree and all happened in games. One team, no randomization and no control team, so the fair description is promising and not proven. The other thing the research points at is less about a program: players who had hip and groin problems one season started the next with worse function, and the longer the symptoms had lasted the more disability they reported (Wörner, Thorborg and Eek, 2020). Finishing the rehab on the one you have now is the part with evidence behind it, and groin strain sets out the stages.
References
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- Wörner T, Thorborg K, Eek F. High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position. Knee Surgery, Sports Traumatology, Arthroscopy. 2020;28(7):2302-2308. https://doi.org/10.1007/s00167-019-05787-7
- Wörner T, Frayne RJ, Magnusson T, Eek F. The Perceived Demands of Ice Hockey Goaltending Movements on the Hip and Groin Region: An Elite Coach and Player Perspective. Orthopaedic Journal of Sports Medicine. 2021;9(11):23259671211055699. https://doi.org/10.1177/23259671211055699
- Wörner T, Eek F. Incidence, Prevalence, and Burden of Health Problems in Elite Female Ice Hockey Players: A One-Season Prospective Study. Translational Sports Medicine. 2025;2025:5092272. https://doi.org/10.1155/tsm2/5092272
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Written and checked by the PocketPhysio editorial team. Last updated 2026-11-06.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.