Adductor Rehabilitation

After Bilateral Laparoscopic Inguinal Hernia Repair

This programme is a guide to gradually restore adductor strength, running and sport-specific function. Progress should be guided by comfort and function rather than the calendar alone.

Days 1–5 | Protect and mobilise

• No resisted adductor exercises.
• Gentle active hip and leg movement within comfort.
• Walk for about 10 minutes initially and increase gradually each day.

Progression: Progress when walking is becoming easier and the wounds are satisfactory.

Week 1 | Gentle activation

• Begin low-load adductor isometrics: lie on your back with knees bent and a pillow or soft ball between the knees.
• Gently squeeze for 5–10 seconds, 5–10 repetitions, 1–2 sets, once or twice daily.
• Start at approximately 20–30% effort. Add gentle pain-free hip flexor, abductor and rotator isometrics.

Progression: Progress if there is no significant increase in pain during exercise or the following day.

Week 2 | Build controlled strength

• Increase adductor squeezes gradually towards 30–50% effort.
• Perform squeezes with the hip and knee in slightly different comfortable positions.
• If comfortable, introduce very light standing resisted adduction using an exercise band.
• Continue longer walks; gentle swimming may begin once wounds are healed. Light stationary cycling is reasonable.

Progression: Progress when walking is near normal and the exercises do not produce reactive groin pain.

Week 3 | Dynamic strengthening

• Progress resistance-band adduction.
• Introduce short-lever side-lying adduction and bridging with a gentle ball squeeze.
• Begin controlled lateral movement and gentle eccentric adductor loading.
• Brisk walking can progress to gentle jogging if comfortable.

Progression: Aim for pain no greater than about 2/10 with loading and no deterioration over the next 24 hours.

Week 4 | Running and early sports rehabilitation

• Progress moderate resisted adduction and eccentric strengthening.
• Introduce short-lever Copenhagen holds: initially 5–10 seconds, 3–5 repetitions.
• Add controlled lateral lunges and gradual change-of-direction drills.
• Progress running, acceleration and deceleration. Light sprinting can begin if comfortable.

Progression: Progress when hip movement is full or near full, tenderness is minimal and single-leg loading is well controlled.

Week 5 | Sport-specific loading

• Progress Copenhagen adduction towards a longer lever as tolerated.
• Increase concentric and eccentric resistance.
• Add lateral lunges, resisted side-stepping and more demanding sport-specific adductor work.
• Progress sprinting, cutting, kicking and sports drills. Heavier weights can be reintroduced gradually.

Progression: Near-symmetrical strength and pain-free sport-specific movement are desirable before unrestricted return.

Weeks 5–6+ | Return to full activity

• Continue progressive adductor strengthening as part of a maintenance programme.
• Progress from training to unrestricted training and then competition when appropriate.
• For athletes, full-speed running, cutting, kicking and other relevant maximal movements should be comfortable before return to competition.

Progression: Clinical reassessment may be appropriate before return to high-level or competitive sport.

Important

• Do not force through sharp, increasing or persistent groin pain.
• If an exercise causes a noticeable flare that persists into the following day, reduce the load or return to the previous stage.
• Seek medical advice for increasing wound redness or discharge, fever, marked swelling, severe or worsening pain, or any other concerning postoperative symptoms.
• Individual recovery varies. Your surgeon or physiotherapist may modify this programme according to the operation performed, symptoms and sporting requirements.

This information provides general postoperative guidance and does not replace individual advice from your surgeon or physiotherapist.