What is an Adductor injury?
Understanding your injury – Brisbane Physiotherapy Edition.
Overview of Adductor injuries:
Description
- Adductor muscle strains are a common cause of medial leg and groin pain especially in athletes engaged in sports that involve sudden changes of direction (football, hockey).
- Adductor tendinopathy may begin as a primary condition or, alternatively, may occur secondary to an adductor muscle strain.
Anatomy
The adductors consist of 5 muscles, which can be divided into the long and short adductors:
- Long adductors: (Gracilis and Adductor Magnus) attach at the pelvis extending to the knee
- Short adductors (Pectineus, Adductor Brevis and Longus) also attach at the pelvis and extend to the thigh bone.
These adductor muscles help to stabilise the pelvis and pull the legs towards the midline (adduction)
Presentation
Adductor Strain
- Pain is usually localized either to the muscle belly or the origin of the adductor muscles at the pubic bone.
- Onset: acute/sudden after quick movement
- Mechanism of injury: most commonly during sprinting. Jumping and overstretching is less common.
- On examination:
o Localized pain on stretch
o Localized pain on resisted muscle activation with reduced strength.
o Localized tenderness on palpation
o May of bruising or swelling in moderate to severe injuries
Adductor Tendinopathy
- Groin pain occurs at the origin of the adductor muscles at the pubic bone.
- Onset: pain can develop gradually or appear as and acute, sharp pain.
- Pain develops after a bout of increased physical activity.
- Untreated the pain tends to persist during activity and may migrate to the other side or towards the pelvis.
- On examination:
o Tenderness over the adductor muscle origin and over the pubic bone
o Pain on stretch
o Pain on resisted muscle activation
o Swelling observed along the affected muscle
Risk factors
- Previous hip or groin injury
- Weak adductors
- Muscle fatigue
- Decreased range of motion
- Inadequate stretching of the adductor muscle complex
Adductor Injury Management
Treatment
Manual therapy:
- Soft tissue release of adductor muscles and hip muscles
Exercises progression:
- Commences with initial reduction of swelling and inflammation by using the RICE regimen (rest, ice, compression, elevation) and active pain-free exercises.
- Progressive strengthening exercises are then commenced after 48hrs.
Active abduction/adduction
Resisted Adduction/flexion
Stabilization exercises
- Functional strengthening
Stationary bike
Pool running
Jogging
Swimming
- Once passive range of motion returns to normal with full strength activities involving rapid change of direction can recommence.
Running – straight line
Running – figure of eight
Rapid changes of direction
Kicking – gradually increase
Prognosis:
- Adductor muscle strain ~4-8 weeks
- Adductor tendinopathy ~8-12 weeks
Preventing Adductor Injuries
To prevent the development of adductor injuries, an athlete should engage in a strength and conditioning programme focused on improving strength and coordination while allowing sufficient periods of recovery.
The athlete must develop muscular strength and stability around the groin and hip regions by engaging in activity specific exercises relevant to the demands of the sport. Muscular flexibility is also important and regular stretching is recommended.