Adductor Tendinopathy

Presentation:

Chronic groin pain, hip stiffness and pain with active leg adduction

Anatomy:

Groin injuries are injuries to any of the following five muscles:

  • pectineus
  • adductor brevis
  • adductor longus
  • gracilis
  • adductor magnus

Pathology:

Repetitive sprinting, turning and kicking may excessively load and stretch the psoas and abdominal muscles. This may generate an interface problem with the ilioinguinal nerve so that irritation of the nerve develops and, as a cause and effect consequence, the groin becomes irritated and poor muscle control leads to weakening of the abdominal wall, poor stability of the symphysis pubis and altered adductor-abdominal synergy during ballistic movement.

Differential Diagnoses:

  • Pelvic girdle pain in the SIJ
  • Osteitis pubis (symphysis pubis stress injury). These patients may have tenderness to palpation focally to the proximal adductor muscles, the symphysis pubis or the superior pubic ramus. Traction on the pubic ramus by the adductor muscles may lead directly to disruption of the fibrocartilaginous symphyseal disc.
  • Lumbar radiculopathy. Symptoms from these nerve roots (T12, L1, L2) may be provoked with slide or femoral nerve stretch tests.
  • Bursitis (irritation to the bursa between the iliotibial tract and the greater trochanter, subgluteus minimus, medius and maximus bursae along with the sub-iliopsoas bursa)
  • Iliopsoas tendinosis
  • Tears within the rectus abdominis and inguinal hernia

Rehabilitation Notes:

Strengthen the adductors and stretch the opposing abductors

Copenhagen Adduction Exercise:

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