Adductor Tendinopathy

The hip adductor muscles help bring your legs together and rotate your hip inwards. The short adductors include the pectineus, adductor brevis, and adductor longus, and the long adductors include the adductor magnus and gracilis. These start at your pubic bone where the crease of your inner thigh meets your body and move down your thigh bone to the inside of your knee. At the end of these muscles are tendons, which are tough, fibrous tissues that connect muscles to bones.

Groin injuries comprise 2 - 5% of all sports injuries; adductor tendinitis and tendinopathy are among the most common causes of groin pain in athletes. The adductor longus is responsible for 62% of groin injuries, and tends to be the most prone to injury, followed by the gracilis muscle. This injury is problematic among athletes especially runners and professional dancers, as both activites stress the adductor tendon quite heavily.

The initial damage can range from overstretching or a slightly pulled muscle (grade 1 strain) to partial tearing (grade 2 strain), to complete rupturing of your adductor muscle or tendon fibers (grade 3 strain). If you do not allow your tissues to heal properly, your previous adductor injuries will build upon each other. The inability of your tendon to repair itself encourages microtears to accumulate faster than they can heal, increasing the breakdown of your tissue and reinforcing your pain and disability. The majority of adductor strains are grade 1 or 2 strains that involve partial tears, where your adductor tendon and muscle meet.

Causes and Diagnosing

The most common cause of tendon inflammation is overuse of your adductors. It results from repetitive stress placed on your adductor muscles and tendons during active sports (especially when running, kicking, twisting, or side-stepping), as a result of a sudden fall or direct hit, and/or overexerting yourself in everyday activities that involve twisting or lifting heavy objects while bending or running on an unstable surface (like grass or mud).

Alignment issues and leg length discrepancies, which affect the way you walk, or incorrect sport-specific motions, as well as strength differences in your muscles, lack of exercise and obesity, age-related weaknesses and/or degeneration, and genetics.

Your doctor will perform a medical history and physical examination, and may use some diagnostic tests (including X-Rays, MRIs, bone scans, CT scans, and diagnostic ultrasound) to determine your situation.

Prevention

Avoid doing too much too soon - decrease, modify and/or avoid any activities that cause pain and irritation.

Stabilize your groin, pelvis and hip area, build your core strength with light weights, exercise bands and balls, core balance training, and exercises to develop strength, speed and agility, such as jumping or bounding. Yoga, tai chi, or a daily stretching routine will also help keep your muscles and joints supple, and will increase your range of motion. Combine these with regular low-impact exercise and healthy diet.

Always warm up and cool down your muscles, learn the proper form and techniques to prevent injuries, and utilize any available mobility supports (braces, taping, orthotics, canes) to help alleviate undue stress and improve your function.

Treatment

When treating adductor tendinitis rest the area, apply cold compression for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day up to 3 days. Blood Flow Stimulation Therapy may be used after the acute swelling is improved. Cold Compression Therapy will reduce initial inflammation and swelling and Blood Flow Stimulation Therapy increases blood flow through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area, helping the tendon heal more quickly.

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibers as possible - something both Blood Flow Stimulation Therapy and therapeutic ultrasound are great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of reinjury down the road is much lower than average.

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