Adductor Muscles
The adductors are a group of muscles that sit on the inside of the thigh. This group of muscles are commonly referred to as the groin and their primary action is to adduct the hip/leg, meaning they bring the leg inwards and across the body. They are heavily involved in sports that require cross body kicking such as soccer, or activities involving controlled change of direction such as hockey.
The adductors are made up of multiple muscles, with the most prominent being the Adductor Brevis, Adductor Magnus, Adductor Longus and Gracillis. All of the adductors begin in the centre of the pubic bone, and attach at various points along the inside of the thigh. The only adductor that attaches below the knee is Gracillis.
Signs of a Groin Strain
- Acute onset of pain, i.e. a specific moment when pain began such as sprinting or kicking.
- Pain on the inside of the thigh.
- Increase in pain when running, sprinting, changing direction and kicking.
- Pain when squeezing legs together.
Injury Gradings
The severity of muscular injuries varies widely. How severe your injury is will determine how long it will take for you to return to normal activities.
| Description | Signs | Healing Timeframe | |
|---|---|---|---|
| Grade 1 (Minor) | Less than 10% of muscle fibres torn. | Minimal loss of strength or range. Minimal pain on palpation or activation. Able to continue playing. | 0-2 weeks. |
| Grade 2 (Moderate) | 10-50% of muscle fibres torn. | Mild loss of range. Moderate loss of strength. Moderate pain on palpation or activation. Unable to continue playing, but able to walk. | 2-6 weeks. |
| Grade 3 (Severe) | 50-100% of muscle fibres torn. | Significant loss of range and strength. Severe pain on palpation or activation. Unable to continue playing and unable to weight bear. | 6-12 weeks. |
Differential Diagnosis
There are a wide range of injuries and conditions that can present in similar areas to a groin strain, some examples of these include:
- Adductor Tendinopathy – Similar area, but gradual / non-acute onset. Read more here.
- Osteitis Pubis – Complex condition involving the pubic symphis. Read more here.
- Athletes Hernia – Pain location up high in the anterior hip.
- Quadriceps Muscle Strain – Similar onset, but pain in the front of the thigh.
- Hip Flexor Muscle Strain – Similar onset, but pain in the front of the hip.
Treatment
Treatment can vary depending on strain severity. Early phases involve protection of the muscle, through rest, compression and elevation. In more severe cases, crutches can be used to decrease weight bearing on the affected muscle.
Strengthening
Strengthening of the affected muscle should begin quite early on, and progress as pain allows.
Initially this may involve isometric exercises, meaning muscles are activated but not shortened or lengthened. Isometrics are reasonably low load for muscle, however can assist in the healing process as well as pain relief.
Strengthening programs should gradually progress to include a combination of isometric, heavy concentric and eccentric exercises. Strengthening protocols aim to address any limb asymmetry prior to return to play. There are a number of objective outcomes measures which may be used to determine your readiness to return to play.
Stretching
Stretching can be beneficial to improve muscle length, and prevent risk of future tears. However stretching should be avoided in the early stages, particularly for more severe tears. Stretching can further separate torn muscle fibres and slow down healing early on.
Therefore, care must be taken when stretching. When stretching begins depends on the severity of your injury.
Manual Therapy
There are a variety of manual therapy options that can improve healing of an adductor strain. In the first 48-72 hours, majority of these should be avoided as healing is still in the inflammatory stage.
After this period, soft tissue release can assist with blood flow and healing. Dry needling can be used to release tight muscles surrounding the injured site, however care should be taken when needling the tear site, and will be avoided in the early stages.
Control and Stability
Groin strains can be caused by a weakness in surrounding muscles, or a strength imbalance. It is important to incorporate strengthening exercises for surround muscles, as well as general lower limb strengthening to improve overall control and stability. This is crucial for preventing re-injury.
Return to Activity and Sport
Returning to normal activities should be done gradually and with care. The exact approach to this will depend on the specific sport or activity. It is important to come up with a clear plan with your Physiotherapist to reduce re-injury chance.
Rehab may progress from strengthening exercises as above, followed by a gradual running program and sport-specific exercises.