Adductor Strain

Topic updated on 08/14/15 3:30pm
  • A common injury to the adductor muscle group
  • Epidemiology
    • incidence
      • occurs in 10-30% of soccer and hockey players due to strong eccentric contraction of adductors during play
  • Pathophysiology
    • mechanism
      • a “pulled groin,” is caused by forceful external rotation of an abducted leg.
  • 1st degree
    • pain with minimal loss of strength and motion
  • 2nd degree
    • compromised strength
  • 3rd degree
    • complete disruption with loss of muscle function
  • Hip joint adductor complex
    • adductor longus  (most common muscle injured in complex)
    • adductor magnus
    • adductor brevis
    • gracilis
    • obturator externus
    • pectineus
  • All have obturator nerve innervation
  • Symptoms
    • pain is immediate and severe in the groin region.
  • Physical exam
    • tenderness is at the site of injury along the subcutaneous border of the pubic ramus. 
    • pain and/or decreased strength with resisted leg adduction compared to the other leg
  • Radiographs
    • recommended views
      • AP pelvis
      • lateral of hip
    • findings
      • if injury is due to an avulsion then fleck of bone may be visible
  • MRI
    • may show avulsion injury of the adductor muscle from the pubic ramus with muscle edema and hemorrhage.
  • Nonoperative
    • rest, ice, protected weight bearing as needed 
      • indications
        • mainstay of treatment
      • modalities
        • dictated by the severity of the symptoms but generally consists of of a period of rest 
          • follow with a rehabilitation program that begins with gentle stretching and progresses to resistance exercise and core strengthening with a gradual return to sports 
          • immobilization should be avoided because this promotes muscle tightness and scarring
  • Operative
    • open repair
      • indications
        • no data exist to suggest that open repair yields a better outcome than nonsurgical management. 


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Qbank (1 Questions)

(SBQ07.28) A professional rugby player has acute groin pain after an awkward collision with an opponent. MRI shows an avulsion injury of his adductor muscle. Which of the following is an appropriate treatment to provide? Topic Review Topic

1. Strict immobilization with the leg in flexion and adduction
2. Immediate rehabilitation consisting of increasing passive and active motion
3. Tendon repair
4. Tendon tenodesis
5. Tendon repair with adjunctive allograft reconstruction


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