Adductor Muscles, Adductor Related Groin Pain, and Inguinal Related Groin Pain

To Understand Adductor Related Groin Pain Learn About the Adductor Muscles
The adductor muscles of the groin sit on the inner side of the thigh, between the pelvis and the knee. This group of muscles includes:
- the adductor magnus (large adductor),
- the adductor longus (long adductor)
- the adductor brevis (short adductor), that sits underneath the adductor longus muscle
- the gracilis (a long strappy muscle)
- pectineus (a smaller muscle)
These muscles can be involved in other roles but primarily work to pull the legs inwards, towards each other (adduction). They also help control the energy of the moving leg or the moving body during kicking actions and changing direction when running. As the body moves away from the planted foot when ‘cutting’ or dodging, the inner thigh muscles have to control the momentum of the moving body.

The adductor longus and often the brevis too, have extensive connections through the groin, into:
- the abdominal muscles at the front of the trunk
- the inner thigh (adductor) muscles of the opposite side.
- the joint at the front of the pelvis (pubic symphysis) and the blend of fibrous tissue that runs across this joint (the pubic aponeurosis)

The abdominal muscles extend from the ribcage down to the pelvis, supporting the spine and allow the trunk to curl up forwards or to the side. They also help control the position of the pelvis. The rectus abdominis (the ‘6 pack’ muscle) joins onto the pubic bone and connects into the adductor muscles and the pubic aponeurosis. There are also another 3 layers of abdominal muscles (external oblique superficially, internal oblique beneath and transversus abdominis deepest) that wrap around your body like a corset. At the front, they join into a big ligament that runs across the groin – the inguinal ligament.
Adductor Related Groin Pain
Tears or strains may occur within the adductor muscles; where the muscles & tendons join (musculotendinous junctions); or within the tendons. Traumatic injury resulting in a rapid onset of pain, is usually associated with sporting actions such as:
- changing direction at speed
- sliding sideways
- kicking
A single cause for more longstanding groin pain can however be much more difficult to establish. One of the main reasons for this is the large amount of interconnection between the soft tissues around the pubic region. Magnetic Resonance Imaging (MRI) scans of someone who has had groin pain for more than 3 months will often reveal a variety or combination of findings, and you may receive a diagnosis of:
- adductor tendinopathy, tendinitis or tear – tendon pain, inflammation or a tear of one or more of the inner thigh muscles
- pubic aponeurosis tear – a tear in the blended fibrous tissue at the front of the pubic bone
- rectus abdominis tendinopathy/enthesopathy, tendinitis or tear – tendon pain, inflammation or a tear of the rectus abdominis (six pack) muscle




Inguinal Related Groin Pain

In the region where the abdominal muscles join onto the pelvis and the inguinal ligament, tears or weakening of some of the connections can occur, leading to pain and/or a hernia. A hernia is where the pressure of the bowel against the weakened area can cause the appearance of a bump, as the bowel pushes into the area. More severe hernias are easily visible, but most of the time inguinal hernias are small and only picked up on ultrasound scans.

Visit our Pain Locator Map to learn more about soft tissue related pain in different regions around the hip and pelvis, or other causes of groin pain.
Need Help? How Can A Hip Pain Professional Help?
Your Hip Pain Professional can:
- provide a thorough assessment of all the soft tissues in the groin region
- refer you for appropriate scans, if necessary
- provide or refer you for rehabilitation of this area,
- provide advice and/conditioning for successful return to sport
- refer you to a surgeon or provide surgery (if your HPP is a surgeon) – this is rarely required but may be necessary with more severe hernias or abdominal tendon tears.
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Authors
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.

Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.
References
- Grimaldi, A. (2017). Understanding tendinopathies of the hip & pelvis. Iliopsoas and adductor related groin pain (Vol. 4).
- King et. al. (2015). Athletic groin pain: a systematic review and meta-analysis of surgical versus physical therapy rehabilitation outcomes. British Journal of Sports Medicine, 49, 1447-1451.
- Weir et. al. (2015). Doha agreement meeting on terminology and definitions in groin pain in athletes. British Journal of Sports Medicine, 49(12).
- Whittaker, J. et. al. (2015). Risk factors for groin injury in sport: an updated systematic review. British Journal of Sports Medicine .

Check Out More You Can Read on this Area at HipPainHelp:
-
Pubic Symphysis Pain, Pubic Related Groin Pain and Pelvic Girdle Pain learn what these terms mean and about the structures involved and how can a health professional can help.
-
Sacroiliac Joint Pain, Pelvic Instability and Pelvic Girdle Pain learn what these terms mean and about the structures involved and learn how can a health professional help
- Groin Pain Groin pain is pain this experienced in the groin region and the inside of the upper thigh. There are many potential causes for groin pain. Understand more about the anatomy of the area and things that may go wrong
- Hip Pain Explained Explore more about possible causes of pain throughout the hip and pelvis region.
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