What is Adductor Related Groin Pain and What is the Cause (Adductor Tendinopathy, Adductor Tear)
Adductor related groin pain is pain in the groin region (upper-inner thigh) related to the adductor muscles and their connections, including adductor tears or adductor strains which may occur within the adductor muscles themselves, where the muscles and tendons join (musculotendinous junctions), or within the tendons (attaches the muscle to the bone) known as adductor tendinopathy.
What do the terms Adductor Related Groin Pain, Adductor Tendinopathy and Adductor Tear Mean?
As there is so much interconnection between the fibrous structures around the pubic region, there may be one or a number of structures or injuries in the adductor region that can be related to pain. This means that sometimes people are given a different diagnosis than someone they know, even though the pain is in the same area. Sometimes people are even given different diagnoses by different health professionals.
These diagnostic terms might include:
- Adductor tendinopathy, adductor tendinitis or adductor 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
This might seem confusing, which is why a group of leading experts in groin injury from around the world came together to agree on a single diagnosis. It was agreed that the diagnosis, Adductor Related Groin Pain, would be most useful (3). This term encompasses all these other terms that are all part of the same picture and are largely treated in the same way.
What are the usual symptoms?
People with adductor related groin pain usually experience pain high in the groin area, within the upper 1/3 of the adductor muscle region. If the pain is long standing however, the painful area may become less localised to the initial area of injury or pain. It can extend across the pubic region and into the lower abdomen. Sometimes it can also spread to the adductor region in the opposite leg.
Following an acute adductor injury pain may be experienced when:
- Standing on one leg
- Turning or changing direction while standing on the injured leg
- Lifting the leg to dress or move in and out of the car
- Coughing or sneezing
If the pain in milder or has been around quite a while, there is usually little or no pain at rest or during normal low-level daily activities. Pain will usually occur during more strenuous or dynamic tasks such as:
- Running, especially when accelerating or decelerating
- Deep split lunges or side lunges
Athletes with adductor related groin pain are often able to continue or return to their sport after the acute injury settles, but they may struggle to reach full speed and sporting performance due to pain or reduced power.
What causes Adductor Related Groin Pain
Typically, adductor related groin pain occurs in a more active and sporting populations. It often occurs or becomes more recurrent or persistent in the slightly older athlete, aged more than 25 years. Pain in the adductor region may also occur in association with hip joint conditions such as femoroacetabular impingement syndrome or osteoarthritis.
Adductor related groin pain may develop rapidly or slowly over time, without a clear injury.
Acute, traumatic injury resulting in a rapid onset of pain, is usually associated with sporting actions such as:
- Changing direction at speed
- Sliding sideways
The strongest risk factors for developing groin injury in sport (4) are:
- a previous groin injury – those who have one groin injury are at significantly higher risk of having another injury or ongoing problems
- weakness of the adductor (inner thigh) muscles
- playing in higher grades of field sports such as the football codes, and
- lower levels of sport specific training such as the FIFA 11 warm up before soccer/football
In some cases, other factors related to the way people move and share forces across all the hip and pelvic muscles may contribute to the development and/or persistence of groin pain.
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?
In our next blog we will look at the many options available in the treatment of Adductor related groin pain, Adductor tears and Adductor tendinopathy. We will look at how a Hip Pain Professional can help.
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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.
- 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:
Adductor Muscles, Adductor Related Groin Pain, and Inguinal Related Groin Pain: Learn more about the specific muscles in this region including of the inner thigh and lower abdominals and their involvement with pain in the area.
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.
- 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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