ADDUCTOR MUSCLE STRAINS

                        Adductor muscle strains



                                                                       Adductor magnus

                                                                              Pectineus

                                                                         Adductor longus

                                                                           Adductor brevis-- 

                                           
                                                                     Gracilis

In sports Adductor muscle strains are a common injury  that involve sudden changes due to  direction.



 onset acute and pain is usually well localized,  the proxy mal musculotendinous junction or the tendon near its origin on the inferior pubic ramus. Examination findings are localized tenderness,
 passive abduction and pain on resisted adduction or combined flexion/adduction cause pain



Treatment during onset and delay 2 to 3 day injury reduction of bleeding and swelling using the RICE regimen .

 Due to concerns that early stretching may predispose to the development of chronic tendinopathy, stretching does not play a significant role in the management of adductor muscle strains.



Progressive strengthening exercises should not be commenced until at least 48 hours after injury.

 It is not until passive range of motion returns to normal, with full strength, that activities involving rapid change of direction can be recommenced.
The treatment regimen is summarized below.



1. 0-48 hours (a) RICE

 (b) active pain-free exercises



2. After first 48 hours 

(a) gradually increase strengthening

(i) active abduction/adduction

 (ii) adduction/flexion against resistance (e.g. rubber tube, pulleys, light weights)

 (iii) stabilizing exercises

(e.g. pulleys with other leg, one-leg squats)



(b) functional strengthening

 (i) bike

 (ii) pool running

 (iii) jogging

(iv) swimming



(c) sport-specific skills

(i) running-straight line

 (ii) running-figure of eight

 (iii) rapid changes of direction

(iv) kicking-gradually increase





Recurrent adductor muscle strain 

Recurrent adductor muscle strains are common. This may be due to inadequate rehabilitation of the initial injury, resuming sport too quickly or not resolving associated problems such as lumbar spine stiffness or pelvic imbalance . 
 If untreated, these injuries can lead to chronic exercise-related groin pain.



In order to find the cause of adductor abnormalities in running athletes,
it may be necessary to analyze running technique.

The adductors play a major role in dampening the contraction of the gluteus medius after the propulsion phase of running.
They also work synergistically with the hip abductors to maintain the stability of the pelvis during the stance phase.



Thus, pelvic stability is required to prevent excessive eccentric load on the adductors.






Acute presentation of adductor tendinopathy 



 as primary condition adductor tendinopathy  or, alternatively, primary condition may accur covert into secondary  an adductor muscle strain.

 It is believed in some centers that the treatment of an acute adductor muscle strain should include ice and rest, but that stretching the muscle should not begin until at least four days after the injury.
It may be that premature stretching of these muscles can lead to a tendinopathy.



Adductor tendinopathy causes proximal Groin pain, which has a tendency to develop with increasing activity.
  untreated condition due to  pain tends to persist during activity and may migrate either to the contralateral groin or to the suprapubic region.

Examination  local tenderness over the adductor origin and over the pubic tubercle , with pain on passive hip abduction and resisted hip adduction.


 Rest aggravating activity,
Treatment of an acute presentation includes a few days relative rest followed by a gradual progression of adductor strengthening