II. Epidemiology
- Most common musculoskeletal cause of Groin Pain in sports
- High Incidence in soccer, hockey and track
III. Pathophysiology
IV. History
- See Hip Pain
V. Symptoms
VI. Exam
- See Hip Exam
VII. Signs
VIII. Differential Diagnosis
IX. Radiology for refractory cases
- MRI confirms Muscle and Tendon Injury
- Ultrasound identifies Muscle and tendon tears
X. Management: Approach
- Determine biomechanical forces predisposing to injury
- Foot and lower leg malalignment
- Leg Length Discrepancy
- Muscular imbalance
- Gait Abnormality
- Identify tear location
- Acute tear at musculotendinous junction
- Aggressive rehabilitation program
- Acute partial tear of tendon insertion at pubic bone
- Requires period of rest before physical therapy
- Acute tear at musculotendinous junction
- Determine Chronicity of Injury
- See management strategies below
XI. Management: Acute
- Rest from provocative activities for 10 to 14 days
- Longer rest needed for tear at tendon insertion
- Physical Therapy
- Initial goals
- Restore range of motion
- Prevent atrophy
- Next goals
- Regain strength (return to sport when 70% regained)
- Regain flexibility and endurance
- Initial goals
-
RICE-M
- Cold therapy initially
- Heat therapy may be used chronically after 72 hours
- Compression Shorts or hip spica wrap
- NSAIDs for first 7 to 10 days
- Avoid local Ultrasound
- Risk of bleeding
- Risk of mutagenesis due to proximity to genitalia
- Cross-training with other aerobic Exercise
XII. Management: Chronic
- Stretching Program
- Low intensity Isotonic Exercise
- Consider active training Exercise program
- Consider surgical tenotomy
XIII. Course: Period of rehabilitation to return to sport
- Acute strains: 4-8 weeks until return to sport
- Chronic strains: up to 6 months
XIV. References
- Schleihauf (2019) Crit Dec Emerg Med 33(5): 19-28
- Akermark (1992) Am J Sports Med 20:640-3 [PubMed]
- Holmich (1999) Lancet 353:439-43 [PubMed]
- Morelli (2001) Am Fam Physician 64(8):1405-14 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
Concepts | Disease or Syndrome (T047) |
SnomedCT | 202893001, 202863007 |
English | adductor tendinitis, adductor tendonitis, tendinitis adductor, Adductor tendonitis, Adductor tendinitis, Tendonitis adductor, Adductor tendinitis (disorder) |
Spanish | tendinitis de aductor (trastorno), tendinitis de aductor |
Ontology: Adductor strain (C0856496)
Concepts | Injury or Poisoning (T037) |
Dutch | adductorverrekking |
French | Foulure du muscle adducteur |
German | Adduktorenzerrung |
Italian | Strappo agli adduttori |
Portuguese | Distensão de adutor |
Spanish | Distensión de aductor |
Czech | Natažení, namožení adduktoru |
English | Adductor strain, adductor strains, adductor strain |
Japanese | 内転筋肉離れ, ナイテンキンニクバナレ |
Hungarian | Adductor húzódása |