While there are many different names used to describe groin pain, many of these diagnoses describe the same condition. A sport’s hernia, athletic pubalgia, and adductor tendinopathy all actually refer to the same injury. To help clear up any confusion caused by the different names, the current terminology used to describe these injuries is adductor related groin pain. This post will discuss what causes adductor related groin pain, how it is diagnosed, and also how it can be treated.
Adductor related groin pain is an overload syndrome of the adductor muscles on the inside portion of the leg. The consistent overload on the adductor muscle leads to irritation and pain near the attachment of the adductor muscles to the pelvic bone. This is commonly seen in people who perform a lot of lateral movements or quick cutting movements, such as in football, soccer, or hockey.
To diagnose adductor related groin pain, the following criteria needs to be met:
- Tenderness along the adductor muscles,
- And pain with the adductor squeeze test.
It is important to rule out other pathologies that may present similarity to adductor related groin pain. Hip pathologies, nerve entrapments, and referred pain from the lumbar spine or SI joint are some of the issues that can be similar in presentation to adductor related groin pain.
Conservative treatment of adductor related groin pain includes soft tissue therapy to the adductor muscles along with strengthening of the abdominal and adductor muscles.
The rehab for the adductor muscles generally begins with isometric exercises and gradually progresses to more challenging exercises. Isometric exercises are exercises that cause the muscles to contract but there is no movement at the joint. For the adductors, a chair can be used to perform isometric exercises. Begin with a knee on the chair and lift the hips off of the ground for 30 to 45 seconds. Once this position can be held for 3-5 repetitions, repeat the exercise but with a foot on the chair.
After isometric exercises, the rehab program can progress to concentric and eccentric exercises. These exercises strengthen the adductor muscles while the muscles shorten and length, respectively. A furniture slider or towel on hardwood can be used with a lateral lunge to begin strengthening the adductor muscles. Pressing the foot into the ground will increase the challenge of this exercise.
Finally, the rehab program can progress to loading the adductor muscles with more resistance such as with an exercise band or weight. Start this exercise slowly and gradually increase the speed of the movement.
Along with strengthening the adductor muscles, strengthening the abdominal muscles will also be beneficial for recovery.
For cases that do not respond to conservative treatment, surgical treatment may be an option. An adductor tenotomy, where the adductor muscle is cut, can provide relief for adductor related groin pain.
In summary, adductor related groin pain is an overload condition that causes pain near the attachment site of the adductor muscles on the pelvic bone. Conservative treatment, including soft tissue therapy along with adductor and abdominal muscle strengthening, can be beneficial in treating this condition. In cases that do not respond to conservative treatment, there are surgical options which can provide relief.
Serner, Andreas, et al. “Study Quality on Groin Injury Management Remains Low: a Systematic Review on Treatment of Groin Pain in Athletes.” British Journal of Sports Medicine, vol. 49, no. 12, 2015, pp. 813–813., doi:10.1136/bjsports-2014-094256.
Weir, Adam, et al. “Doha Agreement Meeting on Terminology and Definitions in Groin Pain in Athletes.” British Journal of Sports Medicine, vol. 49, no. 12, 2015, pp. 768–774., doi:10.1136/bjsports-2015-094869.