Abductor distortion

Similar to the much more frequent adductor strain, the abductor strain is one of the typical sports injuries. Abductors include all muscles of the body that perform a movement away from the body (lat. abducere = to lead away).

For example, the small and middle gluteus medius/minimus muscles and the muscles on the outside of the leg cause abduction of the leg away from the body. Overloading or jerky unaccustomed movements can cause these muscles to become strained. However, an important criterion for a pulled muscle is the integrity of the individual muscle fibres (as opposed to a torn muscle fibre), which allows the pulled muscle to heal faster, but does not necessarily make it less painful.

Causes

Strains are often observed after sudden, very wide, excessive or even uncoordinated movements. The reason for muscle pain is tiny injuries to the muscle fibres, which cause blood to bleed from the smallest blood vessels (capillaries) into the surrounding tissue. Depending on the amount, this can then lead to a haematoma. It is not uncommon for an abductor strain to occur during sporting activities (sprinting, football, tennis). Favouring factors are insufficient or even missing warming up, a general overload of the musculature or also overstretching during rapidly changing movements.

Symptoms

A distortion of the abductor muscles is usually felt very acutely after the triggering event with pulling pain, which can be moderate to very severe depending on its severity. Only a short time later, the affected area becomes swollen, which is almost always accompanied by overheating of the tissue: if you place your hand on the affected area, it feels warm, firm and rather tense. With correct treatment and immobilization, the pain may subside or even disappear completely after some time. However, with movement and corresponding strain, they reappear without delay.

Diagnosis

The diagnosis of abductor distortion is usually made clinically by palpation of the muscular area and the patient’s description of specific pain (anamnesis), usually in combination with a clearly identifiable triggering event. Diagnostic imaging such as an MRI examination is rarely necessary. When making a diagnosis and performing an examination, it is important to exclude a number of other injuries that require completely different treatment (e.g. osteoarthritis in the hip joint that causes the pain; complete muscle rupture or tear; …). Ultrasound (sonography) is a suitable examination method for this. In most cases, however, treatment is initially carried out for a few days without further measures and the course of the pain and swelling is observed (conservative therapy).

Therapy

In case of abductor distortion (confirmed diagnosis or suspicion), immediate initial cooling is recommended. It should be ensured that the ice, cool pack or similar is not placed directly on the skin, as this can lead to hypothermia or even frostbite. In the further course of the treatment, the affected muscle should be spared as much as possible for a relatively long period of time or even completely immobilised.

Any heavy strain, especially over the movement that caused the strain, should be avoided. Similar to light muscle soreness, light, gentle movements can help against the swelling of the muscle and surrounding tissue and thus relieve pain. In order to support the swelling, it is also recommended to elevate or compress the affected muscle groups. A medical examination is particularly useful if another injury is suspected (exclusion procedure) or if existing severe pain is observed over a long period of time with constant intensity. In the case of slight strains, a medical examination is usually not necessary.