An adductor strain is an injury to the adductor group of the thigh muscles. The adductor group is located on the inner side of the thigh and consists of various muscles. Through their origin and insertion they serve to bring the leg closer to the body.
An adductor strain usually occurs due to a sudden jerky movement in the opposite direction of the muscles. A common reason for adductor strain of the thigh is a slippage in football. This causes a very strong abduction (leading the leg away from the body), which can lead to injury of the opposing muscles (adductors).
The adductor group of the thigh is divided into three groups: the superficial, the deep and the middle adductor group. All muscles are innervated by the obturatorial nerve and are mainly used to bring the leg up to the trunk. The muscles originate mainly from bony structures of the pubic bone (Os pubis) or the ischium (Os ischium).
They are mainly located on the back surface of the thigh bone (Linea aspera). Only the gracilis muscle is longer and is located below the head of the tibia. Thus it also exercises its function on the knee joint, which it bends and rotates internally.
Pain often occurs in the area of the tendon attachment of the muscles and in the pubic bone region. If the strain is only slightly pronounced, the pain is often only felt under stress. Adduction (bringing the leg closer) against resistance is particularly painful and thus serves as a diagnostic indication.
Movements in the opposite direction, i.e. the spreading movement of the thigh (abduction), are also often associated with pain after adductor strain. Swelling or bruising may occur in the area of the affected muscle group. In males, it is quite possible that pain may occur as far as the testicles in the context of adductor strain.
The reason for this is the close proximity of the muscle origins of the adductors to the inguinal canal. The adductor strain can lead to swelling in the area of the injured muscles, which could compress other surrounding tissue. A nerve, the so-called “nervus genitofemoralis”, which runs through the inguinal canal to the testicles, can therefore possibly be irritated by the swelling.
Thus, affected persons feel pain along the course of the nerve and in its innervation area. However, this does not occur so frequently. It is important that men with pain in the testicles should in any case consult a doctor for clarification, if the diagnosis of a pulled adductor has not been made before.
This is important because there are many different causes for pain in the testicles. First and foremost are the medical history and physical examination. Even a description of the cause of the accident can lead to the suspicion of a pulled adductor.
Afterwards the groin and thigh muscles are examined for pressure pain and swelling. A bruise also provides evidence of injury to muscular structures. In addition, the thigh can be both adducted and abducted against resistance.
This often leads to pain being triggered in the area of the inner thigh or the pubic bone region. In case of ambiguity, an ultrasound examination (sonography) can distinguish a pulled muscle from a torn muscle fibre. Bleeding into the musculature also indicates an injury and can be easily detected with ultrasound.
In acute cases, adequate initial treatment should be given as soon as possible. This consists of the so-called PECH-rule: The aim of this treatment is a rapid decongestanting of the affected musculature and the stopping of possible bleeding. Subsequently, there are numerous different therapeutic approaches.
The first thing they all have in common is a significant reduction in stress and a break from sport. This is intended to prevent further damage to the injured muscles and to prevent a chronic progression. The healing process can be promoted by anti-inflammatory ointments, ultrasound or electrotherapy.
After the muscles have largely healed again, the following load should be increased slowly and carefully in order not to damage the muscles again. The first load should be carried out under physiotherapeutic guidance. In this way the load is controlled and a new injury is avoided.
It is particularly important that any adductor strain or pain in the groin is well cured. If the complaints become chronic, it can take up to 6 months before the original sporting activity can be resumed. Once the adductor strain is completely healed, the sport can be performed again without any restrictions.
A pulled muscle can also develop into a torn muscle fibre of the adductors if not treated gently, which is also accompanied by severe pain, swelling and muscle bleeding. – Pause (=P), i.e. immediate end of the load. – Cooling of the affected area with ice (=E) or cooling spray,
- Compression (=C) of the injured region by a pressure bandage and
- Elevation (=H) of the affected extremity to avoid swelling.
The decision whether an adductor strain should be treated with heat or cold is made depending on the stage of the injury. If it is an acute adductor strain, cold therapy is indicated. The first measures should be taken according to the PECH rule, i.e. pausing, ice, compression and elevation.
For acute cold therapy, utensils or measures such as ice spray, ice packs or cold compresses are suitable. The cold leads to vascular contraction, i.e. a contraction of the vessels, which results in less blood supply to the area of the adductors. In addition, less inflammatory infiltrate can escape into the tissue, so that swelling is kept within limits in the acute stage.
The cold should be applied for the first 24 hours. After that, heat therapy is recommended. The reason for this is that the heat promotes blood circulation.
As a result, the adductors are better supplied with nutrients and at the same time inflammation and breakdown products are removed more quickly. This promotes an accelerated healing process. In addition, the heat has a relaxing and pain-relieving effect, which is perceived as very pleasant by those affected.
Heat therapy is also an integral part of physiotherapy. The heat can be applied in different ways, for example with heat cushions or heat lamps. In the case of adductor strain, physiotherapy is the treatment of choice in addition to the acute measure according to the PECH rule.
Physiotherapy is intended to promote regeneration after adductor strain. It is important that a reduction of the load is carried out first, so that the adductors can slowly return to a normal load. The aim of physiotherapy is to ultimately ensure that the adductors are able to resume their former performance.
To achieve this, physiotherapy uses various measures and approaches. On the one hand, heat therapy is a component of physiotherapy. Heat therapy has a relaxing, pain-relieving effect and is beneficial with regard to the duration of recovery.
There are several variants of how the heat can be applied. Heat cushions can simply be placed on the adductors or a heat lamp can be directed at the corresponding muscles. Ultrasound, infrared or high-frequency therapy are also conceivable.
Depending on the degree of adductor distortion, less locally applied heat can also be helpful in a steam sauna. In addition to heat therapy, some physiotherapists recommend the so-called “muscle release technique”, an exercise in which the adductors are alternately first tensed and then relaxed again. In addition, aqua jogging or cycling on a home trainer is suitable for slowly bringing the adductors back to full strength.
In general, it is important that physiotherapy exercises should only be used if they do not cause pain. Otherwise a positive effect of physiotherapeutic measures will not be achieved and a delayed healing process can be expected. Taping as a therapeutic measure of adductor strain pursues the goal of pain reduction and fulfils a stabilising and supporting function.
Taping is a kind of functional bandage, which is elastic and self-adhesive on one side. The most important property is its elasticity: the tape can thus cause the tendons to relax by reducing the tension and traction on the adductors. This acts as a support in the healing process.
In addition to the stabilising effect, the tape stimulates the metabolism of the pulled adductors. How exactly the tape should be applied in case of adductor strain is explained in more detail below: First of all, it is important that the skin in the area of the groin and the adductors is not creamed or hairy before the tape is applied. To ensure that the tape adheres well to the skin, the tape should also be rubbed on properly.
The pressure and the resulting heat improve the adhesive function. A total of three tape strips of different lengths are required for adductor strain. In abduction position, the leg on the corresponding side should be slightly spread, the first and longest tape is now applied.
For this purpose, the tape strip is stuck from the knee along the inside of the thigh to the groin in the direction of the pubic bone under slight tension. The second tape strip is also fixed in almost parallel alignment under slight tension. Since it is shorter than the first one, it starts at a common point in the groin region, but ends at the level of the middle of the first tape several centimetres apart in the direction of the front of the thigh.
The even shorter third tape is applied according to the same principle. Thus, the course of the three tape strips should imitate that of the torn adductors. The tape is optimally applied for at least one week. In general, patients are able to tape themselves as long as they have the appropriate “know-how”. Otherwise, it is better to leave the taping of a pulled adductor to a specialist so that it really serves its purpose and has a positive influence on the healing process.
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