ADDUCTOR MUSCLE STRAIN

Adductor muscle strain involves inflammation and pain along the inner thigh muscles and groin. The muscles involved are called the adductor longus, adductor medius, adductor magnus, and the gracilis. These muscles enable the hip and leg to move across the body. Muscle attaches to bone via tendon. This injury usually occurs at the junction between the muscle and tendon or the tendon and pelvic bone. This strain may involve a partial or complete tear of any adductor muscles, but the adductor longus is the most commonly injured.

There are three grades of muscle strains. A grade 1 strain is a mild muscle injury with microscopic tearing of the muscle fibers. There is no loss of strength, or change in muscle length. A grade 2 strain is a moderate muscle injury with tearing of fibers in the tendon, the bone-tendon junction, or the muscle-tendon junction. The length of the tendon or whole muscle-tendon-bone unit is increased, and there is usually decreased strength. A grade 3 strain is a complete rupture of the tendon and is uncommon. Adductor strains are usually grade 1 or 2.

Adductor strains are more likely to occur if there is a sudden increase in the amount or intensity of activity but a single episode of over activity with explosive movements can cause an adductor strain. Adductor strains are more likely to occur during sports that require repeated kicking, such as soccer, martial arts, and football (kickers), as well as sports that require the legs to be brought together, such as dancing, gymnastics and horseback riding. Healing time will be prolonged if the condition is not appropriately treated or not given enough healing time. Recurrence of symptoms and re-injury are possible if activity is resumed too soon. Untreated, the strain may progress to a complete tear (rare) or chronic pain. This strain is usually curable within 2 to 6 weeks if treated appropriately.

Symptoms

Occasionally occurs with a sudden pop in the groin or inner thigh at the time of injury. Pain is initially sharp but later becomes a diffuse aching with tenderness, swelling, and redness over the inner thigh and groin. The pain is often worsened by hip movement and many patients will have hip weakness.

Bruising in the groin and inner can occur up to 48 hours post injury.

Muscle spasm in the groin and inner thigh are common complications.

Treatment

Initial treatment consists of rest, elevation, medication and ice to relieve the pain and inflammation. Cold is used to relieve pain and reduce inflammation for acute and chronic cases. Cold should be applied for 20 minutes 4 times daily. Occasionally a referral to a physical therapist or athletic trainer is indicated for further evaluation and treatment management. Crutches may be recommended for the first 24 to 72 hours if the strain is severe. Surgery may be recommended if chronic, persistent pain exists for more than 3 months despite appropriate conservative treatment, but this is uncommon because suturing torn muscle is usually not helpful.

The initial phase of rest, ice, and elevation usually lasts 72 hours and is followed by a graduated program of stretching and strengthening. It is especially important to concentrate on increasing the endurance of the injured area muscles and supporting muscles to help prevent future injury. One often neglected part of rehabilitation involves re-training proprioception in the injured area. This has also been shown to help reduce the incidence of re-injury.

Topical ointments or liniments may be beneficial. Injections of corticosteroids may be given to reduce inflammation and pain.